Ban Assault Doctors

Unnecessary prescription of antibiotics kill 12 people every five hours.

More than two million people are infected by drug-resistant germs each year, and 23,000 die of their infections, federal health officials reported Monday. The biggest killer by far is C. difficile, the Centers for Disease Control and Prevention reports in its first big overview of a growing problem.

Doctors have been warning of the problem for decades, yet up to half the prescriptions written for antibiotics are unnecessary, the CDC report says. And all these unneeded antibiotics are making the superbug problem worse.

23,000 killed by superbugs in US each year, CDC says – NBC News.com

 

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30 Responses to Ban Assault Doctors

  1. Latitude says:

    the oddest part……they evolve to have resistance to current antibiotics
    stop using those antibiotics long enough….and they evolve back and lose that resistance

    • John B., M.D. says:

      Antibiotics “select for” resistant organisms. They do not cause bacteria to develop resistance. Bacteria mutate on their own. If one bacteria’s genome mutates to be able to resist antibiotic X, administration of antibiotic X to the patient will select for the resistant organism, which will then preferentially multiply in relation to the others.

      I do agree that antibiotics are overused. Of course, lack of tort reform and compensation models based on Press-Gainey scores (patients rate doctors on their service by mailed questionnaires, and patients who demand antibiotics rate you lower if you don’t give them what they want) contributes to the problem.

      Probiotics are an ongoing area of research, as are “stool transplants.” Humans evolved with a gut microbiome, and in fact most of our adaptive immune system is located there. Perturbation of the gut bacteria population increases the risk of C. difficile infection, so using antibiotics only when needed reduces this risk.

      Not a bad idea to eat yogurt when taking antibiotics, though at different times of the day than taking the medication , since calcium in dairy products can interact with the medication when taken at the same time.

      • tom0mason says:

        Another area that received little attention or research money is phagocyte. These handy little organisms will eat the bacteria, the drawback is they are highly specific, and no broad spectrum phagocyte have been found. The Russians are street ahead of us in research and use of phagocyte.

        http://en.wikipedia.org/wiki/Phagocyte

        • John B., M.D. says:

          Disagree.
          Plenty of research is done on cell-mediated immunity.

        • cdquarles says:

          Speaking of that, a ‘weakened bacterium’ from a near MIC antibiotic concentration will be easier for macrophages to kill. If you want to minimize resistance, Take all of your antibiotics when and as directed for the full length of time. That helps the cell mediated immunity do its job.

          One major problem is the time lag of cultures. Still, we need more vaccines and more ‘inhibitory’ anti-virals.

          I agree with Dr. John, There is and has been lots of research in this area. Much of it cancer related.

      • Latitude says:

        John, you got what I meant…

    • Don says:

      I don’t believe “evolve” is the proper term.

  2. Lou says:

    Dermatologists probably made it worse with their sun scare bullshit. Vitamin D at right dosage can act 24/7 antibiotic… and we get majority of vitamin D from the sun, not food. Pretty effective against flu, cold, sinus infection and so on.

    • John B., M.D. says:

      Your claim is not supported by actual data.

    • John B., M.D. says:

      But feel free to take supplemental vitamin D, AND stay out of the sun. Some patients are indeed deficient, especially institutionalized people who never go outside and/or are poorly nourished. Vitamin D is cheap, might help, and it is very difficult to overdose.

    • tom0mason says:

      Interesting TED videoabout sunshine.
      Our bodies get Vitamin D from the sun, but as dermatologist Richard Weller suggests, sunlight may confer another surprising benefit too. New research by his team shows that nitric oxide, a chemical transmitter stored in huge reserves in the skin, can be released by UV light, to great benefit for blood pressure and the cardiovascular system.

      • cdquarles says:

        Flip side is that oxides of nitrogen are potent cell communication and regulation mediators. Still, nitric oxide is a powerful oxidant and can trigger programmed cell death. That, in turn, can contribute to auto-immune diseases.

        • cdquarles says:

          Though I doubt nitric oxide is *stored* by the skin in large amounts. Triggered synthesis, locally, is more likely. Think cyclic GMP.

  3. GoneWithTheWind says:

    There is some intentional misinformation here. Most of the antibiotics are used on animals and not humans. A very large percentage, well above half, of the antibiotics are shipped to countries where you can buy antibiotics over the counter without a prescription. As in Mexico, if you feel a little under the weather walk into a pharmacy and buy a bottle of whatever antibiotics you think will help you, no doctor needed. Yet by the story one would believe this is 100% the fault of lazy American doctors and demanding American patients. Why in the face of the facts would they choose to misrepresent this problem?

    • John B., M.D. says:

      Agree. The number of gastroenteritis cases causes by resistant organisms (e.g. Salmonella, Shigella, Campylobacter) is on the rise, likely due to feeding animals antibiotics (notably, fluoroquinolones) to make them grow better (fighting infections stunts their growth, unsurprisingly).

      Any use of antibiotics selects for resistant organisms, whether that use is legitimate or not. Even if antibiotics are only prescribes when absolutely indicated, resistant organisms wil become more prevalent. And I point out that it is a judgment call to prescribe antibiotics – clinical guidelines help but often the info a physician has imperfect information. A physician will get sued if refuses to prescribe antibiotics for a “cold” and the patient later gets pneumonia, but won’t get sued if overprescribes an antibiotic.

      Clinical pearls of the day: antibiotics are not indicated for bronchitis, nor for most cases of sinusitis. Not all ear infections (otitis media) require antibiotics. Strep throat does.

  4. Bruce of Newcastle says:

    Perhaps the Greastest President The World Has Ever Known could divert some of that vast swathe of money for toy cars and other green boondoggles to something useful, like antibiotics research.

    • John B., M.D. says:

      Check out research funding by the National Institutes of Health (NIH). I’m all for funding energy research by the govt. I am against the wasteful subsidies, tax loopholes, ill-advised guaranteed loans, etc., for the green political cronies as well as Big Oil. The govt needs to stay out of venture capitalism and commercialization of inventions. Seed money for basic research only – let the private sector do the rest.

      • cdquarles says:

        I am for *some* funding by the government, limited to the areas with military uses and implications. Outside of that, the government isn’t needed and, in my opinion, wanted.

  5. NotAGolfer says:

    Ban government-subsidized prescription psychiatric drugs, too. Every mass murderer of the last 50 years has been on them. I’d bet money Aaron Alexis was, too. People who were not formerly violent become violent after taking them. At the very least, our government shouldn’t subsidize them and help Big Pharma push them.

    • John B., M.D. says:

      Name one government-subsidized psychiatric drug and the circumstances of it’s use.
      Define “psychiatric.” Are you talking about antidepressants, antipsychotics, or both?
      Aaron Alexis “talking to himself” hints at a psychotic diagnosis such as schizophrenia – how do you know the voices he was hearing were not telling him to murder, and failure to have medical care and take antipsychotic medications caused his mass murder?
      Are you talking about any drug in any phase of development has used any taxpayer money, or just drug prescriptions paid for through Medicare or Medicaid?

      Here’s my point: There is a time and a place for any medication for any diagnosis, and you (nor I) know the specific facts of this case at this time, nor does correlation of the attack with/without taking certain medications prove causation.

    • cdquarles says:

      Actually, my experience is that psychotics are more dangerous when not medicated, and some are more dangerous until the right medication and dosage are found, while being medicated.

      Plus, some of the older ones have very *bad* side effects in addition to a temporary worsening of symptoms.

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