C. Diff. is a wicked disease. I would not wish it on my worst enemy. For me it took three courses of vancomycin and four months to get rid of it. The antibiotic I took for a foot infection was the culprit. I started to improve last April and slowly returned to health. I am now taking probiotics, a mere 50 billion instead of the 100 billion advised by one reader. If there is any sign of C. Diff returning I will switch to 100 billion. And I will avoid antibiotics. No cure is worth being that sick.
Antibiotic resistance bacteria have been causing problems, including a women who recently died in the United States from a bacteria that none of the antibiotics could help destroy. She did not pick up the bacteria in the United States but that doesn’t mean people shouldn’t be considered with the threat. Utilitarians would ask how the hospitals decisions on their course of actions, making sure the patients were used as an end in themselves for the research. Depending on coverage, some doctors and insurances will get breaks for not giving out antibiotics, thinking cutting back antibiotic prescriptions will help with this growing problem. It may have been two different hospitals looked at under a cross-sectional study with different approaches to treatment. People using too many antibiotics is a risk to everyone. Doctors should use the veil of ignorance when patients come into the hospital, being more consider with if it is a bacteria or virus that is ailing the patient when choosing treatment. The greatest good for all to fight these illnesses in alternative ways, like how we clean hospitals. Studies have found copper and ultraviolent lights to help kill more bacteria than chemicals that can leave from antibiotic resistance bacteria alive or even give them more resistance. Silver, honey, and maple syrup has been added to antibiotics to make them more effective in treating patients.
While limiting antibiotics is a good idea for lots of reasons, especially bacteria becoming more resistant to them, washing hands is still necessary.
I don't think this is new information. Every University hospital and some private hospitals I have worked in require that certain broad spectrum antibiotics be approved by someone in infection control or infectious disease before they can be prescribed. Having to make a phone call or written explanation of why the patient needs such a powerful antibiotic cuts down on knee-jerk or thoughtless (or uninformed) prescriptions and has a big effect on the hospital flora. It's a good reason antibiotics are not available over the counter in the US (though the widespread over the counter sales in the rest of the world limits the effectiveness of this intervention.)
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Fluoroquinolones don't require approval in any of the hospitals I've been training in -- maybe we should add them to the restricted formulary.
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I'd like to know what the vague imperative "restricting antibiotics" means in practice. One is uncomfortably reminded of the burgeoning movement toward restricting the use of prescription painkillers in order to combat our "drug epidemic". In the latter case, and perhaps now in the first, doctors are being intimidated by crude monitoring of their prescribing practices. Thus patients who need the drugs may receive inadequate treatment which fails to alleviate their suffering.
With the increasing emphasis on external and impersonal controls on prescribing, we may be moving into a confrontation between public health and patient welfare which subverts the goals of medical care.
With the increasing emphasis on external and impersonal controls on prescribing, we may be moving into a confrontation between public health and patient welfare which subverts the goals of medical care.
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Appropriate use of antibiotics and narcotics shouldn't endanger patient welfare. Narcotics and antibiotics are powerful drugs with real side effects (that we ignored for years). We SHOULD be using narcotics when appropriate -- for cancer or initial post-op pain -- but they're rarely the best choice for initial treatment of back pain, headaches, or neuropathy: non-narcotic drugs typically work better, with fewer adverse effects. Similarly, we generally shouldn't be using antibiotics unless we are treating a specific bacterial infection.
Unfortunately, patients know what they want, and it is time-consuming (and unpleasant) to explain the risks of antibiotics or narcotics. Emergency rooms have gotten good at saying no to patient who want narcotics, but many still hand out antibiotics like candy. Yesterday, I asked my attending physician what we were treating with the antibiotics he prescribed to an otherwise healthy teenager with a post-infectious cough; his response: "because it's been going on so long".
How to care for the patient who is addicted to opioids after using narcotics "exactly as prescribed" for many years is more difficult. I fear these patients are now getting inadequate pain treatment; there simply aren't enough pain specialists in my area to help safely manage their chronic pain. Failure to treat the pain adequately leads many patients to "doctor shop", leading to fragmented, substandard care.
Unfortunately, patients know what they want, and it is time-consuming (and unpleasant) to explain the risks of antibiotics or narcotics. Emergency rooms have gotten good at saying no to patient who want narcotics, but many still hand out antibiotics like candy. Yesterday, I asked my attending physician what we were treating with the antibiotics he prescribed to an otherwise healthy teenager with a post-infectious cough; his response: "because it's been going on so long".
How to care for the patient who is addicted to opioids after using narcotics "exactly as prescribed" for many years is more difficult. I fear these patients are now getting inadequate pain treatment; there simply aren't enough pain specialists in my area to help safely manage their chronic pain. Failure to treat the pain adequately leads many patients to "doctor shop", leading to fragmented, substandard care.
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Here in Thailand, one can buy antibiotics without a prescription and they are sold same as candy in a supermarket. Doctors will prescribe them for any and every ailment and people will take them for a few days until they fell a bit better and then stop.
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Hospital acquired C Diff killed my brother. He had been given antibiotics for what reason we don't know since he went in because of some falls.
My doctor said my illness was flu and they don't give antibiotics for flu. A week later I was on oxygen going to the hospital. Intravenous antibiotics pulled me through the severe illness. I had colon cancer surgery this month with some antibiotics O.K. no infection no C Diff.
My doctor said my illness was flu and they don't give antibiotics for flu. A week later I was on oxygen going to the hospital. Intravenous antibiotics pulled me through the severe illness. I had colon cancer surgery this month with some antibiotics O.K. no infection no C Diff.
Clearly, there's a lesson here for our Foreign Policy.
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Now let's get the word out about how dangerous fluoroquinolones are to some people and animals. Check the most recent FDA warning, which many doctors and vets are not up-to-date on. Then look up fluoroquinolone toxicity syndrome (FQS), or the FDA's term for the same syndrome, flouroquinolone-associated disability (FQAD).
Also, outside the United States, fluoroquinolones are entering the food supply via farm usage, especially on poultry farms.
FQs were designed to be extraordinary antibiotics, but they are often prescribed casually, before any infections have even been confirmed, or for everyday illnesses that don't need big-gun antibiotics, or for viral infections, which, by definition, never respond antibiotics.
FQs damage human and animal DNA. They can have serious adverse effects. In some cases, the effects are permanent, essentially crippling an individual from the time they're exposed till the end of their lives.
Also, outside the United States, fluoroquinolones are entering the food supply via farm usage, especially on poultry farms.
FQs were designed to be extraordinary antibiotics, but they are often prescribed casually, before any infections have even been confirmed, or for everyday illnesses that don't need big-gun antibiotics, or for viral infections, which, by definition, never respond antibiotics.
FQs damage human and animal DNA. They can have serious adverse effects. In some cases, the effects are permanent, essentially crippling an individual from the time they're exposed till the end of their lives.
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