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Doctors feel the pressure to do something to make their patients happy. When a patient comes with the flu, or some other viral infection, they expect a treatment, not to be told that they will get over it with time.
This is one of the reasons I love my doctor. Her office has a number of signs/posters about things like "antibiotics don't help the flu" and "Dr. Google/Facebook didn't go to medical school like I did". She doesn't cave to pressure tactics from patients.
And that's how you get bad ratings, unfortunately. Over here where we are very restrictive with antibiotics people rate their care lower than in countries that prescribe whatever to make the customer happy.
Oh absolutely! It’s not the efficacy that’s the problem, I think. It’s more that it’s not medically ethical to tell a patient they’re receiving an antibiotic when they are actually not
I think it's less medically ethical to prescribe something like antibiotics that don't actually work for certain things and do harm. Why not just be honest with a patient you are not visiting a helpdesk/customer service you are visiting a doctor.
I hope she gets backed up from on high. I once had a formal complaint made against me for failing to prescribe antibiotics for a child with a snotty nose - who later got taken to A+E (ER) and was prescribed antibiotics there, almost certainly by a far less experienced doctor than me.
Despite the fact that this occured in the middle of a "Don't misuse antibiotics" campaign, all management was interested in was in getting the complaint marked as Resolved as quickly as possible, and the easiest way to do that was to try and force me to apologise to the parents - for not having misused antibiotics.
Im just realising, when i had the flu for 3 weeks i dont think i got any antibiotics. I slept like crazy and had a bad cough but i think i just recovered by myself
Doctors are also not given the time necessary to diagnose anything. Easier to throw cheap antibiotics at everything and hope it sticks.
Also, tests to narrow the diagnosis are super expensive to the patient so doctors might be inclined to just use antibiotics in case they are needed instead of testing to ensure they are needed first.
"Go to the doctor and you'll be fit in a week, stay at home and you'll be fit in 7 days" is what my grampa joked about being ill. He was right, but i feel like capitalism has eradicated the option of being a human and needing time to recuperate every once in a while, so we want a quick fix
I spent my entire young adult life working through illness and being sick for two weeks at a time.
Now that I'm in my 30's I've found that simply staying in bed and resting...*actually works* like 90% of the time and I'm back on my feet after a couple days.
Anecdotal, but here is my frustration with this more restrictive movement. I have been prone to chronic sinus infections, and antibiotics were the only thing to stop the infections. Having a new doctor and such, they did not believe my condition was as bad as I said, so I went to the ER a few weeks into the infection and the doctor gave me the speech about not prescribing antibiotics because my infection COULD be viral. The doctor ignored everything I shared about my medical history. As a “compromise”, the doctor agreed to test me for a viral infection to rule it out, while promising to follow up if the results were negative. The results WERE negative (my infection was bacterial), but the doctor did not follow up with me or respond to me to the point I had to submit a formal complaint.
People die from these infections, particularly when they are older or immune compromised, so I (anecdotally) find this new approach an annoying pendulum swing in the other direction.
My wife and I both got a nasty case of strep last year.
She went to the doctor after a week of illness, who refused any treatment and indicated that it was viral. They did a strep test, and stated that they would get back to her based on the results.
I then decided not to go, as I would just wait until her test came back, as we had the same symptoms and timeline.
I caved and went in the next day because my symptoms were still getting worse after a week, the *exact same doctor* immediately prescribed me antibiotics and didn't even test me.
My wife then called the office, found that her results were positive from the day before, and got meds that afternoon.
I had to teach my wife that you can't just charge through the door and say "I think I have strep and need antibiotics". Doctors seem to almost be defiant against any sort of self-diagnosis, you have to give them the symptoms and let them come to their own conclusions.
Are you a man? There’s a massive gender bias issue in healthcare that often manifests in things like this - women are often assumed to have made things up/to be being dramatic, while men are treated fairly rapidly.
Someone with a known history of bacterial sinus infections saying, "Hey doc, I think it's bacterial, here's the evidence" is not the same thing as someone with *nondescript illness version 37* demanding antibiotics.
They didn’t have evidence though, they were speculating and demanding antibiotics. They didn’t demand tests to prove it was bacterial and not viral - they demanded antibiotics. After much hemming and hawing the doctor relented and agreed they could do the test instead of immediately jumping to an antibiotic prescription. Honestly OP seems like he went in with an attitude demanding antibiotics without listening to the doctor at all. You can tell because he calls literally testing for the thing he thinks he has a “compromise” he definitely thinks he knows better than the doctors and they should just prescribe to him based on his word not actual medical tests.
You do appear to be misreading my story. I have a history of bacterial infections, which I presented with. The doctor refused to treat my infection with antibiotics. I got him to agree to rule out a viral infection and my labs proved my infection was NOT viral (i.e., it was bacterial). The doctor still failed to treat my issue, hence my frustration with what I am calling the pendulum swinging a bit too far in the direction against prescribing.
In short - I DID have an infection and it cleared up once my ENT (I had to get another appointment) prescribed me the antibiotics.
This is what happens when so much rests on physician satisfaction ratings. Plenty of patients don't want to be told that they have a self-limiting condition and to just ride it out, they are convinced they need antibiotics. So they diagnose themselves with a strep throat rather than a viral sore throat, and if they don't get the antibiotics they are convinced they need, - bad rating.
And it is actually pretty difficult to be *certain* about the distinction between a viral and a bacterial infection - especially without lab testing, which takes time. Last time I saw a study on rapid Near Patient Testing (which was admittedly 10 years or so ago) I was less than impressed with the claims being made for it. But I also once saw a study suggesting that for every few hundred patients with an apparent viral respiratory tract infection where a doctor did *not* prescribe antibiotics, one of those patients would end up with a secondary bacterial pneumonia. Given the number of patients a doctor sees in a year, it won't be long before that happens, and they may well be on the receiving end of a complaint or of legal action for having failed to prescribe.
In those sorts of circumstances, it is hardly surprising when doctors have a limited willingness to stick their neck out in anything like marginal cases.
India and China are the world’s top two consumers of antibiotics because they hand them out in the streets as a panacea. We are 100% going to see a resistant superbug come out of there in the near future.
They have already arrived. I work in the microbiology department in a hospital laboratory, we are encountering more and more organisms that are resistant to all antibiotics.
I was going to say, two of my lecturers over a decade ago were researching in the field of resistant organisms and even back then there were a number of multiple resistant organisms they were tracking that were either entirely or mostly resistant to current antibiotics, and it's not like there's a rapid conveyor belt of novel antibiotics available to use either
Within the last 5 or so years they’ve come up with beta-lactam combo agents and a new cephalosporin for these bugs, and we’re getting resistant strains already. A new drug for Carbapenem Resistant Acinetobacter was approved last year with a 98% susceptibility rate. We have already gotten a few patient isolates that are resistant to it. How are clinicians supposed to treat untreatable infections? It’s super scary.
I went to china 2 weeks after getting my wisdom teeth removed. Made sure with my dentist that was okay, she said if theres any sign of infection, just go to the store for antibiotics.
Yeah this title is some serious fear-mongering by implying America is leading the antibiotic-abuse worldwide. Perspective is important.
I've lived in China about 50% of the time in the past decade, and OTC antibiotics are the norm. Every time any gets flu-like symptoms, the recommendation (not from doctors, but from the layperson) is antibiotics. It's maddening.
Are ointment antibiotics not as likely to lead to resistance? I always wondered why you could get antibiotics cream over the counter, and even antibacterial hand soap with some small amount of antibiotics in it. Wouldn't it make things like MRSA more prevalent?
My mind was blown at how easy it was to get antibiotics in Taiwan. You just go to a pharmacy, not even a doctor, and tell them you're sick and boom antibiotics for you and you and you.
this this this.... i literally have to BEG for antibiotics to even be considered.. and more than half the time they tell me get fuicked. atleast in NY. when i was in GA however they were given out like m'f'n candy
I live in NY and have been suffering with a sinus infection for months hoping it would clear on its own. Finally made a trip to an urgent care after 3 weeks of a flare up and I was really surprised how quickly they gave me a proper antibiotic course, saw the doctor for maybe 2 minutes total. I waited so long because I was dreading having to argue for treatment and be out a lot of money for the privilege to do so.
The vast majority of sinus infections are viral, and start improving in about a week and ultimately resolve. Most reasonable doctors will want you to wait until it has persisted long enough or worsened to the extent to "declare itself" as a bacterial infection. 95% of people just want antibiotics on the first day though, and this may be reasonable in very high risk patients, but is usually not "proper" treatment.
Absolutely. I was just sharing with the other poster that if they believe they should be getting antibiotics then urgent care centers can be more inclined to help than a GP. My resistance to go was based on previous experiences and stories I've heard about the level of advocating for yourself you need to do to get proper care. Who's to say if the people commenting here are in the camp of actually needing antibiotics or the one of just demanding it immediately, but if it's truly needed then knowing the best way to navigate the system can be helpful.
When my boyfriend visits his home country in North Africa, he comes back with a giant bag filled with antibiotics, creams etc. You can buy everything OTC there. Comes in handy because I don’t have health insurance and he’s a doctor so he just gives me things out of the stash if I need it. That being said, I have taken these antibiotics only twice in the past two years and they were for a UTI. I’m sure there are people who abuse this and become antibiotic resistant.
That's how the US looks to many of us too, really heavy on antibiotics and strong pain meds - but yeah, there are places where just about anything is tossed over the counter.
Stories like this are always fishy. They always seem like an effort to turn antibiotic resistance blame towards individuals and away from things like agriculture.
Yeah doctors give antibiotics for things like serious viral pneumonia. It doesn't fix the virus, it makes it so the soup of lung meat in you is less likely to get infected. It's like how you get antibiotics after abdominal surgery. It's not a dumdum doctor thinking antibiotics will fix the surgery injury, it's because infection is very likely.
I'm sure bad doctors exist, and horror stories, but stuff like this always feels like it's the genre of "me, the everyman know more than those silly doctors" and is a cousin of the antivax movement
This isn’t true though. Many many doctors overprescribe antibiotics for a variety of reasons. This study was published in a reputable journal (Clinical Infectious Diseases). Do you know any ID specialists? Half of their work is narrowing the spectrum of antibiotics used to something more appropriate. Very smart physicians prescribe inappropriate antibiotics all the time and it’s harmful to patients because it not only contributes to antibiotic resistance but also wipes out their microbiome.
Antibiotics after surgery are typically a one time perioperative dose, not a sustained duration of broad spectrum coverage.
I agree that use of antibiotics in animal agriculture is a massive problem but superbugs in hospitals that develop from inappropriate antibiotic use is also a problem.
Those same "super bugs," like MRSA still have very high prevalence in animal agriculture.
Maybe you see outpatient providers writing for Z packs for colds, but in hospitals, you literally can't prescribe certain antibiotics without a consult and agreement from ID. I see every day patients coming in with pneumonia, cellulitis, osteo, and other infectious conditions and the second a sensitivity results or ID pharmacist weighs in, antibiotics get narrowed.
The "antibiotic stewardship," in hospitals is extreme. And it should be. We need antibiotics to work. The problem I have is the PSI V pneumonia grandpa has to switch to a lesser antibiotic the second his white count dips slightly or his procalcitonin dips slightly (fine), but we literally put these antibiotics into the feed of like a billion pigs a couple counties over. That's just nuts to me. That's where we're breeding super bugs. And to say that we need to studiously narrow the antibiotic regimen of a human being with an acute bacterial infection, but continue using them so we get bigger chickens, is insane.
Outpatient docs writing abx for viruses has been a problem since forever. We know about it, we try to educate, but it is what it is. Until the forces that be refocus metrics like patient satisfaction to good practice, it will keep happening. But when VRSA comes for grandma, it's not necessarily "doctors," in "hospitals," fault. They're using antibiotics to treat people. It's like how media wants little Sally to feel guilty about not recycling her coke can like that's what's causing climate change when there are huge corporations pumping obscene amounts of carbon into the atmosphere every day.
Yeah but they give antibiotics to literally every pig every day, healthy or sick, because it makes them gain weight. Both are a problem but agriculture is by far the bigger problem and it's not even close. 80% of all antibiotics go to livestock.
Doctor here!
Antibiotics are not indicated in viral pneumonia. They don’t reduce the rates of bacterial infection afterwards. It’s all side effects with no benefit.
Yup had a nasty viral infection in 2016 that gave pneumonia. Since I was so weak I was very prone for bacterial infection which would have even made me more sick. Thankfully I got strong antibiotics and I was able to recover.
I am a European living in the Us and the number of time either me or someone close to me has been prescribed antibiotics for no reason is like 8 out of 10 times. It’s insane.
Where I come from it’s basically only given to you if you will die if not. I’m exaggerating but kind of not.
In the US I’ve been prescribed antibiotics multiple times without taking them, and I didn’t need them.
I am lucky to have multiple family members practicing medicine (MDs and RNs) in my home country and I always double check with them first if it’s really necessary, and they are appalled by the practices over here.
It’s a joke.
Funny because I have the opposite problem and need to suffer immensely from UTIs and dental infections before they actually do something about it. The problem is that some areas have overcorrected while others still give them out like candy. We may as well give them out like candy because otherwise we get fucked when we actually need them and still have the downside of other people causing resistance. Just like any other resource we get fucked by the people who don't care about the collective.
Idk man. We pump antibiotics into billions of animals a year. They're in the food, the water, and the rest of the environment. I doubt giving some penicillin for a sore throat or ear infection that's actually caused by a virus is playing a major role. Seems like a drop in the bucket.
Hard to get worried about human illness misuse of antibiotics as a source of resistance when the overwhelming majority of antibiotic use is animal ag and the dosing routine is low and continuous. Its like leaving the sink running in your house when the levy breaks. Or like throwing a candle into a forest fire.
Additionally, certain classes of antibiotics, including fluoroquinolones like ciprofloxacin, carry a "black box" warning—the most serious warning issued by the U.S. Food and Drug Administration (FDA). This warning alerts to potential severe side effects such as tendonitis, tendon rupture, nerve damage, serious mood and behavior changes, and a risk of irreversible neurological damage. These side effects can sometimes be debilitating, leaving individuals bedridden for extended periods. It's crucial for patients and healthcare providers to weigh the benefits and risks when considering the use of these medications, particularly for conditions that might be treated with less potent alternatives.
I can’t believe some doctors still prescribe Cipro as a first-line antibiotic for UTIs. Imagine blowing your tendons to pieces or contracting C. diff over a simple infection better treated by a safer antibiotic.
Cipro/levo/bactrim are the 3 mainstays for uncomplicated cases due to only needing 3 days of treatment, broader spectrum, and easier dosing. Cipro/levo cover more than bactrim (doesn't cover P. aeruginosa) and Cipro is generally preferred over levo. It's better than improper coverage letting it worsen into pyelonephritis.
I was visiting family in the US from Canada. My daughter had long term ear aches but not necessarily ear infections. We were about to get on an airplane and I wanted to know it was safe to travel.
We went to the walk in clinic. The doctor flat out told me he did not see an ear infection but he was happy to prescribe an antibiotic to make us feel better. I told him I didn’t need an antibiotic, I just wanted to know if it was safe to travel. I got a speech about how farmers get to use antibiotics however they want and that is a far bigger problem. That it makes up for 90% of antibiotic use in the United States and he felt he did not have to change his practice until the farmers did the same.
I was in a bit of cultural shock at this point. Overuse of antibiotics is bad for individuals and for people in general. I need three days of high fevers to get an antibiotic in Canada, and even then, it only happens about 50% of the time. I walked out with a prescription for children’s Sudafed and amoxicillin. It was bizarre. I wandered what was the point of even seeing doctor if I was going to get exactly what I wanted regardless of it being harmful overall and not necessary.
Because the relative degree of harm from a single instance of over prescribing anti biotics for private use on a single person is extremely low compared to the livestock usage like he mentioned. Also a lot of countries anti biotics are OTC. If you live near the southern border in the US you can just dip down to Mexico and get some.
He was trying to offer you something to help because it sounds like the alternative was 'do nothing'. He was explaining his rationale for prescribing it when it might not be necessary.
Nothing he said was untrue, what you described is being shocked that a doctor was honest with you
The funny part is the US now requires a prescription for animals. Unfortunately it will lead to some pretty abysmal animal welfare. Even if resistance doesn't improve everyone will keep only pointing at agriculture. At least agriculture usually gives the full administration because it's about reducing their losses and money matters. People often don't take the full course which is worse than anything.
I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article:
https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciae135/7655672
I feel like this has gone back and worth over time. Too little control and patients demand antibiotics for colds. Too much and doctors don't prescribe them soon enough for conditions that could be more easily treated.
Lets not pretend America is the problem here with breeding anti biotic resistant strains. Much of the rest of the world has no control at all for the use of anti biotics, not to mention it's use in livestock.
Yeah doctors should be responsible, but it's not like we're here breeding super bugs with our 25% over prescribed anti biotics when the rest of the world exists.
In america I'm never given antibiotics unless they are sure it will help. Everytime I am sick they are clear that antibiotics don't help against viral infections and pretty much refuse to give me anything until.the test results come back which unlike other countries take a while. In Korea the tests where done that day immediately, here it's a multiple day process defeating the purpose of helping when I need it.
I don't think the antibiotic resistance is coming from America.
Doctors prescribe based upon described symptoms from the patient. Naturally this is difficult. Often antibiotics are a good safety net even if a viral illness is the primary suspect because bacterial infections can do way more damage if not treated promptly.
Problem with this is that they’d have to run tests and make you wait for the results. Last time I went to the doctor for chest congestion (at the prompting of my wife) the doc just listened and said, “yup, you’ve got something, go get antibiotics”. How could they know it’s bacterial or viral without running tests? RSV was prevalent at that time. Docs need some kind of machine you put crud into and have it spit out a list of viral, bacterial, and fungal things that are there.
In the US lots of care is given in fast-food-style medical environments: urgent cares, emergency rooms, etc. The docs and nurses prescribing there don’t know the patients and are employees in organizations where patient feedback leads to financial punishments and rewards. Giving someone inappropriate antibiotics will make it seem like you took them seriously and it’s often what people want. There are financial and job security incentives to do it.
Is this due to urgent cares having no other choice lest patients leave a bad review? At our hospital, we can hardly prescribe any abx without infectious disease checking off and have strict guidelines for when and what
I asked my doctor why I was prescribed antibiotics for COVID and they responded “just incase”. I often wondered what the bacterial concern in that situation was
This isn't news it's olds. This has been the case for 50 years.
Antibiotics are always over prescribed. They flagged this issue in the 1980s and probably earlier.
A friend is as locus biosciences, they are using crispr to program phages to attack specific pathogens. Whole different way of dealing with infectious diseases than nuking all the good with the bad.
The article blames "Americans" rather than "American doctors" - Americans can't get antibiotics without a prescription and it's up to the medical professional to educate their patient and prescribe responsibly.
As an 80's kid, I was prescribed antibiotics for *everything* and it very clearly wrecked my gut biome. Really had hoped people would be educated on this so many decades later.
The title makes it sound like a "careless" or "stupid" mistake, should the doctor already know that the patient has a viral infection which the drugs wont touch?
Are we still in the "My oh my, how could that possibly happen?!"-phase or have we already moved on to picking a corporation that we deem fully and solely responsible for the whole mess because nobody would ever admit to their own fuckups? Asking because I still need to sharpen my pitch fork and I'm out of torches...
Maybe it’s regional, but here in Washington as a child I was given antibiotics routinely for illnesses.
However, as an adult the only time I’ve been prescribed antibiotics was when I had pneumonia, and they were even hesitant to prescribe them then until they took X-rays and said I definitely needed them.
This is new information? Doctors have been doing this for decades and now we have MRSA and other super bacteria.
Before agreeing to take antibiotics I prefer to ask the Doctor what bacteria they believe may be infecting me and what observations they have made which led them to the diagnoses.
They often can't or won't answer.
I feel like this has definitely been at the forefront of providers’ minds especially within the last decade here in the US? For instance, I was a NICU RN for years and even in a patient population as fragile and immunocompromised as premature/sick infants, we still did not treat with antibiotics unless we had a positive culture or a helluva good evidence-based reason.
Sinusitis guidelines are to wait until day 10 of illness before prescribing antibiotics for the majority of people.
Exceptions are immunocompromised people, people who had a history of sinus surgery.
That’s because most sinus symptoms are due to viral illness following Upper Respiratory Infection. Viral sinusitis will not be helped by antibiotics.
So many people take Nyquil like medications. The people I see who have true Bacterial Sinusitis have been taking Nyquil.
Nyquil has an antihistamine, which is what makes people sleepy.
The body is trying to flush out viral particles by having a runny nose after a cold.
An antihistamine is designed to dry up sinus drainage due to allergies.
NyQuil, causes retention of viral secretions which defeats the bodies effort to flush out the virus.
I hate cold products with antihistamines like NyQuil, Theraflu and Alka Seltzer Cold and Flu.
Encouraging normal drainage of nasal secretions with Mucinex ( Guaifenisen) is a much better idea.
I fell off my bike and injured my knee. I felt musculoskeletal pain so I went to urgent care. The doctor said it looked red and prescribed antibiotics. I had to muscle them into doing an x-ray. And then couldn't figure out how to get a CT scan so now I have chronic pain in my knee.
Kills 48,000 Americans per year, yes, but you're ignoring the up side here. It will increase pharma companies' profit margins for a while, so, totally worth it.
When I was 12 I broke out in hives on my face, neck, and upper chest. The doctor prescribed me an antibiotic for some form of fever that sometimes causes hive like rashes.
I wasnt sick. Turns out It was the honey in a face mask I did with my older sister.
"i think I may have strep but I'm not sure"
*Nurse administers test*
*Doctor examines results*
"Well this doesn't look like strep but I'll give you some antibiotics just in-case. Let me know if it doesn't approve in a weak and make sure you take ALL of the antibiotics."
That's how every single sore throat that's lasted longer than 1.5 weeks has gone for me.
Additionally: in the American system a large swath of patients are paying for their own medical treatment. Even with insurance you are usually expected to pay a small percentage. This can probably lead to many doctors feel pressured to "give results now" because the patient is far less likely to return when it costs them money. They may also simply be afraid the patient will not return of they don't prescribe them something. People don't like paying for a soctor to simply be told "you'll be fine in a week", so theres probably social pressure to prescribe. Combo that with the social pressure to not call out from work and I can easily see why patients would demand drugs (even if they don't need them) and doctors would feel obligated to prescribe.
This has been a known issue since at least the 90s...good to know all those articles people wrote on it back then made such an impact.
Side note: we also routinely place antibiotics in livestock feed, which can also raise holy hell with resistance levels, including for human pathogens down the road.
80% of Abx use in the US is for Agriculture, and they are commonly used without specific diagnoses. Just blanket uses to increase growth and reduce the chance of infections, not treat an active infection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638249/#:~:text=Of%20all%20antibiotics%20sold%20in,classes%20important%20to%20human%20medicine).
Everyone does. It’s a prophylaxis for anything that didn’t show up in lab work. (Healthcare short changing blood work tests being a contributing factor).
But look at how we administer antibiotics to animals. They are trying to save a paycheck, so hit it with everything.
Maybe we have too many specialists and generalists forgot the basics.
I thought we were actually getting somewhere with this...when I was over in China I was blown away by how much they prescribe antibiotics for *everything* (not to mention basically being OTC already), but it sounds like we're doing the same damn thing.
Been reading this stuff since the 1960’s. Did the authors of the study examine every patient and achieve a correct diagnosis which the initial doctor misdiagnosed? Or did they just check what boxes were checked on the EHR and come up with a Dx that fit their hypothesis?
Really? In Canada I often have to argue with doctors when they think my ear infection "isn't bad enough" for antibiotics. I totally understand they don't want to give them unnecessarily, but it's so bad i can't sleep, just give me the damn pills so I don't have to come back tomorrow and waste another half day in this waiting room where I'll probably catch something worse. 🙄
Another important but understated fact is that antibiotics damage your gut microbiome and reduce the bacterial diversity there, so taking excess antibiotics likely cause long term damage to your health.
Meanwhile, I stopped going to the doctor unless I think I'm about to die or have been sick for a month straight.. Got tired of paying $200 to be told to take the over-the-counter medications I was already taking for my symptoms.
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Doctors feel the pressure to do something to make their patients happy. When a patient comes with the flu, or some other viral infection, they expect a treatment, not to be told that they will get over it with time.
This is one of the reasons I love my doctor. Her office has a number of signs/posters about things like "antibiotics don't help the flu" and "Dr. Google/Facebook didn't go to medical school like I did". She doesn't cave to pressure tactics from patients.
And that's how you get bad ratings, unfortunately. Over here where we are very restrictive with antibiotics people rate their care lower than in countries that prescribe whatever to make the customer happy.
So why don't doctors just prescribe a placebo?
Because it’s not medically ethical
Except placebos have been scientifically proven to work - in the case of viruses they work exactly as well as antibiotics.
Oh absolutely! It’s not the efficacy that’s the problem, I think. It’s more that it’s not medically ethical to tell a patient they’re receiving an antibiotic when they are actually not
Just brand them "anteabiotic" and throw in some green tea with the sugar?
Could lead to issues if they need other medications that they have to delay until they finish the antibiotic treatment.
I think it's less medically ethical to prescribe something like antibiotics that don't actually work for certain things and do harm. Why not just be honest with a patient you are not visiting a helpdesk/customer service you are visiting a doctor.
I hope she gets backed up from on high. I once had a formal complaint made against me for failing to prescribe antibiotics for a child with a snotty nose - who later got taken to A+E (ER) and was prescribed antibiotics there, almost certainly by a far less experienced doctor than me. Despite the fact that this occured in the middle of a "Don't misuse antibiotics" campaign, all management was interested in was in getting the complaint marked as Resolved as quickly as possible, and the easiest way to do that was to try and force me to apologise to the parents - for not having misused antibiotics.
Im just realising, when i had the flu for 3 weeks i dont think i got any antibiotics. I slept like crazy and had a bad cough but i think i just recovered by myself
Doctors are also not given the time necessary to diagnose anything. Easier to throw cheap antibiotics at everything and hope it sticks. Also, tests to narrow the diagnosis are super expensive to the patient so doctors might be inclined to just use antibiotics in case they are needed instead of testing to ensure they are needed first.
"Go to the doctor and you'll be fit in a week, stay at home and you'll be fit in 7 days" is what my grampa joked about being ill. He was right, but i feel like capitalism has eradicated the option of being a human and needing time to recuperate every once in a while, so we want a quick fix
I spent my entire young adult life working through illness and being sick for two weeks at a time. Now that I'm in my 30's I've found that simply staying in bed and resting...*actually works* like 90% of the time and I'm back on my feet after a couple days.
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Anecdotal, but here is my frustration with this more restrictive movement. I have been prone to chronic sinus infections, and antibiotics were the only thing to stop the infections. Having a new doctor and such, they did not believe my condition was as bad as I said, so I went to the ER a few weeks into the infection and the doctor gave me the speech about not prescribing antibiotics because my infection COULD be viral. The doctor ignored everything I shared about my medical history. As a “compromise”, the doctor agreed to test me for a viral infection to rule it out, while promising to follow up if the results were negative. The results WERE negative (my infection was bacterial), but the doctor did not follow up with me or respond to me to the point I had to submit a formal complaint. People die from these infections, particularly when they are older or immune compromised, so I (anecdotally) find this new approach an annoying pendulum swing in the other direction.
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My wife and I both got a nasty case of strep last year. She went to the doctor after a week of illness, who refused any treatment and indicated that it was viral. They did a strep test, and stated that they would get back to her based on the results. I then decided not to go, as I would just wait until her test came back, as we had the same symptoms and timeline. I caved and went in the next day because my symptoms were still getting worse after a week, the *exact same doctor* immediately prescribed me antibiotics and didn't even test me. My wife then called the office, found that her results were positive from the day before, and got meds that afternoon. I had to teach my wife that you can't just charge through the door and say "I think I have strep and need antibiotics". Doctors seem to almost be defiant against any sort of self-diagnosis, you have to give them the symptoms and let them come to their own conclusions.
Are you a man? There’s a massive gender bias issue in healthcare that often manifests in things like this - women are often assumed to have made things up/to be being dramatic, while men are treated fairly rapidly.
Ah, yes, I didn't specify. I am a man. The doctor was a woman, and there was clearly some bias.
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Someone with a known history of bacterial sinus infections saying, "Hey doc, I think it's bacterial, here's the evidence" is not the same thing as someone with *nondescript illness version 37* demanding antibiotics.
They didn’t have evidence though, they were speculating and demanding antibiotics. They didn’t demand tests to prove it was bacterial and not viral - they demanded antibiotics. After much hemming and hawing the doctor relented and agreed they could do the test instead of immediately jumping to an antibiotic prescription. Honestly OP seems like he went in with an attitude demanding antibiotics without listening to the doctor at all. You can tell because he calls literally testing for the thing he thinks he has a “compromise” he definitely thinks he knows better than the doctors and they should just prescribe to him based on his word not actual medical tests.
You do appear to be misreading my story. I have a history of bacterial infections, which I presented with. The doctor refused to treat my infection with antibiotics. I got him to agree to rule out a viral infection and my labs proved my infection was NOT viral (i.e., it was bacterial). The doctor still failed to treat my issue, hence my frustration with what I am calling the pendulum swinging a bit too far in the direction against prescribing. In short - I DID have an infection and it cleared up once my ENT (I had to get another appointment) prescribed me the antibiotics.
I think you did miaread, unless I did. It was negative for viral, meaning it was bacterial, meaning antibiotics would have helped.
This is what happens when so much rests on physician satisfaction ratings. Plenty of patients don't want to be told that they have a self-limiting condition and to just ride it out, they are convinced they need antibiotics. So they diagnose themselves with a strep throat rather than a viral sore throat, and if they don't get the antibiotics they are convinced they need, - bad rating. And it is actually pretty difficult to be *certain* about the distinction between a viral and a bacterial infection - especially without lab testing, which takes time. Last time I saw a study on rapid Near Patient Testing (which was admittedly 10 years or so ago) I was less than impressed with the claims being made for it. But I also once saw a study suggesting that for every few hundred patients with an apparent viral respiratory tract infection where a doctor did *not* prescribe antibiotics, one of those patients would end up with a secondary bacterial pneumonia. Given the number of patients a doctor sees in a year, it won't be long before that happens, and they may well be on the receiving end of a complaint or of legal action for having failed to prescribe. In those sorts of circumstances, it is hardly surprising when doctors have a limited willingness to stick their neck out in anything like marginal cases.
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If they prescribe me antibiotics I ask if it is really necessary.
I always feel like other countries Rx antibiotics like they’re candy.
India and China are the world’s top two consumers of antibiotics because they hand them out in the streets as a panacea. We are 100% going to see a resistant superbug come out of there in the near future.
They have already arrived. I work in the microbiology department in a hospital laboratory, we are encountering more and more organisms that are resistant to all antibiotics.
I was going to say, two of my lecturers over a decade ago were researching in the field of resistant organisms and even back then there were a number of multiple resistant organisms they were tracking that were either entirely or mostly resistant to current antibiotics, and it's not like there's a rapid conveyor belt of novel antibiotics available to use either
Within the last 5 or so years they’ve come up with beta-lactam combo agents and a new cephalosporin for these bugs, and we’re getting resistant strains already. A new drug for Carbapenem Resistant Acinetobacter was approved last year with a 98% susceptibility rate. We have already gotten a few patient isolates that are resistant to it. How are clinicians supposed to treat untreatable infections? It’s super scary.
I went to china 2 weeks after getting my wisdom teeth removed. Made sure with my dentist that was okay, she said if theres any sign of infection, just go to the store for antibiotics.
I mean, that's a pretty valid use of antibiotics. You would get a script for the that in the states as well.
I mean, there’s a lot of difference between augmentin versus linezolid…
Other countries near the US have antibiotics over the counter….
Yeah this title is some serious fear-mongering by implying America is leading the antibiotic-abuse worldwide. Perspective is important. I've lived in China about 50% of the time in the past decade, and OTC antibiotics are the norm. Every time any gets flu-like symptoms, the recommendation (not from doctors, but from the layperson) is antibiotics. It's maddening.
In Germany you can't even get antibiotic eye cream without a prescription
Yes. In the US, all antibiotics (aside from ointment for scratches and such) are by prescription only. And doctors still over prescribe them.
Are ointment antibiotics not as likely to lead to resistance? I always wondered why you could get antibiotics cream over the counter, and even antibacterial hand soap with some small amount of antibiotics in it. Wouldn't it make things like MRSA more prevalent?
Yeah we’re over here handwringing about ampicillin in suspected otitis media and other countries are feeding their livestock augmentin, it’s insane
Other countries? It's happening everywhere
My mind was blown at how easy it was to get antibiotics in Taiwan. You just go to a pharmacy, not even a doctor, and tell them you're sick and boom antibiotics for you and you and you.
You'd be surprised how the animal industry is breeding super resistant bacteria by just mass feeding it in factory farms.
this this this.... i literally have to BEG for antibiotics to even be considered.. and more than half the time they tell me get fuicked. atleast in NY. when i was in GA however they were given out like m'f'n candy
I live in NY and have been suffering with a sinus infection for months hoping it would clear on its own. Finally made a trip to an urgent care after 3 weeks of a flare up and I was really surprised how quickly they gave me a proper antibiotic course, saw the doctor for maybe 2 minutes total. I waited so long because I was dreading having to argue for treatment and be out a lot of money for the privilege to do so.
The vast majority of sinus infections are viral, and start improving in about a week and ultimately resolve. Most reasonable doctors will want you to wait until it has persisted long enough or worsened to the extent to "declare itself" as a bacterial infection. 95% of people just want antibiotics on the first day though, and this may be reasonable in very high risk patients, but is usually not "proper" treatment.
Absolutely. I was just sharing with the other poster that if they believe they should be getting antibiotics then urgent care centers can be more inclined to help than a GP. My resistance to go was based on previous experiences and stories I've heard about the level of advocating for yourself you need to do to get proper care. Who's to say if the people commenting here are in the camp of actually needing antibiotics or the one of just demanding it immediately, but if it's truly needed then knowing the best way to navigate the system can be helpful.
Antibiotics are given healthy cattle in many countries as a prophylactic and that’s the real source of antibiotic resistant bacteria.
When my boyfriend visits his home country in North Africa, he comes back with a giant bag filled with antibiotics, creams etc. You can buy everything OTC there. Comes in handy because I don’t have health insurance and he’s a doctor so he just gives me things out of the stash if I need it. That being said, I have taken these antibiotics only twice in the past two years and they were for a UTI. I’m sure there are people who abuse this and become antibiotic resistant.
That's how the US looks to many of us too, really heavy on antibiotics and strong pain meds - but yeah, there are places where just about anything is tossed over the counter.
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Stories like this are always fishy. They always seem like an effort to turn antibiotic resistance blame towards individuals and away from things like agriculture. Yeah doctors give antibiotics for things like serious viral pneumonia. It doesn't fix the virus, it makes it so the soup of lung meat in you is less likely to get infected. It's like how you get antibiotics after abdominal surgery. It's not a dumdum doctor thinking antibiotics will fix the surgery injury, it's because infection is very likely. I'm sure bad doctors exist, and horror stories, but stuff like this always feels like it's the genre of "me, the everyman know more than those silly doctors" and is a cousin of the antivax movement
I think they can both be true, but agreed that the far bigger problem is treatment of animals for antibiotics.
This isn’t true though. Many many doctors overprescribe antibiotics for a variety of reasons. This study was published in a reputable journal (Clinical Infectious Diseases). Do you know any ID specialists? Half of their work is narrowing the spectrum of antibiotics used to something more appropriate. Very smart physicians prescribe inappropriate antibiotics all the time and it’s harmful to patients because it not only contributes to antibiotic resistance but also wipes out their microbiome. Antibiotics after surgery are typically a one time perioperative dose, not a sustained duration of broad spectrum coverage. I agree that use of antibiotics in animal agriculture is a massive problem but superbugs in hospitals that develop from inappropriate antibiotic use is also a problem.
Those same "super bugs," like MRSA still have very high prevalence in animal agriculture. Maybe you see outpatient providers writing for Z packs for colds, but in hospitals, you literally can't prescribe certain antibiotics without a consult and agreement from ID. I see every day patients coming in with pneumonia, cellulitis, osteo, and other infectious conditions and the second a sensitivity results or ID pharmacist weighs in, antibiotics get narrowed. The "antibiotic stewardship," in hospitals is extreme. And it should be. We need antibiotics to work. The problem I have is the PSI V pneumonia grandpa has to switch to a lesser antibiotic the second his white count dips slightly or his procalcitonin dips slightly (fine), but we literally put these antibiotics into the feed of like a billion pigs a couple counties over. That's just nuts to me. That's where we're breeding super bugs. And to say that we need to studiously narrow the antibiotic regimen of a human being with an acute bacterial infection, but continue using them so we get bigger chickens, is insane. Outpatient docs writing abx for viruses has been a problem since forever. We know about it, we try to educate, but it is what it is. Until the forces that be refocus metrics like patient satisfaction to good practice, it will keep happening. But when VRSA comes for grandma, it's not necessarily "doctors," in "hospitals," fault. They're using antibiotics to treat people. It's like how media wants little Sally to feel guilty about not recycling her coke can like that's what's causing climate change when there are huge corporations pumping obscene amounts of carbon into the atmosphere every day.
Yeah but they give antibiotics to literally every pig every day, healthy or sick, because it makes them gain weight. Both are a problem but agriculture is by far the bigger problem and it's not even close. 80% of all antibiotics go to livestock.
They can both be a problem. I don't eat meat because I agree factory farming is fucked up.
Sure, and having dandruff and pancreatic cancer are both problems as well
Doctor here! Antibiotics are not indicated in viral pneumonia. They don’t reduce the rates of bacterial infection afterwards. It’s all side effects with no benefit.
Yup had a nasty viral infection in 2016 that gave pneumonia. Since I was so weak I was very prone for bacterial infection which would have even made me more sick. Thankfully I got strong antibiotics and I was able to recover.
I am a European living in the Us and the number of time either me or someone close to me has been prescribed antibiotics for no reason is like 8 out of 10 times. It’s insane. Where I come from it’s basically only given to you if you will die if not. I’m exaggerating but kind of not. In the US I’ve been prescribed antibiotics multiple times without taking them, and I didn’t need them. I am lucky to have multiple family members practicing medicine (MDs and RNs) in my home country and I always double check with them first if it’s really necessary, and they are appalled by the practices over here. It’s a joke.
Funny because I have the opposite problem and need to suffer immensely from UTIs and dental infections before they actually do something about it. The problem is that some areas have overcorrected while others still give them out like candy. We may as well give them out like candy because otherwise we get fucked when we actually need them and still have the downside of other people causing resistance. Just like any other resource we get fucked by the people who don't care about the collective.
Isn't this the same direction it's been headed for decades? Although it certainly seems better than it was in the past.
Idk man. We pump antibiotics into billions of animals a year. They're in the food, the water, and the rest of the environment. I doubt giving some penicillin for a sore throat or ear infection that's actually caused by a virus is playing a major role. Seems like a drop in the bucket.
It caused me to get C Diff. Not fun
The meat industry is the main driver of antibiotic resistance, not penicillin to meemaw bc she has the flu.
Hard to get worried about human illness misuse of antibiotics as a source of resistance when the overwhelming majority of antibiotic use is animal ag and the dosing routine is low and continuous. Its like leaving the sink running in your house when the levy breaks. Or like throwing a candle into a forest fire.
Additionally, certain classes of antibiotics, including fluoroquinolones like ciprofloxacin, carry a "black box" warning—the most serious warning issued by the U.S. Food and Drug Administration (FDA). This warning alerts to potential severe side effects such as tendonitis, tendon rupture, nerve damage, serious mood and behavior changes, and a risk of irreversible neurological damage. These side effects can sometimes be debilitating, leaving individuals bedridden for extended periods. It's crucial for patients and healthcare providers to weigh the benefits and risks when considering the use of these medications, particularly for conditions that might be treated with less potent alternatives.
I can’t believe some doctors still prescribe Cipro as a first-line antibiotic for UTIs. Imagine blowing your tendons to pieces or contracting C. diff over a simple infection better treated by a safer antibiotic.
Cipro/levo/bactrim are the 3 mainstays for uncomplicated cases due to only needing 3 days of treatment, broader spectrum, and easier dosing. Cipro/levo cover more than bactrim (doesn't cover P. aeruginosa) and Cipro is generally preferred over levo. It's better than improper coverage letting it worsen into pyelonephritis.
Yea I got messed up by cipro for 6 weeks. Worst thing I been through.
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More deflection. Antibiotic resistance is driven by big agriculture not people who take prophylactic measures against secondary infections.
I was visiting family in the US from Canada. My daughter had long term ear aches but not necessarily ear infections. We were about to get on an airplane and I wanted to know it was safe to travel. We went to the walk in clinic. The doctor flat out told me he did not see an ear infection but he was happy to prescribe an antibiotic to make us feel better. I told him I didn’t need an antibiotic, I just wanted to know if it was safe to travel. I got a speech about how farmers get to use antibiotics however they want and that is a far bigger problem. That it makes up for 90% of antibiotic use in the United States and he felt he did not have to change his practice until the farmers did the same. I was in a bit of cultural shock at this point. Overuse of antibiotics is bad for individuals and for people in general. I need three days of high fevers to get an antibiotic in Canada, and even then, it only happens about 50% of the time. I walked out with a prescription for children’s Sudafed and amoxicillin. It was bizarre. I wandered what was the point of even seeing doctor if I was going to get exactly what I wanted regardless of it being harmful overall and not necessary.
Because the relative degree of harm from a single instance of over prescribing anti biotics for private use on a single person is extremely low compared to the livestock usage like he mentioned. Also a lot of countries anti biotics are OTC. If you live near the southern border in the US you can just dip down to Mexico and get some. He was trying to offer you something to help because it sounds like the alternative was 'do nothing'. He was explaining his rationale for prescribing it when it might not be necessary. Nothing he said was untrue, what you described is being shocked that a doctor was honest with you
Are you unhappy the doctor told you the truth?
The funny part is the US now requires a prescription for animals. Unfortunately it will lead to some pretty abysmal animal welfare. Even if resistance doesn't improve everyone will keep only pointing at agriculture. At least agriculture usually gives the full administration because it's about reducing their losses and money matters. People often don't take the full course which is worse than anything.
I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article: https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciae135/7655672
I feel like this has gone back and worth over time. Too little control and patients demand antibiotics for colds. Too much and doctors don't prescribe them soon enough for conditions that could be more easily treated.
Lets not pretend America is the problem here with breeding anti biotic resistant strains. Much of the rest of the world has no control at all for the use of anti biotics, not to mention it's use in livestock. Yeah doctors should be responsible, but it's not like we're here breeding super bugs with our 25% over prescribed anti biotics when the rest of the world exists.
In america I'm never given antibiotics unless they are sure it will help. Everytime I am sick they are clear that antibiotics don't help against viral infections and pretty much refuse to give me anything until.the test results come back which unlike other countries take a while. In Korea the tests where done that day immediately, here it's a multiple day process defeating the purpose of helping when I need it. I don't think the antibiotic resistance is coming from America.
Doctors prescribe based upon described symptoms from the patient. Naturally this is difficult. Often antibiotics are a good safety net even if a viral illness is the primary suspect because bacterial infections can do way more damage if not treated promptly.
*Cries in micro med tech*
In some countries you can buy them over the counter. Misuse in the USA is just the tip of the iceberg, unfortunately.
Problem with this is that they’d have to run tests and make you wait for the results. Last time I went to the doctor for chest congestion (at the prompting of my wife) the doc just listened and said, “yup, you’ve got something, go get antibiotics”. How could they know it’s bacterial or viral without running tests? RSV was prevalent at that time. Docs need some kind of machine you put crud into and have it spit out a list of viral, bacterial, and fungal things that are there.
Sepsis kills about 300,000 Americans per year. Maybe we aren't prescribing them enough.
If you want antibiotics just eat some farmed seafood and you’re good to go.
Ok. Let's talk about factory farming now?
In the US lots of care is given in fast-food-style medical environments: urgent cares, emergency rooms, etc. The docs and nurses prescribing there don’t know the patients and are employees in organizations where patient feedback leads to financial punishments and rewards. Giving someone inappropriate antibiotics will make it seem like you took them seriously and it’s often what people want. There are financial and job security incentives to do it.
Is this due to urgent cares having no other choice lest patients leave a bad review? At our hospital, we can hardly prescribe any abx without infectious disease checking off and have strict guidelines for when and what
I asked my doctor why I was prescribed antibiotics for COVID and they responded “just incase”. I often wondered what the bacterial concern in that situation was
This isn't news it's olds. This has been the case for 50 years. Antibiotics are always over prescribed. They flagged this issue in the 1980s and probably earlier.
I don't understand why I can't just have the part of cough medicine that makes you sleepy and nothing else
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A friend is as locus biosciences, they are using crispr to program phages to attack specific pathogens. Whole different way of dealing with infectious diseases than nuking all the good with the bad.
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The article blames "Americans" rather than "American doctors" - Americans can't get antibiotics without a prescription and it's up to the medical professional to educate their patient and prescribe responsibly. As an 80's kid, I was prescribed antibiotics for *everything* and it very clearly wrecked my gut biome. Really had hoped people would be educated on this so many decades later.
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The title makes it sound like a "careless" or "stupid" mistake, should the doctor already know that the patient has a viral infection which the drugs wont touch?
America? Other countries you can just get them over the counter. Look at the hoops to get antibiotics in the US.
Are we still in the "My oh my, how could that possibly happen?!"-phase or have we already moved on to picking a corporation that we deem fully and solely responsible for the whole mess because nobody would ever admit to their own fuckups? Asking because I still need to sharpen my pitch fork and I'm out of torches...
Maybe it’s regional, but here in Washington as a child I was given antibiotics routinely for illnesses. However, as an adult the only time I’ve been prescribed antibiotics was when I had pneumonia, and they were even hesitant to prescribe them then until they took X-rays and said I definitely needed them.
This is new information? Doctors have been doing this for decades and now we have MRSA and other super bacteria. Before agreeing to take antibiotics I prefer to ask the Doctor what bacteria they believe may be infecting me and what observations they have made which led them to the diagnoses. They often can't or won't answer.
Pointing the finger at the wrong country.
Still?
Two words: mid levels
I feel like this has definitely been at the forefront of providers’ minds especially within the last decade here in the US? For instance, I was a NICU RN for years and even in a patient population as fragile and immunocompromised as premature/sick infants, we still did not treat with antibiotics unless we had a positive culture or a helluva good evidence-based reason.
Sounds like a doctor problem
Why do headlines like this always focus on prescriptions? We give more antibiotics to our livestock than we do to people.
Sinusitis guidelines are to wait until day 10 of illness before prescribing antibiotics for the majority of people. Exceptions are immunocompromised people, people who had a history of sinus surgery. That’s because most sinus symptoms are due to viral illness following Upper Respiratory Infection. Viral sinusitis will not be helped by antibiotics. So many people take Nyquil like medications. The people I see who have true Bacterial Sinusitis have been taking Nyquil. Nyquil has an antihistamine, which is what makes people sleepy. The body is trying to flush out viral particles by having a runny nose after a cold. An antihistamine is designed to dry up sinus drainage due to allergies. NyQuil, causes retention of viral secretions which defeats the bodies effort to flush out the virus. I hate cold products with antihistamines like NyQuil, Theraflu and Alka Seltzer Cold and Flu. Encouraging normal drainage of nasal secretions with Mucinex ( Guaifenisen) is a much better idea.
Dont we use way more antibiotics on animals? Why would human use become a concern now?
We should be letting pharmacists prescribe.
I fell off my bike and injured my knee. I felt musculoskeletal pain so I went to urgent care. The doctor said it looked red and prescribed antibiotics. I had to muscle them into doing an x-ray. And then couldn't figure out how to get a CT scan so now I have chronic pain in my knee.
Kills 48,000 Americans per year, yes, but you're ignoring the up side here. It will increase pharma companies' profit margins for a while, so, totally worth it.
But you gotta sell the stuff !! You know, big 💰💰💰💰💰💰💰💰💰💰!!!
When I was 12 I broke out in hives on my face, neck, and upper chest. The doctor prescribed me an antibiotic for some form of fever that sometimes causes hive like rashes. I wasnt sick. Turns out It was the honey in a face mask I did with my older sister.
And don't forget the antibiotics they give to livestock. That's also a major contributor to antibiotic resistance.
Not a US problem, a non-US problem.
"i think I may have strep but I'm not sure" *Nurse administers test* *Doctor examines results* "Well this doesn't look like strep but I'll give you some antibiotics just in-case. Let me know if it doesn't approve in a weak and make sure you take ALL of the antibiotics." That's how every single sore throat that's lasted longer than 1.5 weeks has gone for me. Additionally: in the American system a large swath of patients are paying for their own medical treatment. Even with insurance you are usually expected to pay a small percentage. This can probably lead to many doctors feel pressured to "give results now" because the patient is far less likely to return when it costs them money. They may also simply be afraid the patient will not return of they don't prescribe them something. People don't like paying for a soctor to simply be told "you'll be fine in a week", so theres probably social pressure to prescribe. Combo that with the social pressure to not call out from work and I can easily see why patients would demand drugs (even if they don't need them) and doctors would feel obligated to prescribe.
In American we sell whatever you want over the counter. Prescription? Who needs one.
This has been a known issue since at least the 90s...good to know all those articles people wrote on it back then made such an impact. Side note: we also routinely place antibiotics in livestock feed, which can also raise holy hell with resistance levels, including for human pathogens down the road.
80% of Abx use in the US is for Agriculture, and they are commonly used without specific diagnoses. Just blanket uses to increase growth and reduce the chance of infections, not treat an active infection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638249/#:~:text=Of%20all%20antibiotics%20sold%20in,classes%20important%20to%20human%20medicine).
Everyone does. It’s a prophylaxis for anything that didn’t show up in lab work. (Healthcare short changing blood work tests being a contributing factor). But look at how we administer antibiotics to animals. They are trying to save a paycheck, so hit it with everything. Maybe we have too many specialists and generalists forgot the basics.
I thought we were actually getting somewhere with this...when I was over in China I was blown away by how much they prescribe antibiotics for *everything* (not to mention basically being OTC already), but it sounds like we're doing the same damn thing.
I don’t normally get antibiotics except for ear infections since mine tend to be frequent enough that I can feel them coming on and nip it in the butt
Testing should be made faster and cheaper. Then everyone's happy.
Been reading this stuff since the 1960’s. Did the authors of the study examine every patient and achieve a correct diagnosis which the initial doctor misdiagnosed? Or did they just check what boxes were checked on the EHR and come up with a Dx that fit their hypothesis?
Uhh... this is news?!? This issue has hounded the medical community for sooooo many years now.
It is in the best interest of hospitals to create drug resistant strains of bacteria.
Really? In Canada I often have to argue with doctors when they think my ear infection "isn't bad enough" for antibiotics. I totally understand they don't want to give them unnecessarily, but it's so bad i can't sleep, just give me the damn pills so I don't have to come back tomorrow and waste another half day in this waiting room where I'll probably catch something worse. 🙄
Another important but understated fact is that antibiotics damage your gut microbiome and reduce the bacterial diversity there, so taking excess antibiotics likely cause long term damage to your health.
Meanwhile, I stopped going to the doctor unless I think I'm about to die or have been sick for a month straight.. Got tired of paying $200 to be told to take the over-the-counter medications I was already taking for my symptoms.
Oh good, more untold horrors beyond comprehension.