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CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

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Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#71
post #50

Earlier quoted context omitted.

While I can appreciate your situation, those last two paragraphs read with the same kind of anecdotal logic that lead people to the conclusion that vaccinations do more harm than good.

It wasn't ment that way. The vaccination conspiracy theorists are the opposite evil here. They are even worse. I didn't want to say that I would not give my kid antibiotics. This is bullshit. But I will change the doctor if his only solution is antibiotics. I had that situation already with my girlfriend. She is ill pretty often. She works in a kindergarden and parents tent to get rid of their sick kids by sending th…

I'm Norwegian. Norwegian doctors at least used to be extremely careful about anti-biotics. I now live in the UK, and the doctors here often prescribe anti-biotics after telling us we most likely have a viral infection.

I think the main thing is to challenge them to explain why. If they can't give a coherent explanation, ask them to explain to you what they think the risks are of waiting.

Most of the time when doctors here want to prescribe anti-biotics their answer is pretty much "just in case I missed something and it's actually a bacterial infection", and usually they'll then concede that if I'm ok with it, I can wait it out a couple of days and only take antibiotics if things doesn't start to improve with minimal risk. A couple of times the explanation has been that they've often seen specific symptoms exacerbated by a simultaneous bacterial infection, but again their response has been the same: if I don't keep getting worse, I'm fine to wait.

The only time I've ended up taking the antibiotics on offer was when I came in once spitting blood and with massive white lumps at the back of my throat (from whence the blood came, as they were ripped open when I coughed). Yay. Even then the doctor assumed, probably correctly, that it most likely was a viral infection that was making the rounds - she had a steady stream of the same symptoms that week -, but pointed out that given that my throat was so swollen and painful that I could hardly even drink, and the coughing of blood, if she was wrong and it got worse without antibiotics, next stop might be the hospital.

But of course few people care - they don't question the reasons for prescriptions at all.

Part of the high level of prescription of antibiotics in the UK is because of the health system here - they're paid per roughly per patient (adjusted for patient age, morbidity levels in the area they operate in, and a number of other factors meant to adjust for the cost of providing service, but the point is they are not paid per patient visit). If they get me out the door quickly and I don't come back, that's a win for them, so they are incentivised to get me well, but there's no downside to them short term from doing so by prescribing me something there might only be a 5% change that will make a difference to me at all - that's five percent fewer repeat visits at no real risk to them.

Few patients will complain, as the prescription cost is low, and when they get better in a few days, many of them will assume it was the antibiotics and so assume the doctor was right.

It's hard to set rules that prevent these kind of incentives, other than monitoring of whether or not they are in line with guidelines and/or whether or not they prescribe grossly more than the baseline.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#72
post #34

Earlier quoted context omitted.

> Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections. > "We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Haug. I wish more of us would follow this approach and learn to accept being 'sick' for a few days (or even a week) every now and then.

In addition to rtdsc's comment, I have also observed that people in the US are more touchy about just the fact of 'being sick' and treat minor colds like it was TB or something. My girlfriend from here after I got a cold, "Oh, are you okay? Why do you think you got sick? Stay in bed for a while and take some medicine." No, it's just a cold. Why do I think I got sick? People get them when it turns cold out. Doesn't ma…

I'm Norwegian, and worked for a US company years and years ago. Three of us went to Santa Cruz to visit the rest of the team. First morning there the local news was all up in arms about a storm. We looked out: There was a light drizzle.

We walked to the office without umbrellas, in light clothes, and hardly got wet. It was well over 20 degrees celsius, and a pleasant enough 15 minute walk despite the light drizzle.

We got into the office to find people in what looked like full survival mode, with raincoats, and hairdryers to get dry and warm. These were people who had driven right up to the office door.

When they saw us they were horrified and worried we'd get pneumonia and wondered how we could have chosen to walk 15 minutes through the "storm". Of course it did rain slightly more some other places - causing mud slides that closed a couple of roads and cut off the gas supply for a couple of days. But for us it was all terribly amusing.

After we went swimming in "only" something like 22 degrees in the water the following weekend, they got equally shocked (some of them asked if we'd used wet suits). I pointed out the coldest water I've been swimming in was 12 degrees, but I'm not sure they believed me.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#73
post #53
post #34

Earlier quoted context omitted.

> Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections. > "We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Haug. I wish more of us would follow this approach and learn to accept being 'sick' for a few days (or even a week) every now and then.

What I noticed in US is that people are very touchy about being uncomfortable. Doctors are supposed to "fix" problems and make things "comfortable". This usually means "give me antibiotics to kill this infections as fast as possible" and "give me more pain pills, I don't want to feel any slight discomfort". If doctor tells them to drink some hot tea and lay in bed instead they might just switch doctors who will give…

It's ironic this attitude comes from the same country that tells you to "man up and walk it off" for just about anything.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#74
post #38

People need stop using antibiotics for everything and use it only when necessary. When Drugs Stop Working-Norway's Answer: http://www.cbsnews.com/2100-205_162-6014559.html

Two weeks ago a doctor lost his license here in Norway due to long term, high dosage antibiotic usage: http://translate.google.no/translate?hl=en&sl=auto&tl=en&pre...

His case is/was extreme: He was prescribing extreme high doses for extended periods of time to a small number of patients because some believe it works against extreme cases of Lyme disease, despite total lack of evidence.

It's rather shocking that he's been allowed to keep practicing as long as he has.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#75
post #53

Earlier quoted context omitted.

What I noticed in US is that people are very touchy about being uncomfortable. Doctors are supposed to "fix" problems and make things "comfortable". This usually means "give me antibiotics to kill this infections as fast as possible" and "give me more pain pills, I don't want to feel any slight discomfort". If doctor tells them to drink some hot tea and lay in bed instead they might just switch doctors who will give…

It's ironic this attitude comes from the same country that tells you to "man up and walk it off" for just about anything.

"Man up and walk it off" is not uniformly distributed around the country. I give good odds that the rdstc is not from one of those areas.

As usual, accusing huge groups of hypocrisy is not well-founded unless you can establish that the hypocritical attitudes really are held by the same people.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#76
post #53
post #34

Earlier quoted context omitted.

> Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections. > "We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Haug. I wish more of us would follow this approach and learn to accept being 'sick' for a few days (or even a week) every now and then.

What I noticed in US is that people are very touchy about being uncomfortable. Doctors are supposed to "fix" problems and make things "comfortable". This usually means "give me antibiotics to kill this infections as fast as possible" and "give me more pain pills, I don't want to feel any slight discomfort". If doctor tells them to drink some hot tea and lay in bed instead they might just switch doctors who will give…

When you watch people lose jobs for sick time you tend to have that reaction.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#77
post #71
post #50

Earlier quoted context omitted.

It wasn't ment that way. The vaccination conspiracy theorists are the opposite evil here. They are even worse. I didn't want to say that I would not give my kid antibiotics. This is bullshit. But I will change the doctor if his only solution is antibiotics. I had that situation already with my girlfriend. She is ill pretty often. She works in a kindergarden and parents tent to get rid of their sick kids by sending th…

I'm Norwegian. Norwegian doctors at least used to be extremely careful about anti-biotics. I now live in the UK, and the doctors here often prescribe anti-biotics after telling us we most likely have a viral infection. I think the main thing is to challenge them to explain why. If they can't give a coherent explanation, ask them to explain to you what they think the risks are of waiting. Most of the time when doctors…

Thank you for outlining the basics of how we can ask questions of our doctors without feeling (or sounding) like we are saying "I don't trust you to know what you're doing". As you point out, often the doctors DO have reasons, but sometimes they might do it because if they don't, other patients will complain that the doctor "didn't do anything".

When we're sick or worried, it's easy to forget to ask these questions. I don't even manage to ask them of my car mechanic.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#78
Since new anti-biotic development is so critical, I don't get why the feds don't in-source it to the CDC or provide massive incentives already. This is an infuriating problem that should've been dealt with decades ago on the R&D-funding front.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#79
post #71
post #50

Earlier quoted context omitted.

It wasn't ment that way. The vaccination conspiracy theorists are the opposite evil here. They are even worse. I didn't want to say that I would not give my kid antibiotics. This is bullshit. But I will change the doctor if his only solution is antibiotics. I had that situation already with my girlfriend. She is ill pretty often. She works in a kindergarden and parents tent to get rid of their sick kids by sending th…

I'm Norwegian. Norwegian doctors at least used to be extremely careful about anti-biotics. I now live in the UK, and the doctors here often prescribe anti-biotics after telling us we most likely have a viral infection. I think the main thing is to challenge them to explain why. If they can't give a coherent explanation, ask them to explain to you what they think the risks are of waiting. Most of the time when doctors…

Yes! I think so many of the problems in the world are because people have become too specialized. Nobody really understands how to do basic maintenance on their car anymore, what's happening with their data on the Internet, why their politicians make the decisions they do, or what their doctors are prescribing them and why. Capitalism pushes us so much in the direction of specialization (with good reasons), but I think we need to step back often and make sure we still have some good general understanding of the world.

>> The only time I've ended up taking the antibiotics on offer was when I came in once spitting blood and with massive white lumps at the back of my throat (from whence the blood came, as they were ripped open when I coughed).

As a side note, it sounds like you were probably at pretty high risk for a secondary infection through the wounds, as well - possibly another reason they prescribed antibiotics.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#80

Since new anti-biotic development is so critical, I don't get why the feds don't in-source it to the CDC or provide massive incentives already. This is an infuriating problem that should've been dealt with decades ago on the R&D-funding front.

As I understand it, the problem is more fundamental than that.

Antibiotics were originally discovered accidentally, and a lot of subsequent antibiotics were discovered/created by investigating and extending the mechanisms of the original discoveries.

We're now running out of those implications to chase down. To get the "next breakthrough" in antibiotics will require another surprise discovery, or some other fundamental breakthrough in basic biological understanding.

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