Obtaining Antibiotics without a Prescription (2002) • Hacker News Board

Re: Obtaining Antibiotics without a Prescription (2002)

#91

Post by skue » Wed, Jan 15, 2014, 9:52 PM UTC

mberning wrote: post #79

carbocation wrote: post #31

Earlier quoted context omitted.

By what means did you self-diagnose MRSA? At a hospital, that would involve a Gram stain / culture/speciation / sensitivities and take a few days. Gram stain, because it's very fast (minutes) and can tell you, e.g., that you have Gram positive cocci in clusters (thus, likely staphylococcus species ). Culture, then, to grow the bugs and see what nutritional requirements they have and what biochemical modifications the…

There are several signs that distinguish MRSA from a normal staph infection. 1. Intense pain that extends beyond the boundaries of the visible irritation. Pain that is much more intense than a normal pimple or ingrown hair. 2. Distinct rash (as far as I understand the rash is caused by the specific toxins MRSA generates) 3. Necrosis of the skin. MRSA will produce blackened dead skin which many people mistake for a sc…

What you are describing could be necrotizing fasciitis, and although MRSA is a common cause there are many classes of pathogens responsible. Any of them can constitute a medical emergency, and if not diagnosed and treated quickly a surgeon may need to butcher you to save your life. I've been in the OR for a debridement and you do not want to be that patient.

If you have pain way out of proportion and darkening skin (or any rash for that matter), that's not the time to play House. Call your doctor if you have one, or just go directly to the ER.

Re: Obtaining Antibiotics without a Prescription (2002)

#92

Post by guard-of-terra » Wed, Jan 15, 2014, 9:53 PM UTC

angersock wrote: post #88

guard-of-terra wrote: post #85

Earlier quoted context omitted.

Let people decide. If they want antibiotics: sell it to them.

No , because people are idiots and have no concept of how overuse of antibiotics reduces their utility. People, as a whole and on average, are terrible at judging long-term costs and overuse. Now, if the product was priced to properly reflect negative externalities of use and abuse, maybe. But, that's not going to happen.

Let's stop selling cars, PCs and alcohol to people.

Because, you know, people are idiots and you know better.

So make them consult a well-paid and often clueless bureocrat before buying anything listed above. No prescription - no bottle.

Re: Obtaining Antibiotics without a Prescription (2002)

#93

Post by carbocation » Wed, Jan 15, 2014, 9:59 PM UTC

mberning wrote: post #79

carbocation wrote: post #31

Earlier quoted context omitted.

By what means did you self-diagnose MRSA? At a hospital, that would involve a Gram stain / culture/speciation / sensitivities and take a few days. Gram stain, because it's very fast (minutes) and can tell you, e.g., that you have Gram positive cocci in clusters (thus, likely staphylococcus species ). Culture, then, to grow the bugs and see what nutritional requirements they have and what biochemical modifications the…

There are several signs that distinguish MRSA from a normal staph infection. 1. Intense pain that extends beyond the boundaries of the visible irritation. Pain that is much more intense than a normal pimple or ingrown hair. 2. Distinct rash (as far as I understand the rash is caused by the specific toxins MRSA generates) 3. Necrosis of the skin. MRSA will produce blackened dead skin which many people mistake for a sc…

For those reading along at home, none of those distinguish MRSA from a normal staph infection.

The primary distinguishing feature of MRSA vs regular staph aureus ("MSSA") is MRSA's resistance to oxacillin/methicillin. While you can find research papers distinguishing MRSA from MSSA on clinical grounds, I'm not familiar with any clinical distinguishing feature that is used in practice (aside from sensitivity analysis or PCR, which are laboratory techniques, not clinical ones).

Re: Obtaining Antibiotics without a Prescription (2002)

#94

Post by tommu » Wed, Jan 15, 2014, 10:21 PM UTC

Fomite wrote: post #81

nathanvanfleet wrote: post #68

Earlier quoted context omitted.

Or does it exist in places where medical care is cheap or free (Canada or the UK)?

Having recently been to an international Epidemiology conference, I can say that there's intense interest/concern from researchers in the UK and Europe about both MRSA and carbapenem-resistant Enterobacteriaceae. For that matter, the current strain of C. difficile which is causing so many problems was first observed in the UK and Canada.

Was it first observed and reported in these countries because they have socialized healthcare?

Re: Obtaining Antibiotics without a Prescription (2002)

#95

Post by Fomite » Wed, Jan 15, 2014, 10:43 PM UTC

tommu wrote: post #94

Fomite wrote: post #81

Earlier quoted context omitted.

Having recently been to an international Epidemiology conference, I can say that there's intense interest/concern from researchers in the UK and Europe about both MRSA and carbapenem-resistant Enterobacteriaceae. For that matter, the current strain of C. difficile which is causing so many problems was first observed in the UK and Canada.

Was it first observed and reported in these countries because they have socialized healthcare?

Unlikely, as surveillance for C. difficile is pretty intensive in the U.S., and it was reported there shortly thereafter (which isn't particularly a surprise).

Re: Obtaining Antibiotics without a Prescription (2002)

#96

Post by grkvlt » Thu, Jan 16, 2014, 3:26 AM UTC

DanBC wrote: post #53

CWuestefeld wrote: post #39

Earlier quoted context omitted.

I have self-medicated with antibiotics in the past, when circumstances warranted. It is indeed an access problem (at least for me), but not caused by the cost (I have good healthcare insurance). Rather, it's caused primarily by the delay before one can see the doctor. And all evidence suggests that the results of the USA's current healthcare initiatives will exacerbate this waiting problem, and therefore also the sel…

Obviously th need to be a bit careful with the meds and the country you're travelling to. Some people are imprisoned for the anti anxiety pill in their bllodstream that they took before the flight. Carrying prescription medications with unclear prescriptions is risky advice unless you're sure about the country you're travelling to.

> [...] imprisoned for the anti anxiety pill in their bloodstream [...]

Really? Which countries are now demanding blood samples at the border?

Re: Obtaining Antibiotics without a Prescription (2002)

#97

Post by grkvlt » Thu, Jan 16, 2014, 3:37 AM UTC

DanBC wrote: post #67

klibertp wrote: post #56

Earlier quoted context omitted.

> Some people are imprisoned for the anti anxiety pill in their bllodstream that they took before the flight. OMG, where? I need to be sure to never go there, given my random (being treated) phobias and such.

The case I remember is a woman travelling to UAE with diazepam in her blood. I have no idea how they discovered that. I'm unable to find a reference. It was a long time ago, ten years or more. http://wikitravel.org/en/United_Arab_Emirates has some relevant info.

http://news.bbc.co.uk/1/hi/england/southern_counties/4481621...

A woman was arrested for some passport/visa irregularity and they then took a urine sample and found Codeine and Temazepam in it, which she had been given by a doctor in the UK. They gave her a four year sentence, but she was eventually acquitted, after two months.

Harsh.

Re: Obtaining Antibiotics without a Prescription (2002)

#98

Post by PythonicAlpha » Thu, Jan 16, 2014, 4:39 AM UTC

davidw wrote: post #71

PythonicAlpha wrote: post #50

Earlier quoted context omitted.

It is that notion in modern people "pain must go away, fast!" that makes things worse. Because people think that way, many will go to hospital and get said: There is nothing we can do for you (anymore). And wait some years, than the problem will widespread. We are indeed really lucky: Only 100 years before, there was no cure for many diseases where we just throw a pill today. But we today just take it for granted and…

You should try walking a mile in someone else's shoes before telling them what they should and should not think or how they should act.

I do. I also have pains sometimes, but I don't take pills every time. And when I have to take antibiotics, I go to a doctor. What is the problem with that.

Ok, in the US, the people oftentimes have no adequate healthcare, but that is an other problem in my opinion ... The US seems to be rich enough to handle it ....

Re: Obtaining Antibiotics without a Prescription (2002)

#99

Post by msandford » Sun, Jan 19, 2014, 2:21 PM UTC

chillingeffect wrote: post #77

msandford wrote: post #23

Earlier quoted context omitted.

Nice try, but not a chance. You want to see where resistance comes from? Have a little look-see at this chart: http://www.washingtonpost.com/blogs/wonkblog/files/2014/01/a...

well, the biggest segment of the graph isn't identical to what the previous guy said, so you must be right!

Well plus also the animals get the antibiotics in a very low dose all the time. If a human takes antibiotics it's in large doses for a week or two. Which one of those situations sounds like a long-term incubator for resistance?