You are exactly right - the money is in chemotherapeutics, lipid lowering agents, antidepressants, treatment for sexual dysfunction, etc.
Fortunately, most of the really bad players (VRE, ESBL, HA-MRSA, etc.) occur most often in the debilitated and poly-instrumented. It is still uncommon for a previously healthy young man to show up in the ED with something that does not respond to our bigger antibiotic guns. That may change in the next 20 years.
I may disagree with some of my colleagues about the narcotic issue since I believe that the effectiveness of monitoring measures is being overstated for most states. I personally believe that it is far easier to get a prescription for a narcotic than an antibiotic, and the indiscriminate use of controlled substances kills far more people per year than pan-resistant infections. This is based on the fact that hydrocodone is still America’s most prescribed medication despite deaths from overdose increasing 600% in 10 years. Antibiotics are not even in the top 5 (Azithro is 6, Amox is 7).
Yup as my grand parents always said…let the sickness get you for 7 days if you dont improve…MAKE SOME CHICKEN SOUP…I uphold that to today…I do not get flu shots, I do not get antibiotics…I suffer through the sickness for 7 days…drink herbal tea w/ honey
Old school yes…crazy…some say yes…but I RARELY get sick
I only go to the doctor for broken bones. He’s a busy man, and pretty much everything else I get heals itself eventually.
I think it’s been 15 years since I took antibiotics. I’m one of those weird people that just doesn’t get sick. I think I took my last sick day at work about 6 or 7 years ago. I had a cold, and I didn’t want any of my minions to catch it. So I worked from the house for a couple of days. They preferred that as well - win-win.
And as you gents have pointed out, staph and MRSA are really scary stuff. If I stay away from sick people, I’m less likely to get that, right?
So is antibacterial soap really a bad thing? Or those alcohol hand cleansers? I’m just curious.
I’ve been on Amoxicillin for a week to attempt to clear an aggressive sinus infection, and have seen minimal, incremental improvements, at best. Either I’ve just been that bad off, or the meds aren’t having the same effect as usual … or some combination thereof. Whatever the case, I’ve yet to see much of a miracle from my miracle drugs. Doesn’t completely surprise me that we might be teetering ever-closer to the edge on this one.
I have heard this for years. Used to date a girl who was a nurse, she was one who wanted people to wash hands and use hand sanitizer nigh on compulsively. She had to also be tested for TB and several other things because of the place she worked in, remember telling her not to be surprised if when they did skin tests for TB if she came back positive. Know several LE guys who because of the shit holes they work in are constantly testing positive on the skin, but otherwise are fine and when the blood tests are done come back negative. She quite literally freaked when she did but couldn’t understand why I wasn’t surprised or alarmed. She was also always saying whatever the latest bug going around in the news was a pandemic and how it was going to be the end of the world. Thinking about it now I must say it is probably a good thing we broke up, don’t think we could have raised kids together, I am much to inclined to let the kids play in the dirt.
Personally other than a few herbal remedies for colds I don’t take much in the way of drugs, and honestly hate hospitals and doctors offices. The first because they never truly smell clean and I honestly believe I have a better chance of dying there than in a combat zone, and the second because I can’t stand waiting and many doctors I am convinced don’t know what they are doing, but that is another story for another thread.
Well, no…that’s not the way it works. Those various hand solutions are useful in preventing the spread of bacteria in high risk environments. And although they may kill viruses in the lab, they don’t really have much effect in the real world. It’s not due to the body getting used to them, however.
Has always been true, but there is a huge number of strains of any given bacteria species, some benign, some very dangerous.
Competitive inhibition. You don’t try to kill everything because this gives the bad bugs a chance to flourish. You try to have benign bugs out place the bad bugs. More COIN than carpet bombing.
The bugs always win, unless you go for creamation.
Your infection might be a resistant strain or might be a different bacteria altogether where amoxicillin isn’t effective. You’re likely to have some degree of immune system compromise which can change the bacterial environment. This may be a different infection than what you’ve had before.
Given that I’ve also been on a strong steroid to attempt to keep tumor swelling at bay, I’d say that you’re entirely correct. Everything we do now is pretty much just palliative, and to some extent, experimental. Finding the right balance has been a process, for sure.
It is a myth that hand soaps and sanitizers somehow contribute to antibiotic resistance. Antibiotics work by inhibiting key bacterial metabolic processes that are needed for protein production or cell wall construction. Resistance is conferred when bacteria, after repeated exposure, are able to produce enzymes that attack or otherwise bypass (layman’s terms) the effect of the antibiotic.
On the other hand, most soaps and hand sanitizers directly denature proteins and emulsify lipids in the bacteria cell walls. There is no cross-talk or similarity between this mechanism and the effect of antibiotics. Thus, it behooves you to wash your hands frequently and for long durations as we approach the Winter. Portable hand sanitizers are a reasonable option if you are never around a sink.
The argument is that widespread use of hand sanitizers is killing off our resident saprophytic bacteria or other low level pathogens we have always been commonly exposed to and that we therefore lose the ability to acquire immunity to otherwise common bugs. I agree it is a myth, without any level 1 evidence to support it.
Hand washing or sanitizers in hospitals or other such high risk environments have been shown to limit transmitted bacterial infections and even viral infections to some degree. OTOH, while those sanitizers will kill most enveloped viruses like influenza, and even some non-enveloped viruses like Norwalk, they haven’t been shown to have much practical affect on viral infection rates in schools or homes, other such public venues.
"When a bacterial population is placed under a stressor—such as an antibacterial chemical—a small subpopulation armed with special defense mechanisms can develop. These lineages survive and reproduce as their weaker relatives perish. “What doesn’t kill you makes you stronger” is the governing maxim here, as antibacterial chemicals select for bacteria that endure their presence.
As bacteria develop a tolerance for these compounds there is potential for also developing a tolerance for certain antibiotics. This phenomenon, called cross-resistance, has already been demonstrated in several laboratory studies using triclosan, one of the most common chemicals found in antibacterial hand cleaners, dishwashing liquids and other wash products. “Triclosan has a specific inhibitory target in bacteria similar to some antibiotics,” says epidemiologist Allison Aiello at the University of Michigan School of Public Health."
It doesn’t but that’s not what’s being said. Some specific anti bacterial soaps may indeed increase the anti biotic resistance bacteria however. See article I just posted.
Good old soap seems the tried and true way to go, and hand sanitizers are mostly alcohol based, which is also GTG it appears.
We live in a culture that wants a quick fix. Many people go to the doctor with a viral infection and want antibiotics (which only kill bacteria). Doctors prescribe them to get them out the door and voila, people stop reacting due to overuse.
In a hospital setting patients are prescribed wide spectrum antibiotics before the cultures come back. Usually these meds are then stopped mid course and a specific medicine is given.
There have also been talks about the flu vaccine and how that is just speeding up the evolution of the flu virus. I had a college professor that used to go crazy on anyone that got the flu shot that wasn’t a child, immuno compromised, or a geriatric patient.
I’m a respiratory therapist in a major hospital setting. I am around MRSA, VRE, RSV, c-diff, CMV, psuedo, TB etc. We are encouraged to use purell unless the hands are visibly soiled, then the soap comes out. For the record I only ever get sick once a year in the spring time at the end of the flu season. I was always against the flu shot, but due to my patient population get it for their safety.
