The doctor's office just told me that they were not allowed to call in

[Maraya1969]

an antibiotic because it was FL. law. They are full of crap because my pulmonary doctor will call in a prescription as long as he is in his office and has access to my files.

My family doctor also has access to my files. I have had asthma since I am a little kid and if I go to long without an antibiotic after a bad cold I know I'm headed to the hospital.

I feel as if they are doing this now because they just want the money from you coming in.

I could not find any laws in FL saying this was regulated. It says they are over-prescribed but not that it was illegal.

I sound sick as a dog.

[cleanhippie]

1. Are you a doctor?

How do you know you need antibiotics? Are you sure? How can you possibly be sure without the proper tests?


Over-prescribing antibiotics (especially when they are not needed) is the #1 reason for the epidemic of antibiotic-resistant bacteria.

See your doctor. You may not have a bacterial infection that requires antibiotics.

As inconvenient as it may seem to you, your doctor's office is doing the right thing.

[Maraya1969]

3. He is not going to do any tests either. He is going to look into my throat

He is going to hear me say the mucus is green and very thick and he is going to listen to the wheezing in my chest. Which will, I assure you be worse from having to walk from the parking lot all the way into the building and then his office.

I understand for people who do not have life threatening illnesses like mine.

[cleanhippie]

7. And he is likely to tell you that you have a viral infection.

For which antibiotics are useless.

But sure, be angry that your doctor is actually doing his/her job, and requiring that you be seen before prescribing meds.

[Maraya1969]

9. I've only had this about 55 times in my life. Yea I don't know the

difference between when I have an infection in my lungs and sinus and when I have a virus.

Some things need discretion. If my lung doctor would call in an antibiotic why can't this guy?

[cleanhippie]

11. So you are a doctor, or just have special powers of diagnosis not requiring medical training?

Are you listening to yourself? Are you listening to your doctor?


Good luck. I hope you feel better.

[Maraya1969]

47. So I just got back and I have an infection - not a virus as you

sure I had. I was prescribed an antibiotic and some other meds that the doctors knows I may not take.

If you were in charge of me I would have been dead many years ago.

[Niceguy1]

86. 2 hrs

That was fast..

[Aristus]

126. Okay: a virus IS an infection, just not a bacterial infection.

Any illness involving a pathogen like viruses, bacteria, parasites, etc is an infection.

You probably wouldn't be happy with the care I provide. I treat the actual illness, not whatever vapors an uncooperative patient might be having...

[FarCenter]

132. What test did the doctor perform to determine that it was a bacterial infection?

[cleanhippie]

151. So you took my advice and got a proper medical diagnosis?

Good for you. That was the right decision. Now get better so we can have it out with hidden posts and everything!

[MineralMan]

153. Problem solved, then. You went to the doctor, who prescribed for you.

That's how it works, I believe.

[grasswire]

160. yes, it's a monopolistic franchise

....perpetrated on the citizenry by government/medical community.

[cleanhippie]

197. lol

[pipi_k]

15. Maybe it's that

your lung doctor doesn't give a shit about prescribing antibiotics when they're not needed?

Some doctors prefer to just write out the Rx rather than have to deal with repeated and endless exhortations from patients about how they NEED an antibiotic.

[Maraya1969]

53. MY lung doctor knows that it can be deadly not to prescribe an antibiotic

for me. You don't know what the Hell you are talking about.

[pipi_k]

188. If he's doing it

without actually seeing you, then he is part of the problem.

[marsis]

22. I totally understand

your problem.

Before I began using a nasal rinse daily, I often would get a cold and it would move to my chest. No, antibiotics do not work on virus', we know that. But when you do get that heavy green phlegm in your lungs and head it has turned into a bacterial infection according to my Md. So when that happens you know what you need to do.

Why are you people flaming this person? I've been there and know what they are going through.

You are comparing apples to oranges, they are not using antibiotics for the virus but for the resulting infection.

[Maraya1969]

48. I know. It is really pissing me off. Like a diabetic learns his body

and when to dial the meds up or down - that's fine.

But I think the ones playing doctor on here are the flamers. And they are all wrong. Up - thread I just posted that I am home from doctor and pharmacy and he gave me exactly what I knew I needed.

[brooklynite]

60. ...after examining you in person.

[kestrel91316]

76. I totally get it, too. And I am a doctor (veterinarian). I am very prone to complications of

colds and flu: I get severe laryngitis and bronchitis at the drop of a hat from viruses, complete with the horrible, deep cough and large amounts of disgusting green phlegm. I keep antibiotics on hand so that when it happens I can just start on them, and they work their miracles in just a couple of days.

I have tried to tough it out without antibiotics and I just get sicker and sicker and sicker. I can't afford to be sick in bed, in need of home nursing, for TWO WEEKS every time I catch a freaking cold.

[Ms. Toad]

124. laryngitis and bronchitis can also be (and most often are) viral

not bacterial.

[kestrel91316]

251. They do start out as viral, but then develop secondary bacterial

complications in certain patients. Generally we such patients know who we are and know to take these things very seriously.

I have a degree in microbiology in addition to being a veterinarian with over 30 years of experience, so I probably know just a tad more than you about these things.

And I have ZERO interest in dying of an untreated bacterial infection.

Fortunately, the combination of getting flu shots religiously EVERY year and my giving up animal products in my diet seems to be keeping me from being quite so susceptible to respiratory infections. Haven't had any in 8 months.

[Aristus]

24. You can have lung and sinus infections that are viral. it doesn't matter how many times you've had

it. A viral URI doesn't require antibiotics; if fact, they are contraindicated, due to the reasons ennumerated above; the possibility of contributing to antibiotic resistance.

I have patients tell me all the time: "I KNOW MY BODY!" And I acknowledge that they certainly do. But they may not know medical science.

Antibiotics won't treat a virus. Neither 55 times, nor 55,000 times. They won't treat a virus. And as far as green mucous goes, the only colors of mucous you need to be concerned about are red or black. If it's green, yellow, or clear, you're going to be all right.

Your pulmonologist sounds like the kind of provider who prescribes antibiotics just to get overanxious patients off his back with their incessant demands for antimicrobials. I don't endorse that kind of medical practice, but I can at least understand it.

Think of this the next time you insist on antibiotics for a viral infection.

I have patients tell me all the time that the last time they had a virus, their provider gave them penicillin or something, and then they felt better. I tell these patients: "Look. You had a virus, which antibiotics won't touch. You got better on your own, as you will when you have a common URI virus, and you thought it was the antibiotics that did it."

The vast majority of medical practitioners are conscientious, caring scientists who want to do what's best for your health. We don't derive mean-spirited enjoyment from denying you medication simply out of spite.

[jeff47]

40. You won't get dark green phlegm with a viral infection. (nt)

[Aristus]

49. Happens all the time.

But thank you. Concern noted...

[Ms. Toad]

128. Yes you do.

Every single time I have a cold that I don't catch early enough with zinc, I have dark green phlegm for weeks on end.

Color doesn't make it bacterial:
http://shs.osu.edu/blog/medical-mythbusters-green-snot
http://www.entnyc.info/2013/08/26/debunking-the-green-mucus-myth/

[pnwmom]

217. If a person has a cough for weeks on end,

a doctor should rule out walking pneumonia, which can be effectively treated with certain antibiotics, and whooping cough (in addition to asthma -- the only symptom of which can be coughing). I read somewhere that a fourth of adult admissions with a fever and a cough to CA emergency rooms were caused by whooping cough. In adults, the symptoms are often not that severe, but they can go on for a long time.

Walking pneumonia can go away by itself if you wait long enough. But it can also lead to a worse bacterial infection, if left untreated.

(This fall I had the adult vaccine for whooping cough, by the way. It was no worse than a flu shot.)

[Ms. Toad]

228. The key part of that being - "a doctor should rule out"

I do have some concern that far too many doctors prescribe antibiotics to get their patients to stop complaining, but my primary concern is just prescribing antibiotics over the phone because a patient doesn't want to come in.

And, just to continue my general theme, pneumonia can either be viral, bacterial, or in some instances caused by parasites - so even pneumonia shouldn't just have antibiotics thrown at it.

(My personal weeks-on-end is just the pattern my colds have followed since I was a child. Violent coughing to clear the thick green phlegm for at least two weeks, and another two in the lead-up and tail end. Perhaps a third of a time it turned into bronchitis (diagnosed by a doctor). Until I discovered zinc a dozen or so years ago. I just got over one I caught early enough with zinc - started with a scratchy throat on Monday around 5 PM, and was done by Saturday morning. So after 40 years of never having a cold last fewer than 4 weeks, the only time they last longer than a week now is when I ignore that first scratchy throat - or exhausted my stock of zinc and can't get to a store fast enough).

[pnwmom]

238. I swear by zinc also, but for once, it didn't work recently.

Turned out I had strep throat (for the first and hopefully last time.)

The other thing I've learned is that, despite what they say, I need to take antihistamines when I have a cold -- because just as a cold virus triggers my asthma symptoms, it triggers my upper respiratory allergies, too. So the antihistamines might not help with the cold -- but it keeps my allergic reaction a little bit at bay. Since I figured that out I've managed to avoid any more sinus infections.

[Ms. Toad]

243. That would be why it didn't work . . .

It doesn't work for the flu, either :/

Good job figuring out what works.

[3catwoman3]

138. Yes, you can. Toward the...

..end of a viral upper respiratory infection, in what is known as the resolution phase, secretions can be a variety of disgusting colors. The same is true for secretions that have sat around overnight and get cleared out first thing in the morning

What matters just as much, if not more, is the color of the mucous membrane lining the nose. If there is a bacterial sinusitis, the membrane is typically bright red and swollen. When we are healthy, that membrane is about the same shade of pink as the lining of the cheeks. When allergies are the primary culprit, the membrane will look pale.

The best a health care professional can do when asked to treat over the phone is make a guess. While it is an educated guess, it is still a guess. I tell the parents of my patients that I do not wish to risk guessing wrong for their children.

(credentials for the above - nurse practitioner since 1976)

[Maraya1969]

51. Really? What would you prescribe a person who is having asthmatic

symptoms, thick green mucus, congestion in the lungs and sinuses and no fever?

Your patients are smarter than you think. Get over yourself.

[Aristus]

67. First, a nebulizer treatment, then symptomatic treatment.

In the abscence of evidence for bacterial infection: no antibiotics.

I treat acute asthma exacerbations on a daily basis. I never said my patients weren't smart; just not trained in medicine. There's a difference...

[Maraya1969]

96. I also said green thick mucus and no fever. Is that not evidense of

a bacterial infection? Do you actually need to LOOK at the mucus to see if the patient knows what green and thick mean?

And I have a nebulizer right here with tons of medication to go in it. I also take Symbacort and albuterol.

[Aristus]

108. Yeah, I always like to exam my patients.Obviously, I can't do that in this case.

My adult medicine instructor told us you can get 80% of your diagnoses from the history of present illness alone. And based on your history, I'm not convinced it's a bacterial infection.

Very likely, you have viral bronchitis. Without an exam, of course, hard to say.

Still: no antibiotics. Give your doctor a break. He sounds like he knows what he's doing...

[Maraya1969]

112. Did you not hear? I posted that I am now back from the doctor's and

the pharmacy and he prescribed an ANTIBIOTIC!

You are starting to scare me know.

[Aristus]

118. Boo!

Probably because you kept going on and on about it.

There are some providers, you nag them enough, they'll do it to get rid of you.

Feel better...

[Maraya1969]

123. Can't stand it when you are wrong?

[Aristus]

141. Yes. I can't stand it when I'm wrong.

There have been times when I treated a patient empirically with antibiotics, and obtained a specimen for lab testing, culture and sensitivity. When it came back negative for bacterial infection, I kicked myself for jumping the gun. But being wrong is when I learn what to do, and what not to do. Conservative antibiotic prescription is about the only thing about me that is conservative. But it's necessary for good clinical medical practice.

If you view your new prescription as some sort of victory, well, you go, girl. I'd hate to deny someone a triumph.

[elias7]

165. On night duty in the ED for a few nights

Last night, tonight and tomorrow night. I'll have this discussion in one form or another at least half a dozen times. Patients still go away pissed rather than understand that proper medicine was practiced. Sometimes I give in just to avoid having the life sucked out of me.

[Aristus]

172. Right there with you.

And please accept my deepest respect for everyone who works in emergency medicine. You guys are the best.

We live in a society that teaches us from birth to go after what we want. And to harp, and crab, and complain, and "I-wanna-speak-to-your-supervisor" until you get it. Now if you're buying a widget, I can see holding out for exactly what you want. But if what we want is not necessarily the best thing for us, as determined by trained professionals, constant complaining is only a way for one to make oneself a pain in the ass, as I'm sure you see all the time.

Hang in there...

[Ruby the Liberal]

203. Thank you for weighing in on this

and sticking to your guns. I am terrified about the ramifications of antibiotic resistancy, and it is coming. I am allergic (anaphalactic) to about everything but zithromax and cipro - and as I am sure you are aware, they are not indicated but for a handful of things. Right now - head to toe in a doxycycline rash as I type this (for 2 weeks and counting) because of a post-biopsy incident where they couldn't stop the bleeding and wanted to be "proactive".

[Drahthaardogs]

205. I hate to be a downer but come watch us brand this spring

I will show you what overuse of antibiotics looks like. It was like the old days when they told you to not brush your teeth with the water onwhile major ditches were unlined and had shrinkage up to twenty percent. Denying someone penicillin is doing very little, but if it makes you feel better, cool. And yes I am a doctor but not a MD.

[Aristus]

207. I'm aware of the role that feeding massive amounts of antibiotics to livestock

in factory farming installations can do. Nowhere in any of my replies did I deny that.

I'm talking about antibiotic resistance in human beings. It's a very real concern to those of us who practice medicine on homo sapiens. It's certainly a concern at the lab that does our culturing. Along with the results of the culture, they include a sensitivity list, revealing what medications the pathogen is sensitive to, and just as important, what it is resistant to.

You worry about the livestock, cowboy. I'll deal with the human beings.

And if that hurts your feelings, remember that you accused me of denying medications to patients because it made me feel 'cool'.

That's kind of a dick thing to say...

[Drahthaardogs]

241. Okay Doc

why don't you explain to me the mode of action, in THIS woman, by which a bacterium becomes resistant to antibiotics IF (by your own deduction) no bacterium is present....


The problem is not some poor lady who right or wrong, really believes she NEEDS an antibiotic. The problem is hog farms, feed lots, bee yards, chicken houses, and over the counter sales in third world countries.

The rice fields in California are all under 18-inches of water but you go ahead and turn that faucet on and off while you brush your teeth.

[Aristus]

249. Wow! Really? Are you sure you want to make an argument that's that stupid?

I mean, shit! I'm embarrassed for you!

You should try this on someone who is not as smart as I am.

(Incidentally, I'm not a doctor; I'm a Physician Assistant. But don't let that throw you. I've been trained in clinical medicine. Got a diploma and a medical license and everything. I'm not qualified to brand cattle, but that's not what I do all day in clinic anyway.)

I never said bacteria weren't present. Simply that they may not be pathogenic, or contributing to the patient's current infection.

Pathogenic bacteria rarely need to be controlled by bacteriocidal medications. This is most often done by simple, natural growth of beneficial bacteria. We call it 'flora' in clinical medicine, because if you say 'bacteria', people freak out. Just look at, well, every reply up above that wasn't posted by allied health personnel.

Of the millions of varieties of bacteria, the vast majority of them are neither helpful nor harmful; they're just there. Most of the rest are beneficial to humans, helping us to digest our food, and so on. Only a very small portion of these organisms are pathogenic.

Two simple examples of flora are gut flora and vaginal flora. The growth of billions (and in the colon, trillions) of these bacteria help to arrest the growth, and crowd out the population of pathogenic bacteria. Consumption of too many antibiotic medications, or routine use of some specific antibiotics, kill not only the bad bacteria, but the good, as well. Which is why antibiotic use can cause bacterial vaginosis or yeast infections in women, and diarrhea in both men and women. With the overgrowth of flora killed off by the medication, any pathogens that survived due to resistance mutation are free to multiply like crazy, with no flora to check the spread.

If you want to have a serious discussion with a serious scientist, I welcome that. If you're just going to post idiotic arguments in order to be a pain in the ass, well, that's not going to hurt me. But other people may be mislead by your misinformation, and that's not good. Show some responsibility, and drop out of the discussion.

[Drahthaardogs]

259. So you are telling me, that the gut flora will become resistant

and suddenly become dangerous in an otherwise healthy individual. How many people do you suppose died last year from drug resistant gut flora that overpopulated from antibiotic use? How many subsequent people were infected when this deleterious bacteria moved through the population?

It.Does.Not.Happen. The microbiology and genetics do not work that way. Sorry, it just does not. True resistance takes a long time to develop. The relative risk of dosing someone with a full course of un-needed antibiotics in a non-hospital setting is at, or close to zero.


Now, 80% of all antibiotics produced are fed to animals in low doses or sprayed on crops. THAT is a dangerous practice. Read below and know your true enemy.

http://www.jhsph.edu/news/news-releases/2013/casey-schwartz-mrsa.html

If you want to have a serious discussion regarding horizontal acquisition of resistance genes, phagocytotic substitution of DNA into the chromosome, or by mutations in different chromosomal via cross linking, you let me know.

[Aristus]

260. I can see this is going nowhere. You obviously didn't read what I wrote.

Or are just perpetuating this out of bullheadedness.

I didn't say that the normal gut flora would become resistant, but the pathogenic bacteria normal growth of flora usually keeps under control.

Shit. It's giving me a headache just trying to think down to your level.

And you departed from the point of this whole shindig ages ago: which was - antibiotics don't treat viral infections, and should not be prescribed for them. That's the point. Everything else is just hot air.

[Drahthaardogs]

261. Of course they don't work on viruses. My point is,

that poor lady THINKS she needs them. You make it sound like giving her a course of antibiotics is just horrible and I am saying, oh nonsense. The science does NOT support that premise. If it makes her feel better, there is little to no chance of it actually contributing to REAL dangerous and drug resistant bacteria. If her pulmonologist gives her antibiotics more liberally, statistically speaking, from a relative risk point of view, it is not doing any harm. He is not being lazy, it is his bedside manner. He may have decided that the mental benefits outweigh the risks (which, they most likely do since the RR is at or about 0 )

Another thing that grinds my gears are physicians that tell people moist smokeless tobacco is a strong promoter of oral cancer. Again, when you actually crunch the numbers you will see that it likely is not, or if it does contribute to oral cancer, it carries a relative risk extremely low.

[pnwmom]

223. Are you talking about feeding antibiotics to livestock?

If so, you're absolutely right. That's a much bigger problem. Feeding last-resort antibiotics to livestock for the purposes of weight gain should be a criminal offense.

[pnwmom]

221. How will you feel the first time one of your patients --

with a history of asthma and repeated pneumonias -- dies of a treatable pneumonia while you were waiting for the culture to come back?

One of our relatives, a man in his 60's, went to his doctor's office with a fever and cough. They took a culture and told him to take Tylenol. Feeling worse that night, he went to the emergency room -- and died a few hours later.

Sometimes pneumonias are very fast.

[Aristus]

224. Wow. Now you have me killing people, huh?

If the State of Washington finds out, they may not renew my license to practice clinical medicine.

I don't know anything about this relative of yours other than that he died.

Think before you post.

If a patient walks into any medical facility with a fever and a cough, he's going to get more than Tylenol. Certainly from me, he will. I'll auscultate his lungs very carefully. If there are no adventitious sounds, I'll defer antibiotic treatment. If there are rales or crackling, I'll prescribe an appropriate prophy antibiotic. If his O2 saturation is less than 95%, he'll get a nebulizer treatment. If he doesn't have diabetes, I'll prescribe him a prednisone taper for lung inflammation, an albuterol inhaler for maintenance, an appropriate cough suppressant, and refer him for a chest x-ray. I'll schedule a follow-up appointment, and advise him of precautions if his symptoms get worse. "If respiratory distress develops, have someone take you to the emergency room right away."

There. You see? A proper workup. That's how it's done in the big city. Or the small town. Or in rural medicine.

That's how it's done.

I'd feel bad if your relative died just so you could make a poorly informed point...

[pnwmom]

226. Some hospital and doctor mistakes do kill people.

My relatives' family won a malpractice suit -- against the doctor and the hospital -- because the doctor DID fail to prescribe anything but Tylenol; and the hospital later admitted him but didn't start him on any antibiotics. They needed his doctor's order to do that and his doctor didn't come in that night. (This was in a small hospital in a rural area, and there was no such thing as a "hospitalist" twenty years ago -- at least in that part of the country.)

So the only treatment of a man with a history of emphysema (due to work in mines) was an oxygen tent. But they did think about treating him. A nurse wrote in his chart that he was cyanotic, so she asked him if he "needed anything." He said he didn't know, and died within the hour. All alone. They found him hours after he had died.

You see? That's how fast pneumonia can kill someone, when he's unlucky enough not to get antibiotics as quickly as he needs them.

[Barack_America]

234. He needed intubation, not antibiotics.

The award was for lack of medical evaluation, not lack of antibiotics. Antibiotics are not a first line treatment for a COPD exacerbation. They are a consideration, but not the first thing that should be prescribed.

[pnwmom]

236. The doctors who testified said he should have been put on I.V. antibiotics.

He died of bacterial pneumonia, according to his autopsy. (Which said his heart was in great shape, by the way.) The only reason he wasn't put on antibiotics was because the hospital was waiting for him to see the doctor.

[Barack_America]

244. Antibiotics don't treat respiratory failure.

Antibiotics were indicated, but they would not have saved your uncle. He needed a physical exam, chest X-ray and a blood gas. He likely needed mechanical ventilation. He could have been started on the biggest gun antibiotic in the hospital and would not have survived without these measures.

Bottom line, antibiotics should never be given without a clinical evaluation and diagnosis.

Here's a fun fact for you, when someone comes in with full-on septic shock, what is the initial treatment? Antibiotics? No, pure and simple fluids. Antibiotics are a secondary consideration after the patient is somewhat stabilized and a presumed source identified.

[pnwmom]

256. He wasn't in respiratory failure when he entered the hospital.

That afternoon, he was still driving around town on his own.

The respiratory failure happened at least ten hours after he got to the hospital.

[Barack_America]

233. Um, no. Pneumonia is diagnosed by chest X-ray, not sputum culture.

For the old school docs, physical exam is often enough. The point of the sputum culture is to tailor the antibiotic therapy, not to decide whether to prescribe antibiotics at all. Once the culture comes back you can narrow your spectrum or switch classes all together if the infection is resistant (more and more common these days now everyone is demanding antibiotics for their viral infections).

[pnwmom]

237. Often doctors will wait to prescribe any antibiotic

till they get the result of the culture back.

And in the meantime, an infection that was just beginning (and didn't show up on the X-ray yet) can turn into a life-threatening pneumonia.

You are aware, aren't you, that not every pneumonia shows up on an x-ray? Especially in the earlier, more treatable stages?

[pnwmom]

218. And what evidence are you looking for? Cultures that take days

to be processed?

The last time I went through a bad pneumonia, I had to wait for the results to come back so I could start treatment. They ended up having to give me three different antibiotics to get rid of it.

After that, my doctor told me to call her as soon as I get a fever with a cough.

[pnwmom]

213. You're not acknowledging that viral pneumonia can be complicated

by secondary bacterial infections; or that mycoplasmal pneumonia can be effectively treated with antibiotics.

[Aristus]

220. Yes. I didn't acknowledge that.

If I acknowledge everything an antibiotic-obsessed patient (or participant in this thread, for that matter) parses out of one of my replies, we'll be here all night.

If I diagnose a patient with viral pneumonia, I treat the symptoms. I also get a chest x-ray to confirm or rule out pneumonia.

And I plan close follow-up with the patients to monitor for worsening symptoms or for secondary infection. If those present, I treat appropriately. (It's worth pointing out that follow-up often requires a return visit to the clinic, which some in this thread have characterized as a greedy grab for more money. You can't win with some people.)

The point we advocates for sensible antimicrobial prescribing are trying to make in this thread is that we treat appropriately, using evidence-based medicine, and standard of care. If antibiotics are indicated by history of present illness, review of systems, physical exam, and lab testing, we prescribe them.

But the detractors have turned this into: "My provider hates me and is a bad provider because he doesn't give me whatever I want, whenever I want it."

[pnwmom]

222. If you really wanted to advocate for all of us,

you'd be urging the FDA and the Dept. of Agriculture (as I am) about allowing last-resort antibiotics (and other antibiotics) to be fed to livestock to increase their weight gain.

That's a bigger problem than some doctors over-prescribing antibiotics.

http://www.ucsusa.org/food_and_agriculture/our-failing-food-system/industrial-agriculture/prescription-for-trouble.html


Resistant bacteria that develop in CAFOs (confined animal feeding operations) can be transferred to the general human population via food. The government, public health officials, and physicians are increasingly concerned about foodborne diseases caused by Campylobacter and Salmonella bacteria. According to the Centers for Disease Control and Prevention (CDC), nationwide there are 76 million cases of foodborne illness a year and 5000 deaths from viral and bacterial pathogens.


SNIP

In addition, livestock producers have bought into the myth that bacteria that cause illness in humans develop resistance only in medical settings. While no one denies that unwise use of antibiotics in human medicine is a source of serious resistance problems, this view has prevented recognition of one of the best opportunities to cut back on these drugs—in nontherapeutic agricultural applications.

Agricultural use for growth promotion and prevention of diseases due to overcrowded CAFO conditions accounts for the vast majority of the antibiotics and related drugs used in the United States. This enormous amount of drugs is delivered to animals under conditions conducive to the development of resistance. Large numbers of similar animals are raised in CAFOs that characterize contemporary agriculture. Chicken houses, for example, can contain 50,000 birds. And the Environmental Protection Agency estimates there are about 11,000 operations with over 1,000 beef cattle, 700 dairy cattle, 2,500 hogs, or 30,000–125,000 chickens.

In such large operations, antibiotics are often delivered to animals in food and water over extended periods. Bacteria are constantly being exposed to the drugs and eliminated from the populations. It is hard to imagine how resistance would not develop under these circumstances. Indeed, industrial livestock systems are hog heaven for resistant bacteria.

[Aristus]

225. There are plenty of people advocating for that already.

And I support their advocacy. In the meantime, I'm going to practice clinical medicine.

Please don't waste my time with this. Your point in all this seems to be: "If you're not doing X you're not doing anything!"

Not true.

[pnwmom]

227. "Please don't waste my time with this."

I'm not the one causing you to spend your precious time on an online discussion board!


Remember this sudden death?
http://www.nytimes.com/1990/05/29/science/the-doctor-s-world-henson-death-shows-danger-of-pneumonia.html
THE untimely death of Jim Henson, the creator of the Muppets, from pneumonia this month at the age of 53 may have shocked many Americans who believed that bacterial infections no longer could kill with such swiftness.
Antibiotics, vaccines and other health measures have dramatically reduced the incidence and consequences of many bacterial infections. But antibiotics must be carefully selected and they are lifesavers only when given in time. Such drugs cannot always be relied on to be a last-minute salvation, particularly if the microbes have gotten the upper hand by spreading through the body.

SNIP

Dr. David Gelmont, who headed the intensive care team that treated Mr. Henson at New York Hospital, believes he died from toxic shock syndrome produced by the streptococcal bacteria. The condition is similar to the toxic shock epidemic from staphylococcal infections that struck women who used a certain kind of tampon in the early 1980's. Streptococci Group A, the type that killed Mr. Henson, also causes scarlet fever and rheumatic fever. Health officials suspect that Group A is becoming more powerful and is occurring more often.

Antibiotics might have saved Mr. Henson's life if he had come to the hospital a few hours earlier, Dr. Gelmont said, illustrating how speed can count in many types of infections.

[Aristus]

232. Wasting bandwidth, then.

I, and the other medical providers and allied health personnel came onto this thread to point out the detrimental effects of prescribing antibiotics for viral infections, and about being judicious about prescribing them in general.

You, and others, including the OP, have made a series of nonsensical arguments that are essentially a wasteof time, and ignore the good points we have made.

Rebuttal has been basically:

"Why don't you do what the patient wants?"

"Did you try this? If not, why not?"

"How would you feel if...?"

"Cows get way more antibiotics than humans do, so good, sound medical practice is meaningless."

"My cousin's barber's next door neighbor's nephew died from not getting antibiotics!"

And as the biggest fan of the Muppets on the planet, it pains me to point out that Henson's doctor himself stated that Henson put off going to the hospital until it was too late. An indication that the patient, any patient, bears some responsibility in evaluation and outcome.

[pnwmom]

240. There are good doctors, and there are M.Deities.

I have great doctors now, but I have run into more than one in the past that wasn't a good listener. And being a good listener is a critical skill.

I brought my two year old in to see a pediatrician at the only practice in town. His regular doctor couldn't see him, so we saw the doc with an opening. My son had a fever and visibly swollen lymph notes in his neck, and he wouldn't turn his head up to look at me. He was my third child and I'd never seen anything like this before.

The doc examined him and talked to me for about five minutes, and then diagnosed him with a "virus." He said he saw a lot of it going around, and that there was nothing to do but wait it out, and make him comfortable with Tylenol and fluids. So we left.

Halfway home, I changed my mind, and took my son to the emergency room instead. They took a blood sample and discovered he had a serious bacterial infection. They told me it was very lucky I'd gotten him in when I did.

When I told my regular pediatrician what happened, she said she was going to have to speak to the other doctor about it. She said he wasn't always a good listener, and he needed to know that this had happened.

And she underlined that, as a parent, I should always trust my gut. My gut feeling had been correct, and the doctor -- despite his medical degree -- was wrong. It wasn't the "virus" that was going around.

[Aristus]

245. Nobody denies that there are some bad practitioners out there.

That's not the issue. I have already addressed the fact that when I diagnose a patient with a bacterial infection, I prescribe an appropriate antibiotic.

The issue is antibiotics don't cure viruses, and no amount of wishing or "one time, my kid had..." is going to make it so.

[karynnj]

33. If your "lung Doctor" will call it in, why not call him/her?

I think it makes sense for the doctor to see someone before prescribing medicine. It may be that what he sees will lead him to give you exactly what YOU think is needed -- or he may see that the problem is something different.

I know there were times when my three daughters were all 5 and under, that I was SURE "pink medicine" was needed for one - only to pack the three into the car and have the sick one come up negative for strep throat - which I was positive she had because of how her throat looked, fever and how bad she felt. Sure enough, chicken soup, a humidifier etc were enough.

[Maraya1969]

56. My PULMONOLOGIST is away and he will not prescribe unless he is in

the office. Which I can understand because he has to look at my chart. My GP has that information also and he can always call the pulmonologist for more information.

Don't you people remember when our health care was not so completely controlled? We all survived!

[BlueStreak]

81. I am trying to understand the complaint

You pulmonologist won't phone in an antibiotic when he is away, but would do it without seeing you if he were in? That doesn't make much sense. And you are angry that your PCP wants to see you before prescribing anything? That also doesn't make any sense.

There is a reason these drugs aren't offered over the counter.

I, as you say, you have this condition so frequently that you are able to diagnose your own treatment, it seems to me your treatment isn't working very well.

[Maraya1969]

85. MY PULMONOLOGIST HAS BEEN PRESCRIBING FOR ME FOR YEARS!

But he needs to be in his office to access my chart to make sure, (although that used to not be necessary). My regular MD has my chart too.

[BlueStreak]

91. If he has been doing this for years and you keep requiring antibiotics

it sounds like they aren't working very well. It is not normal for a person to need frequent antibiotics. I'm not a doctor, but it sure seems that at minimum he should be investigating your immune system.

[treestar]

182. the pulmonologist might feel more comfortable doing it

the GP might not. He's not a specialist in that field. He has not dealt with you on this issue so directly.

[Yo_Mama]

180. Okay, so you normally see another doctor for this sort of thing

and then you just wanted to call your "other" doctor because the one who normally treats you for this was away? That does not make sense to me.

If your lung doctor is normally treating you for this, perhaps he feels confident about the prescription, but if a doctor who normally doesn't treat your lungs just randomly writes a prescription for a patient, it can be malpractice. If you developed something like C. Dif. from an unneeded antibiotic, your doctor might be in line for a lawsuit.

I don't think the doctor was being unreasonable at all.

[Samantha]

58. I agree with you

When one has a repeated pattern of vulnerability for a certain problem, for years has gone to the doctor when the very same symptoms as always appear, the doctor always prescribes the same medicine in the same dosage, why should you have to pay for a doctor's visit and jump thru a lot of hoops to prove you have what you have often had for the same reasons? You don't have to be a doctor for that, just a person with common sense.

Sam

[Ms. Toad]

133. Because bacterial infections result from a specific exposure to a specific bacteria.

And they need to be diagnosed (preferably by a culture) to determine the proper antibiotic to treat the specific bacteria causing the infection.

They are not (as a general rule) part of a repeated pattern of vulnerability. (There are some rare circumstances when they are - my daughter had what appeared to be repeated bouts of cellulitis. We were specifically trained by her infectious disease doc what symptoms to look for and how to track the progress of the infection. Even so, and even though when we showed up at the ER with one of these bouts, we were ushered in ahead of anyone who didn't have a bone fracture sticking through their skin - they are that serious - her doctor (one of the top in the field NEVER suggested we start antibiotics without him laying eyes his own eyes (or the eyes of trained clinicians) on the hot spot before starting antibiotics.

Believe me - cellulitis is far more immediately serious than bronchitis - yet this specialist in infectious disease, who became very confident in my ability to recognize what we all believed was a bacterial infection - and which (unlike respiratory infections is almost never viral), would never have prescribed an antibiotic sight unseen.

And - the kicker - even with this doctor (and at least two other ER doctors) diagnosing it as cellulitis (almost always bacterial, and quickly life threatening), and watching it "respond" to antibiotics in exactly the same way a bacterial infection should have, it turns out it wasn't bacterial. Which we discovered after about 3 years of treating repeated hot spots as bacterial - when a new hot spot developed while she was already on antibiotics.

So - yes. Even when you have what appears to be a repeated pattern of vulnerability over time, you need to be seen (and preferably cultured) by a medical professional before antibiotics are administered. (In our case cultures were not an option, without a surgical biopsy, which we had near the end of the period of repeated "infections" which resulted in a diagnosis that she had vasculitis, which can mimic cellulitis even to the eyes of a trained professional).

[Ms. Toad]

121. Do you really not understand that infections

can be caused by either bacteria (which the proper antibiotic can treat) or a virus (which an antibiotic will not touch - and using an antibiotic for an infection which is not caused by a virus risks creating antibiotic resistant bacteria).

We are at risk of losing major antibiotics which are needed to treat life threatening illnesses (like MRSA and VRSA), because doctors prescribe antibiotics merely because it is easier than educating patients that most bronchial and sinus infections are viral, not bacterial. Even if you are congested. That over-prescription is a major contributor to antibiotics becoming ineffective. Even if the snot is thick. Even if the snot is green. None of those are signs that the infection is bacterial. And if your lung doctor is calling in an antibiotic, sight unseen (absent special circumstances which make you particularly susceptible to bacterial infections - or make it particularly risky that a bacterial infection would spiral out of control quickly), you would be better served by finding a new lung doctor.

It has nothing to do with money, and everything to do with the responsible practice of medicine.

[CreekDog]

209. you've had something that required antibiotics 55 times?

really?

probably not really.

[GeorgeGist]

235. Call the lung guy.

[pnwmom]

212. How can you say that? Asthmatics often get viral infections

that trigger asthma that makes them susceptible to secondary infections -- caused by bacteria.

[azurnoir]

230. actually if she has green mucus she most likely has a bacterial infection

which are wait for it-treated with antibiotics

[cleanhippie]

252. So you too, are a doctor?

One that diagnoses people over the Internet without ever seeing them?


Yeah, that's what I thought.

You have a nice day.

[azurnoir]

257. I think you should look down thread :)

and no I'm a clinical assistant

[Niceguy1]

130. if you are so unstable that the walk from the car to

His office is too much for you then tou do need to see the doctor...a phone in rx would be foolish .

[Orrex]

6. One thing about over-prescribing

I'm not too worried about a person who takes too much antibiotic, because the amount that they might consume in an entire life time is dwarfed many times over by the amount pissed out by pigs and cattle on a single factory farm in a single day.

The real threat over resistant strains comes from overuse of livestock antibiotic.


Even so, that doesn't mean that people should get to order their own prescriptions on demand.

[pipi_k]

18. Another huge problem

is the numbers of people who stop taking their antibiotics as soon as they start to feel better, thinking they can save the rest for next time they get sick again and thus avoid another visit to the doctor.

This only enables the bacteria that survived the initial stages of the antibiotic to build up an immunity...resistance...to that antibiotic, then pass it on to their progeny , which is what creates Superbugs.

We are slowly killing ourselves with stupidity and ignorance...

[Orrex]

25. That's a great observation

I've seldom had to take antibiotics in my adult life, but I take it as a minor point of pride that I've always taken the full course!

[pipi_k]

190. Same here, and...

I really wish that, when we're told to do or not do something, there would be a reason included so people know what the consequences would be.

I'm one of those people who always wants to know WHY.

Like, for example, when I heard that you shouldn't put an egg in the microwave without piercing the yolk first.

WHY????

So I tried it.

Now I know why

(it explodes)

So, antibiotic bottles say to take all of it, but don't say why. They really need to.

[marsis]

92. Just to play the devils advocate

here. Most get that antibiotics don't work on virus' and yes overuse is a huge problem. But as the original poster commented, it is such a hassle to get what you need.
Maybe if was easier for one with personal body awareness to get them they wouldn't have to try to save them for the next time.

[Ms. Toad]

136. Personal body awarness means bupkus in terms of distinguishing bacterial infections

from viral ones.

Sometimes even trained professionals cannot tell the difference (see my earlier post about our experience being misdiagnosed with repeated life-threatening bacterial infections for more than 3 years by at least three professionals). The only sure way to know is to culture it or, if there is nothing to culture, to biopsy the lesion.

[marsis]

155. bupkus well that is a stretch,

the same misdiagnosis' also applies to heart conditions or any other myriad of medical problems. I've heard many stories of people not getting correct diagnosis for any number of problems. Maybe you gave a valid argument for making your own diagnosis since the medical profession can't.

As the poster posted this is a recurring problem that many, like myself, suffer with. How many times must one have the same exact symptoms before you might think they are aware of what's happening to them.

[Ms. Toad]

174. Unfortunately, with respect to the distinction between viral and bacterial respiratory infections

the symptoms are virtually indistinguishable. Even if the last 20 were bacterial (and merely having been treated as bacterial - unless cultures were done - doesn't mean they were), it does not mean that this one is. It would depend on what particular microbe caused the infection (and the vast majority are viral, not bacterial).

I am a big believer in people knowing their bodies - I have specifically "diagnosed" a rare (29,000 in the US) condition my daughter had when the doctor was sure nothing was wrong, and I also knew something serious was wrong with her for two other conditions when two different doctors were sure nothing was wrong - and had I had the research skills I have now, I would have specifically "diagnosed" those two conditions as well. (I say "diagnosed" because even though I identified the disease and the tests which needed to be run to verify the disease she had, the actual diagnosis was made by the doctor after he finally ran the tests to humor me and confirmed that I was correct.)

But - distinguishing between a viral respiratory condition and a bacterial respiratory condition is not something that anyone (even doctors) can do without a culture or observation about how it progresses (or responds to antibiotics) over time. And - with a daughter who cannot tolerate most oral antibiotics, the mis/over-use of antibiotics is a MAJOR issue for me. She is likely to have repeated bacterial infections because at some point bacterial backflow from her intestine - and a compromised blood flow because of cirrhosis (a consequence of the autoimmune disorder she has) - will almost certainly result in very hard to treat bacterial cholangitis. If one of the few antibiotics she can tolerate becomes ineffective because of antibiotic resistance created by taking antibiotics for viral infections, and the only remaining ones which are effective against a bacterial infection are ones she cannot tolerate, she will be up a creek without a paddle. And, although the range of antibiotics she can tolerate is more limited than most people, we are all too rapidly heading to a post-antibiotic world for everyone - because so many antibiotic resistant strains of bacteria have developed.

Actually going to the doctor to have the doctor make an assessment as to whether - this time - the infection (of similar repeated infections) is actually bacterial in nature (rather than the far more common viral variety) is both good medicine, and a small price to pay not to lose the effectiveness (for everyone) of antibiotics which are necessary to treat some increasingly deadly diseases (MRSA and VRSA, to name two).

[marsis]

255. So glad you have a handle

on your daughters condition, people really need to be hands on these days.

But what you are suggesting is some pay $200+ (office visit, lab work, mileage) every time they get that chesty condition, which was 2-3 times a year for me, and then wait a day or more. Then drive another 40 miles to get a prescription. That's a pretty big price for many of us on a recurring condition.

[Ms. Toad]

258. I suspect doing the test once or twice

would convince you that it really isn't bacterial. The vast majority aren't, and will clear up on their own.

Until I discovered zinc, all of my colds went in that direction. I had multiple diagnoses with bronchitis (as well as many times I didn't bother going to the doctor, because I knew the diagnosis would be bronchitis). When the doctor (routinely) prescribed antibiotics, I asked how likely it was that it had a bacterial cause - and his answer was always not likely. He was prescribing antibiotics for two reasons (1) the very small chance that it was bacterial and (2) he was tired of arguing with patients who insisted that they needed something for their condition (or that all the other doctors prescribed antibiotics, etc.) Way back when (when the patterns were established - and the myths/misunderstandings created) we were really dumb about antibiotic resistance. Now we know better - but the patterns still hang on because of the all of the people who were prescribed antibiotics - not because the infection was caused by bacteria, but for the reasons above.

Patterns are very hard to break - but this is a very dangerous one, so I work on breaking it wherever I see it. And no, I'm actually not suggesting that you pay that much money every time you get that chesty condition. What I am suggesting is that you sit down with your doctor at least once and have a heart to heart about how likely it is that your chesty condition is really bacterial in nature, so aren't taking antibiotics for these conditions unless there is a very specific reason your doctor believes your chesty conditions, unlike the vast majority, are bacterial in nature (Rather than just continuing to demand antibiotics because that is what you have always received in the past.)

Because continuing to use antibiotics when they are not necessary puts my daughter's life at risk. She really is likely to have recurring bacterial infections in her liver and bile ducts - and if the infection is caused by a bacteria that learned resistance because of the misuse of antibiotics, I'm going to be really pissed (and I am, perhaps, more sensitive to this particular issue because a friend with my daughter's condition died recently, and part of the cause was a liver/bile duct infection by VRE - vancomycin resistant enterococci.).

[pipi_k]

191. Maybe.

That's a possibility...

But if they really really understood the ramifications of doing that, they might think twice.

But then, most people sort of don't give a shit about the long term. It's all about the NOW.

Young people who spend hours in the sun not even thinking about what might happen to their skin in 30 or 40 years.

Young women who wear torture devices on their feet (i.e. "shoes&quot that could set them up for severe foot problems in later life.

Smokers. Lets not even go there.

So yes, I suppose anything is possible, but I don't have much faith in the intelligence of most people, and even if they could get what they needed without a big hassle, they might still hoard the meds "just in case".

[Jesus Malverde]

36. Feeding antibiotics to cattle is what is causing epidemic of antibiotic-resistant bacteria.

They buy antibiotics by the ton.

[Mariana]

117. Lying is not the right thing.

Refusing to prescribe an antibiotic without seeing the patient is on thing. Lying about the reason for doing so is wrong.

[pnwmom]

211. Are you an asthmatic? How many times have you yourself had pneumonia?

If you were a doctor or even an experienced patient, you would know that many early cases of pneumonia aren't detectable to the doctor or visible on an x-ray. But in the course of a day, the symptoms can worsen so quickly that the patient needs to be hospitalized -- or worse.

I've had pneumonia more times than I care to admit, and I know exactly how it feels -- just like I know how a UTI feels. My doctor finally told to call her on the first day that I have a fever along with a cough. She doesn't wait around till pneumonia is unmistakable.

[cleanhippie]

253. Jesus fucking Christ. Who knew that advising one to get proper medical attention would be so bad!

What. The. Fuck.

[sharp_stick]

2. You aren't allowed to prescribe your own drugs

no matter what the drug is. If it's a refill they'll call it in but not if it's a new prescription.

[Th1onein]

164. That is not true.

[Orrex]

4. Why don't you also order 500 Vicodin, since you're self-prescribing anyway?

[Maraya1969]

5. Oh Gawd.

[NV Whino]

10. I hear you

When you have what amounts to a chronic condition, and an antibiotic clears it up, and has cleared it up every time before, making the trip to the office, waiting twenty minutes to be "examined" only to be told what you already know seems senseless.

I dumped a doctor who wouldn't renew a prescription. I had been in the day before for a tick bite. Couldn't see my doctor on short notice but saw another. Then my doctor wouldn't renew without seeing me. I said read the chart. All you're going to do is weigh me, take my temperature and my blood pressure and ask me how I am. They said I must come in. I said, screw you.

[Maraya1969]

59. You forgot the part where you PAY THEM before you even get into

the office.

Thanks for understanding.

[Ms. Toad]

137. Viral infections vanish on their own -

often in about the same time a bacterial infection would when treated using an antibiotic. So many people who have been (improperly) "treated" for their viral infections believe that the viral infection clearing up (as it will on its own) mean it was bacterial to start with.

[nadinbrzezinski]

163. Well, a cold is a viral infection, not bacterial

so if anything is indicated would be tamiflu, oh wait this is not flu either.

Antibiotics will do none to the a virus. This is firm science.

That said, sometimes antibiotics are used in patients with chronic conditions to prevent a bacterial pneumonia from developing. But let's make this clear, it is not clearing the virus, whatsoever.

And countries are trying to shut down on the abuse since antibiotics will soon be a has been miracle drug

[Orrex]

14. Slap yourself all you want. You still can't self-prescribe.

There are two main reasons:

1. You don't get to pick and choose your own prescription medication just because you've decided that you need them. Why not simply stomp into the pharmacy and demand a handful of your favorite pills?

2. What if something else is going on? You've decided that it's the same as every other time, but you're not actually qualified to make that call on the microscopic level.


You describe it as a life-threatening condition, and I don't doubt that you're correct. That's all the more reason to involve your doctor in the process of prescribing medication.

[sweetapogee]

34. any life-threating condition

involving ABC (airway/breathing/circulation) is a 911 trip to the ED.

[Maraya1969]

61. It is not self prescribing. It is speaking with the doctor over the phone

telling him your symptom and him knowing your history making a decision and calling it into the pharmacy.

[Orrex]

75. Well, get a new doctor, since you obviously know more than this one.

A quick chat over the phone is no substitute for an actual check-up. Even if it's a refill on an existing prescription, there are a million reasons why your doctor wouldn't want to diagnose you over the phone, and only one reason (your convenience) why they might go that route.

[Maraya1969]

82. IT'S NOT FUCKING CONVENIENCE!! DO YOU KNOW WHEN A PERSON

HAS AN ASTHMA ATTACK THEY VERY OFTEN WILL GO OVER THE EDGE JUST BY WALKING TO THE CAR??????? THEN IT IS 911 AND NOW YOU ARE IN TROUBLE.

WALKING FROM THE FUCKING COUCH TO THE BATHROOM IS EXHAUSTING AND CAUSES ME TO WHEEZE WORSE!

[Orrex]

99. THEN GO TO THE FUCKING HOSPITAL BEFORE YOU PASS OUT!!

HOW THE HELL ARE YOU GOING TO WAIT FOR THE DOCTOR TO PHONE IN THE PRESCRIPTION, THE PHARMACY TO PREPARE IT, THE PHARMACY TO DELIVER IT, AND THE ANTIBIOTIC TO TAKE EFFCT?!?

INSTEAD OF TYPING ALL SHOUTY-CAPS ON AN INTERNET FORUM, YOU SHOULD BE SEEKING MEDICAL ASSISTANCE ASAP!!

[nadinbrzezinski]

166. I feel your pain, I have ashtma

and every time mine flares up, I drag my happy ass to the doctor's office. Once, when dad still lived and he was smoking, I almost dragged my happy ass to the ER. Yes, it got that bad. Me and my health care provider are damn confused, a cold will get it going, nice smoke from your local wild fire, not so much. That said, I avoid taking antibiotics with a passion, and even so I developed an allergy to one of them. It has to do with the creation of super bugs, which we have done with the abuse of these drugs.

A provider, for many reasons listed on this thread, should see you first before prescribing. And anyhoo, an antibiotic will do nothing to a virus. Somebody with an MD behind their name should explain this to you. Now if you happen to get the flu, please make your way to your provider within 72 hours of first signs, Tamiflu is that time sensitive and does need a script too. Oh and it could prevent a few issues down the line with your asthma.

[pangaia]

8. I had pneumonia in theearly 1980's. right lung only.

Ever since then, every few years I get bronchitis, sometimes mild, sometimes worse. I used to always get a prescription for an antibiotic, usually eurethromicin (spell?). A couple years ago my doctor, who I think is very good, didn't want to prescribe an antibiotic right away for the reasons described above. And if he said yes, I still would have had to go to the office. I live in NY.
It's a tricky situation.....
BTW, I have about 50- 5 mg valium pills. I think I got them last year when I had a bunch of chemo, Cat Scans, etc... Never use them... except for my annual MRI.
Want some?

[Ranchemp.]

19. I know you're not serious,

but, offering to give a schedule IV drug to someone else is a Federal offense and the way the NSA snoops on us, I wouldn't be surprised if your post has been flagged by the DEA, whom I have nothing but contempt for, for further review.
Just sayin.

[dionysus]

28. party pooper.

[Ranchemp.]

29. Sorry about that,

but I wouldn't put it past the NSA to notify the DEA. Arggg, maybe I'm being a bit paranoid, but being a federal employee, I kinda know the spying done on us.

[dionysus]

31. i once had a coworker innocently offer "i can mail you some of mine, right?"

"no no no, no you most definitely cannot. that's highly illegal"

"really? oh...."

[Ranchemp.]

41. Yep.

Last edited Mon Dec 9, 2013, 01:44 PM - Edit history (1)

If she had mailed them, not only would the DEA be involved, but now the postal inspectors would be involved also.

[dionysus]

42. the poor lady didn't even know they were controlled... i had to explain the concept.

I explained we'd be in adjacent cells for such activity.

"well I certainly wouldn't want that!"

indeed.

[Jesus Malverde]

37. post flagged by the DEA..

[Ranchemp.]

50. Post flagged by the NSA

and passed on to the DEA.

[Jesus Malverde]

63. I'm guessing surveillance at DU is mostly done by the FBI.

I would not be surprised if skinner has received national security letters.

If you're looking for activist troublemakers you go where there is activism.

It would be funny if between all the fusion centers, dod agencies, uk, euro, ME agencies, PR flaks and informants the majority of posters were on the clock.

[Ranchemp.]

71. I would say, with some experience,

that DU is monitored by the FBI, and the Secret Service, my agency also monitors the social networks looking for fugitives that are dumb enough to post mocking our efforts to nab them.

[Jesus Malverde]

83. Is that the marshalls service?...

Cause you'll never catch me...



Jking

[Ranchemp.]

93. Correct,

and you're probably right.

[nadinbrzezinski]

170. So does the media... every amber alert and I am trolling

those same sites looking for an idiot to post.

[Orrex]

107. Good luck catching me for those BlockBuster Video late fees, copper!

$3.50 late fee incurred in 1997 and running ever since!

[Ranchemp.]

113. Ahhh, but you just don't know, but you've just been moved

to the #1 position on our 10 most wanted.

[Orrex]

114. Doh! That puts me above those mattress tag scofflaws!

I'm doomed!

[Ranchemp.]

116. It's hard time for you I tell ya,

hard time.

[madinmaryland]

189. The name is Agent Mike Hunt. He's all over DU!!

[OwnedByCats]

178. Yeah it was a joke

I'm sure but the DEA are harsh, I cannot stand their MO either.

[pangaia]

206. If the DEA wants them they are welcome to them

I really don't remember why I ended up with 50. Seems kinda weird.
I remember being given vicoden after spinal surgery, but have no memory of getting the valium. So I take one, as I said before my sort of routine MRI or Cat Scans as I am a little claustrophobic.
With the valium in the MRI tube i really get off on the clanging noises those machines make. (I'm a drummer, among other things)

3 minutes of--
kerchang ga chang, kerchang ga chang kerchang ga chang, kerchang ga chang kerchang ga chang, kerchang ga chang

then 2 1/2 minutes of--
baloofaaa, baloofaa baloofaaa, baloofaa

then 4 minutes of --
doioioing gonga doioioing gonga doioioing gonga doioioing gonga

etc etc...

[loli phabay]

62. lol, it makes as much sense.

[wercal]

12. Reminds me of the Vet on Saturday

They had a sign stating they were not allowed to prescribe medication, without seeing the patient.

I thought it was a little extreme for pets...but thought it probably was due to antibiotic requests. Its become a big deal, and it doesn't surprise me that the doctor insists on seeing the patient.

[pipi_k]

21. Same thing for my vet...

One of my dogs is prone to getting UTIs because of the way her urethra is positioned. She's been on antibiotics a number of times, and each time, even though she has the same symptoms, we need to get a sample and bring it, and the dog in, to see the doctor.

I actually learned from the vet, who said she would rather not have to keep prescribing antibiotics for this dog, that if I use a baby wipe each day to swab the area, then slather a bit of A & D ointment on the surrounding area (because she also gets sores) I can keep things pretty much under control. She is also prone to getting Staph sores on her tummy, and has gotten meds for that as well. Now, each evening when I do the baby wipes deal, I check the tummy area for sores (which can pop up literally overnight). She had a nasty case of sores in September which I eradicated by washing with a weak Betadine solution twice a day, and then spraying with antiseptic spray. Gone in less than a week, and no antibiotics!

[Maraya1969]

66. CoQ10 would probably help her a lot.

[pipi_k]

246. Upon checking

on CoQ10, I see that it's mainly used to treat cardiac issues, which my dog doesn't have.

http://www.vcahospitals.com/main/pet-health-information/article/animal-health/coenzyme-q-10/261

And although the article says it's safe and doesn't appear to have interaction problems with other drugs, she's on Soloxine (for thyroid) and I would be leery of giving her anything without checking with the vet first.

[Maraya1969]

262. I had an adopted dog Rusty, an old Beagle dog who had a lot of problems

One of them being chronic ear infections. Finally after all the drugs didn't work I decided to try CoQ10 because I had read an entire book about it many years ago and it is actually good for all the organs but it is mostly good for the larger ones because they need the most energy.

Anyway I gave Rusty a high dose of it for 1 week and his ears cleared up completely and he was a new dog. I was amazed. He has since passed away but I was just thinking today that my 2 dogs now, who are younger than those that I usually adopt, should get some CoQ10 just to make sure they stay healthy. I got ubiquitol instead of CoQ10 this time because I read that it is a purer form and is absorbed better. So I am going to prick a pill and put the liquid in their doggy pill chews and give it to them tonight.

Also I put Paco on a special diet of no grains and limited ingredients because he has what looked like an allergic reaction, with itching and redness and when I got him all his fur on his stomach was gone from a flea infection. He is so much better. No more constant scratching.

[magical thyme]

30. dogs and cats get a lot of the same antibiotics that people do

there is nothing to stop somebody from claiming they need it for their dog and then using it for themselves.

[sharp_stick]

44. Well then you'll need a vet to prescribe it

even for an animal you can't just purchase prescription drugs.

[magical thyme]

248. that is the point of my post. it is why vets will not prescribe without actually seeing your pet. nt

[Maraya1969]

64. And it hasn't occured to any of you that it might have a bit to do with

MONEY!

[wercal]

79. From the CDC website:

•Do not treat viral infections with antibiotics, even when patients ask for them

•Prescribe antibiotics only when they are absolutely necessary – giving them at the right dose and only for as long as they are needed

•Include microbiology cultures when placing antibiotic orders

Yes the doctor gets paid...but there really is a push to reduce antibiotics...and for good reason.

Think about it from the doctor's perspective. If patients just call up and demand a prescription...the doctor takes on all the risk, and its a lot of risk (legally) to prescribe anything without seeing the patient...and gets absolutely nothing in return. I wouldn't do it.

[BlueStreak]

88. Speaking of risk

I have no doubt that if the OP got that dial-in antibiotic and then the disease developed into something else (pneumonia, lung cancer, etc) he/she would be first in line wanting to sue that PCP for malpractice.

[wercal]

95. Its a huge risk

It could be something completely different than what he/she suspects. Lawsuit central.

[BlueStreak]

104. The doc would lose 100% of those cases

The other lawyer would simply say "Now Doctor Jones, do I understand correctly that Mrs. Smith called your office with serious symptoms, and your receptionist simply called in a prescription for some generic antibiotic, and it never even occurred to you that maybe you ought to examine the patient to see what was wrong?"

[Aristus]

147. Money. Good point.

I hired a contractor a couple of years ago to re-do my kitchen. He took a look at the kitchen, did some careful measurements, drew up a plan, and then charged me money to do my kitchen.

I'm thinking of getting the bathroom re-done. Should I call him up, demand a plan for re-designing the bathroom without him taking a look? Should he charge me again? After all, I paid him once already.

[Maraya1969]

148. Yes. And I do realize the similarity between me and a kitchen.

Throwing oranges with peanuts and calling it all fruit.

[Aristus]

150. Was the allergory too complex for you? Sorry.

I'll break it down for you: my kitchen and my bathroom are under the same roof, so no need to evaluate the bathroom like he did with the kitchen, right? And why charge me money? I paid him already!

[Change has come]

219. Please remember,

This poster is a person. You made your points very well earlier and I'm sure some of the folks that have read this thread have learned a thing or two. No need to start calling this person dumb.

[nadinbrzezinski]

168. As it has been pointed out to you, it has to do with reducing the abuse of anitbiotics

Imagine a day when they are as good as piss because the bugs have EVOLVED to be resistant to them. We have already created a few strands of super bugs.

Anyway, what you describe is a COLD, which is a VIRAL infection, for which antibiotics will do nothing, except help create super bugs, Your doctor needs to make sure that there is an underlying BACTERIAL infection and then prescribe the appropriate antibiotic if that is the case.

Oh and this is the reason

http://www.usatoday.com/story/news/nation/2013/03/05/superbugs-infections-hospitals/1965133/

[kestrel91316]

89. How is that extreme?? We are required to maintain a valid doctor-client-patient relationship,

your pet can't talk, and we aren't psychic. Add to the the propensity for clients to completely misinterpret things they observe about their pets, exaggerate terribly, minimize terribly, or just plain lie, and you have a huge malpractice case in the making along with the risk to your license if you don't examine the patient when it is indicated.

I have lots of patients on long-term medication that we just refill as needed, but when a client calls and says "my cat is REALLY SICK" the answer is always going to be "what day do you want to bring it in, and do you want a morning or afternoon appointment?" I'm not going to commit malpractice or jeopardize my license just because somebody doesn't want inconvenience or expense over an acutely ill pet.

[wercal]

101. I really don't think its extreme

It just took me a minute to realize that pets can be 'prescribed' medicine...since so much of the stuff for them is over the counter.

BTW - I was at the vet, cat in hand, not trying to game the system.

The existence of the sign, I assume, means a lot of people are trying to call in for meds...I had just never even thought about that happening.

[HappyMe]

13. If they aren't comfortable with that, you will just have to go in.

I can't blame the doctors or PAs for wanting people to come in. I wouldn't want to jeopardize my ability to practice, or set myself up for a malpractice suit.

[mainer]

16. He is allowed to call in a prescription. He just doesn't want to

because he may think it's inappropriate without seeing you first.

[Mariana]

149. Lying about the reason was wrong.

I agree with not prescribing antibiotics without some evidence they're necessary. Nevertheless, if I were the OP, I'd change doctors immediately, rather than continue to see one that has lied to me.

[mainer]

154. Agree. I think the lying sucks

What he should have said was: "I won't call in antibiotics until I confirm your illness requires them."

Saying there's a law against it is just so wrong.

[elias7]

167. I don't think her doctor would mind

If she changed doctors immediately. I'm thinking the doctor is not lying, I'm thinking some things are being a little distorted here. Docs spend a disproportionate amount of energy on patients who are uneducable.

[Mariana]

186. That may be true.

I was answering as if the OP accurately states what was said. It is very possible that it does not.

[FarCenter]

17. Preppers and doomsters buy antibiotics from aquarium supply stores.

[HappyMe]

20. Whaaaat?!

That doesn't even sound close to being a good plan.

[FarCenter]

23. Just google "how to buy antibiotics without a prescription"

I'm pretty sure that economies of scale dictate that there are only a few global producers of any specific antibiotic -- in many cases there will only be one. And it is unlikely that they will set up different plants to manufacture human versus animal antibiotics.

So the active ingredient will be identical in human and animal drugs. You are taking your chances with the other stuff. But since aquarium fish will die at the slightest provocation, if it doesn't kill them, it probably won't kill a human.

[HappyMe]

32. I wouldn't be comfortable with dosing myself

with fish antibiotics.

If those people don't care - good for them.

[RebelOne]

90. They are the exact same antibiotics for which a doctor

would give you a prescription for. I have been buying from pet websites for years. If there is an antibiotic that you have taken before that works and you can buy it from the pet websites at half the price, why not?

[HappyMe]

97. How the hell do you know how many to take?

Do you have to be a vet to get them?

[grasswire]

111. milligrams are milligrams

There are no special measurements for fish. You read the label and compute.

And no. You don't have to be a veterinarian to buy them. Many different antibiotics are available thus.

[840high]

27. True.

[RebelOne]

84. I buy my antibiotics from pet supply websites

all the time and no prescription needed.

[ScreamingMeemie]

229. Not just preppers and doomsters...people who don't have insurance do the same.

Sometimes it's all you can do.

[alc]

26. antibiotics are different than other drugs

I think the antibiotics prescriptions require a doctor to see you to reduce over-prescription and superbugs. I know a number of people who ask their doctor for antibiotics on their first cough. A few have gotten pissed recently because the doctor who always prescribed it now makes them wait.

But, laws, regulations, threats of law suits, etc. result in doctors having to do things they don't need to and greatly increase the cost of health care.

The last 3 times I got antibiotics (the only 3 times in my life) the nurse looked in my throat and told me what I needed. Then I waited 20-60 minutes for the doctor to come fill out the prescription.

When I broke my arm the nurse looked at the x-rays and said "you need to see a specialist to put it in a cast". Then I waited for a doctor to come say the same thing.

Just think how much cheaper it would be if a nurse could set up a low-cost clinic and give advice for so many things that require a doctor's visit. And how may more people would be able to get "some" advice. It may not be the best advice but being able to ask someone who has training whether to go get an x-ray vs icing ice is better than making that decision on your own and not getting the x-ray. And nurses could accurately prescribe antibiotics (with the pharmacist's double-check on allergies, people needing it too much and indicating a larger issue, etc).

Maybe it's not the best idea to give more power to non-doctors. But we need to find some way to reduce the cost of health care and improve access rather than focusing on payment. And, getting rid of the doctor monopoly is a good start. Knowledge, diagnosis equipment, nurse training, and many other things have improved significantly since the doctors got their monopoly. And arguments about the dangers of not seeing a doctor are nowhere near as strong. It would be great if everyone could see a specialist with 10+ years of education/experience for every issue, but that's not realistic. Realistically, everyone could see someone with medical training for every issue at least to ask if they need to see a doctor.

[FarCenter]

39. Antibiotics screw up the digestive tract

They affect the balance of microbial life in your intestines, particularly the colon. It is estimated that you have about 10 times as many bacteria and virii than cells in your body, and it is best to keep them healthy. Once they are out of balance, it is hard to bring them back.

That is the biggest reason to avoid antibiotics unless absolutely necessary.

I'm not sure whether the restrictions on use ostensibly to reduce antibiotic resistant pathogens make sense, particularly when many countries do not implement the restrictions and when they continue to be widely used on animals globally.

It also may be that the medical and drug establishment wants to keep antibiotics in the high-margin prescription drug category instead of the low-margin over-the-counter category. Since the lethal dose of any antibiotic is pretty high, prescriptions are not required for safety reasons.

[Maraya1969]

68. I know - I also take probiotics.

[IdaBriggs]

98. We *so* need to talk!!!

I am working on the write-up for the Project, and *this* is one of the 5 causes of micronutrient deficiency issues we are identifying.

It appears to be why the protocol helps with sensory processing issues in both neuro and autistic kids (Only 4 out of 5, of course - disclaimer, blah, blah, blah) with the digestive track being messed up causing absorbtion issues.

Pet theory - the use of antibiotics in the 2 year old population (for ear infections) might be a part of the problem....

Want to talk?

[FarCenter]

120. I'm not an expert in the field -- just a casual observer of the science scene

I happened to recall this publication, which you may be familiar with.

Clues About Autism May Come from the Gut

http://www.sciencedaily.com/releases/2013/07/130704095121.htm

The PLOS ONE paper is

Reduced Incidence of Prevotella and Other Fermenters in Intestinal Microflora of Autistic Children

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0068322

An overview would be

Host-Bacterial Mutualism in the Human Intestine

The distal human intestine represents an anaerobic bioreactor programmed with an enormous population of bacteria, dominated by relatively few divisions that are highly diverse at the strain/subspecies level. This microbiota and its collective genomes (microbiome) provide us with genetic and metabolic attributes we have not been required to evolve on our own, including the ability to harvest otherwise inaccessible nutrients. New studies are revealing how the gut microbiota has coevolved with us and how it manipulates and complements our biology in ways that are mutually beneficial. We are also starting to understand how certain keystone members of the microbiota operate to maintain the stability and functional adaptability of this microbial organ.

http://www.sciencemag.org/content/307/5717/1915.full?sid=d88c3097-0109-4837-9ae1-1ee82a6fa3c2

[nadinbrzezinski]

171. One thing that was recommended forever by my pediatrician

and I still do it whenever, rarely, I am prescribed antibiotics, was to feed yogurt twice a day to the little tykes.

You might want to control for that!



Recently I had to be on a course (and that was nasty, my tract is NOT what it used to be)

[magical thyme]

35. if you come in they can get a swab for culturing

and can confirm whether it is bacterial or viral, and then prescribe the most appropriate antibiotic, if necessary. The color green suggests there is an infection; it is not automatically bacterial.

Doctors willing to prescribe antibiotics either prophylactically (just in case) or just to shut up the demanders contribute greatly to the spread of antibiotic resistance.

When you ingest an antibiotic, it attacks both pathological and nonpathological bacteria in your entire system. The survivors are resistant to that antibiotic and can pass their resistance genes on to other bacteria.

So if you are subsequently exposed to nonresistant pathogens, they can pick up those resistance genes. That is how VRSA (vancomycin resistant staph) has appeared -- by normal staph picking up resistance genes from vanco-resistant enterococcus (VRE).

[Maraya1969]

72. yes and if they did that years ago, while waiting for the damn culture

I would have died. I have an allergy to bacteria. When I get bacteria in my lungs they fill up and close up and I can't breathe.

[magical thyme]

250. no. when they see you they can give you a broad spectrum antibiotic.

once they get the culture results, they can switch to a targeted antibiotic that will kill type of pathogen you have but not be as lethal to the non-pathogenic bacteria that your body depends on.

And if the culture comes back clean, then they know you more likely have a viral infection, not bacterial, and they can stop the antibiotics early on.

[HockeyMom]

38. My husband has to take antibiotics every time he goes to the dentist

or gets a severe cut. With the dentist he has to start taking them 2 days before the visit, and 8 days after. He had 3 stents put in and this is apparently routine procedure for potential infections.

Every time he sees the dentist he has to see his heart specialist before? No. Hey, doc, I got a dentist appointment next week. Doctor calls up PUBLIX in Florida, and my husband does there and picks up the antibiotic for FREE. If you live in Florida, you do know that antibiotics are free at Publix and have been for a number of years.

I do know Florida keeps track of the number of times you buy antibiotics, or for that matter, even OTC stuff like Mucinex. They write down you Driver's License number when you purchase them. I was told you cannot buy multiples at a time because ingredients used are also used to make illegal drugs. Don't remember which ones. Is this what you mean?

Edit: How I found out about the Mucinex. I had a Health Saving Plan which I didn't use. The cash in it had to used by the end of the year. I decided I would buy a whole bunch of OTC cold/cough, etc., and give it away. I couldn't do that in Florida. When I went back up to NY, I took my adult daughters with me. Gave the clerk my boxes and the card. You look over 18. Yep. This box is for me. Those boxes are for my daughters. I am paying for all of them. Ok. No problem. No Drivers License number either. So, it must be a Florida requirement, not a federal one.

[Maraya1969]

74. Thank you. All these "doctors" are pissing me off. For some people

an infection can be deadly.

[Niceguy1]

106. that's why you should see your doctor

[nadinbrzezinski]

193. Why a doctor needs to make sure it is due to a BACTERIA and not a VIRUS

antibiotics work on bacteria, NOT ON VIRUSES.

If you are as sick as you state, GO SEE YOUR DOCTOR. It is not a racket, serious.

[Ms. Toad]

139. Your husband has as specific predisposition to bacterial infections

because of the heart issues. The mouth is full of bacteria - which is relatively harmless if it stays there, but can be deadly for people with specific heart conditions if the bacteria moves into the bloodstream because as a result of the teeth being beat up during cleaning.

I have to fight to avoid being required to take prophylactic antibiotics in advance of dental appointments because I have a murmur. Mine has been fully evaluated, and is not the kind associated with deadly bacterial infections.

That is way different from believing a cold/sinus/bronchial infection needs to be treated with antibiotics without first determining that the infection is caused by bacteria.

[HockeyMom]

177. I agree and that was my point

Antibiotics should only be used for extreme specific, not run of the mill, conditions. The flu is not one of them. The only times I myself have taken antibiotics were for food poisoning, and an abscessed tooth where half my face was the size of a watermelon.

Extreme conditions.

[Ms. Toad]

199. .

Sorry - I thought you were suggesting the very appropriate prophylactic antibiotic treatment for dental visits (without needing to go in for a check-up before getting the prescription) was similar to getting a phone-in prescription for what is, in all likelihood, a viral infection.

[3catwoman3]

173. Those OTCs containing pseudoephedrine...

..., which is a decongestant, are the ones you have to sign for. That active ingredient is used to make crystal meth. It would not be in plain Mucinex, but would be in Mucinex-D (the D stands for decongestant.)

Pseudoephedrine is the active ingredient in the original Sudafed formulation. The Sudafed that is on the shelves, and requires no signature or tracking, contains the decongestant phenylephrine - similar in action to the original, but can't make crystal meth with it.

Perhaps in NY you were buying either single ingredient Mucinex, or Mucinex with phenylephrine.

Mucinex, by the way, contains exactly the same expectorant as old-fashioned Robitussin, with a different label and at a higher price.

[OwnedByCats]

183. Last time I bought that decongestant in NY (3 months ago)

it required a driver's license and I don't think they would have been keen on me buying several boxes at a time. In Nebraska 3 years ago, driver's license and I think I could buy 2 boxes but no more.

It's the only decongestant that helps when I have a cold/flu and luckily I only need to buy it once or twice a year. The only problem with the procedure is if you need it in the middle of the night, the pharmacy has to be open to get it.

I recently heard that some states are considering making that prescription only to curb the meth production. I really hope they don't do that because I don't want to go to the doctor just to unplug my nose for Pete's sake. I get it when it involves antibiotics, I think doctors should be more careful when prescribing those. Psuedoephedrine on the other hand would be awful for me.

[frazzled]

43. It's about drug resistance, and also,

giving an antibiotic when there is no bacterial condition can be harmful rather than helpful.

For decades, that has meant a certain expectation of prescribed antibiotics, but the rising tide of antibiotic-resistant conditions has caused physicians to take another look at when, why and to whom they prescribe these potent germ-killers. This year, you may just get an explanation about what antibiotics do and don’t do, and perhaps a decongestant or cough suppressant to go with it, rather than those Z-packs or Amoxicillin tablets.

Health and medical groups have become outspoken about when antibiotics are needed (in cases of bacterial, fungal or certain parasitic infections) and are not (virus-caused illnesses), and have advised physicians to be more forthright about explaining the differences to their patients rather than merely offering antibiotics.

The Centers for Disease Control and Prevent has its “Get Smart” program, which includes a website dedicated to the subject (cdc.gov/getsmart/).

It reads: “Taking antibiotics when you have a virus may do more harm than good. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.”

It goes on to call antibiotic resistance “one of the world’s most pressing public health problems” and adds, “Almost every type of bacteria has become stronger and less responsive to antibiotic treatment when it is really needed. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates and co-workers, threatening the community with a new strain of infectious disease that is more difficult to cure and more expensive to treat.”

https://www.floridatoday.com/article/20131114/HEALTH/311140039/

People taking antibiotics when they shouldn't puts everyone at risk, because bacteria are growing resistant--and when you really need them they may be ineffective. My husband had a medical emergency several years ago, when a hematoma on his leg (the result of a serious bicycle accident he'd had several months earlier--he'd broken a shoulder and ribs and punctured a lung, so no one was too interested the hematoma at the time) became seriously infected. It was a staph infection, of the kind that can kill you within hours. He was put (first intravenously in the hospital and then orally at home) on an antibiotic "of last resort." What happens when staph becomes resistant to these antibiotics, too?

The CDC has recognized that this is a huge problem, so don't expect to get an antibiotic every time you think you need or want one. I believe your doctor was correct to ask you to come in to see him/her. It's the responsible thing to do for the public health.

[HockeyMom]

57. That is exactly what my daughters pediatrician said 30 years ago

Unless they had a SEVERE infection, he did not give a scrip for antibiotics for simple ailments like flu, strep, etc. People build up an immunity to them, and then need to keep taking stronger and stronger meds because the lower dosages don't work. That is what the doctor said 30 years ago.

BTW, if you build immunity to the meds, doesn't it also make sense that you just might build up immunity also to the flu, strep, etc., if you aren't constantly take meds?

[Ms. Toad]

140. It is actually the bacteria that builds up the immunity -

not the people.

[Avalux]

143. Yes! Your daughter's pediatrician knew his stuff, and so do you.

My background is infectious diseases and I've raised three daughters who RARELY took antibiotics. My youngest, who is now 17, has only had two rounds in her entire life.

Also - I don't use antibacterial soap, gel, lotion....whatever. Sterile environments aren't good for people.

[B Calm]

45. It's all about money with my doctor too. My old doctor

would give me prescription's for my blood pressure with refills good for a year. My new doctor wants me to make an appointment and come in every 3 months just to get a prescription.

[HappyMe]

46. It doesn't have anything to do with money.

My ex had to go every three months for the same thing. They check to make sure that your liver function is still good, and if the meds need to be adjusted.

[B Calm]

54. Whatever. . If I don't feel right I make an appointment. He

could make my prescription's good for at least 6 months and still keep a good eye on my health.

[Maraya1969]

77. They can just call into the laboratory that draws the blood.

[HappyMe]

80. Well, you have to go to the doctor's office

to have the blood drawn.

They tested the blood at the ex's doctor's office.

[Maraya1969]

87. I don't know one doctor that draws blood anymore. They all make you

go to the laboratory and have it drawn.

[HappyMe]

94. You don't know ALL doctors.

My husband was sick a couple of months ago. They drew the blood right there.

[BlueStreak]

100. Same with my doc. I think this is more common than ever.

The trend is toward larger practices that can do more services in house. I have had 2 PCPs the past 2 years and they both were that way. They draw the blood and actually run the basic tests in the office. The more elaborate tests are sent out. I actually prefer to go to the lab because have extreme needle phobia and there is one lab with a technician I really like. He is able to draw without having to go in 5 times. My PCP understand, but he would prefer I do it all at his office.

[HappyMe]

105. My husband did have 2 vials taken.

They sent one away for more testing, and did do the basic testing in house.

[Baitball Blogger]

52. It's bullshit.

My doctor's office calls them in all the time.

Maybe your doctor is on some watch list?

Edited to add that I usually come in for a doctor's visit.

[Maraya1969]

78. Thank you.

[backscatter712]

102. That's my bet too.

Narcotics, like Vicodin, can't be called into the pharmacy. They're controlled substances.

There's no such law for antibiotics.

[tammywammy]

55. What a crappy doctor wanting to SEE their patients and not randomly prescribe medicine

[HappyMe]

70. The nerve of him/her!

Not wanting to set themselves up for malpractice!

I have a friend here that is a PA. He said the worst thing ever is people digging around on the internet trying to diagnose themselves. Then they show up and argue with him.

[grasswire]

115. boo hoo!

Considering the scandalous alliance between big pharma and the medical community, it's a smart thing to research your health concerns on the Internet. How many Americans have been mistreated by their trusted providers because of outdated protocols? Hint: Millions of Americans have been injured by statin therapy alone.

How dare patients argue with their PAs?? How dare they??

[HappyMe]

119. Okay, just let everyone diagnose themselves

and order whatever they want from the internet. Everyone's a doctor!

[grasswire]

125. why not?

Many times the patient is right and the medical provider wrong, anyhoo.

I trust people to seek information for themselves.

[HappyMe]

127. LOL!

You are free to do so for yourself.

[grasswire]

131. why don't you trust fellow citizens to think for themselves?

The authoritarian nanny state is quite disturbing.

[HappyMe]

134. As I said before,

do whatever the hell you want with your health.

I will do what I want with mine, which includes seeking out trained medical professionals.

"authoritarian nanny state" I wondered how long before you would drag that tired meme out.

[grasswire]

159. no one is seeking to limit your health choices

Quite the contrary.

But you are seeking to limit the choices of others.

[Orrex]

135. Ah, yes. The "Experts? I don't need no stinkin' experts" Libertarian mantra.

You suspect collusion between doctors and the pharmaceutical industry, but you're willing to trust that hundreds of millions of untrained people will have the skill, experience and judgment to make informed and reasonable medical decisions?

Preposterous.

You are, in fact, holding people solely accountable for choices that they're not qualified to make, so that we can thereafter blame them for their "bad decisions" and their failure to bootstrap their way to good health. Exactly the way Libertarians like to scold people who get fucked over by shady investment deals and junk mortgages. It's the "fuck 'em if they're too stupid to figure it out" business model, and it has no place in progressive thinking.

[grasswire]

158. preposterous?

Your extrapolation from this narrow discussion to the accusations you make is preposterous.

I am not a Libertarian. I just have libertarian tendencies in two areas where regulation is silly and stifling.

And consider this: 28 European countries (progressives and socialists among them) allow purchase of antibiotics with no prescription. Millions of them are not dying from "bad decisions."

[Orrex]

162. Yes, preposterous.

You already extrapolated the discussion:
http://www.democraticunderground.com/10024152307#post125

[pipi_k]

187. If people make choices

that will, in the end, affect only themselves, then I, personally, would not give a rat's ass what they do.

However...in this case, wrong choices have the potential to be catalysts for the deaths of hundreds of thousands...millions...of innocent people when antibiotics are being taken for things they're not meant to treat.

Doctors spend a whole lot of time learning their craft. Why should a layman be allowed to endanger others while playing doctor?

Rebelling against The Nanny State is OK only when the person doing it is likely to hurt himself.

[grasswire]

204. your prediction is not supported by evidence.

Once again.

28 European nations allow antibiotics with no rx.

Despite this freedom, less than 10 percent of antibiotics bought are without rx.

Ergo: It is not possible to kill hundreds of thousands or millions of people by antibiotic overuse when only a small percentage of those who are allowed to purchase antibiotics without rx actually do so.

The far greater danger is the agricultural use of antibiotics. That's the part that actually does threaten us all.

[pipi_k]

192. I think people

should also be allowed to perform their own surgery.

Most households have a pretty decent array of kitchen tools...

[brooklynite]

65. So, can we call it a day?

You got the opportunity to vent about how mean your doctor was...

You got the opportunity to flame everyone who disagreed you....

You got your prescription....

I'd say that pretty much covers it.

[1awake]

69. In Florida the only medicine I think it NOT allowed called in

is Psychotropics. I'm no expert so take with a grain of salt.

[grasswire]

73. I am a libertarian regarding the rx exclusive franchise MDs/government have created.

It's the nanny state to the extreme. Europeans don't force this kind of control on citizens.

I'm for abolishing rx for meds, except for the most potent addictive painkillers.

Provide educational materials. Provide plenty of advice online, through phone, through literature.

Let the doctor make a recommendation if he/she so wishes. No rx required.

Let pharmacists make recommendations too.

And let people be.

The cost of health care would shrink exponentially. The ugly cooperation between big pharma and the medical community would be gone.

The downside? Many people are too stupid to treat themselves properly. But then many people are too stupid to drive well but we allow them on the roads with a heavy killing machine every day.

[Humanist_Activist]

103. And when antibiotic resistant bacteria start exploding in proliferation worse than now...

leading to many people, even the non-stupid ones getting sick, and even dying, you will, I assume, think it was a good idea all along?

[grasswire]

109. as someone else said above

The misuse of antibiotics by humans is dwarfed by what our government already allows meat farmers to feed Americans.

Europeans don't seem to have any such problem.

[grasswire]

122. 28 European countries require no rx for antibiotics

....and yet a very very slim percentage of all antibiotics sold in those countries was without a rx.

Ergo: people are not rushing to buy their own antibiotics without a doctor's involvement as you suggest will happen. The only country where more than 10% of antibiotic purchases were without a scrip was Romania. Most others were below 5% of all antibiotic purchases.

[yawnmaster]

196. Europeans DO have a problem! Here are some links!...

Self-medication with antibiotics in Europe: a case for action. http://www.ncbi.nlm.nih.gov/pubmed/20615180

Antibiotics for upper respiratory infections: public knowledge, beliefs and self-medication in the Republic of Macedonia.http://www.ncbi.nlm.nih.gov/pubmed/24280886
a quote from above: "Self-medication as part of the irrational use of antibiotics contributes to the spread of antimicrobial resistance. "

Self-medication with antibiotics--does it really happen in Europe? http://www.ncbi.nlm.nih.gov/pubmed/16095749
^45% were using it for the common cold!!!!

"If tough measures are not taken to restrict the use of antibiotics and no new ones are discovered, said Dame Sally Davies, "we will find ourselves in a health system not dissimilar to the early 19th century at some point".http://www.theguardian.com/society/2013/mar/11/superbugs-antibiotics-bacterial-diseases-infections


[Ecological niche altering: bacterial resistance to antibiotics]. http://www.ncbi.nlm.nih.gov/pubmed/16539980

A survey of patient behaviours and beliefs regarding antibiotic self-medication for respiratory tract infections in Poland. http://www.ncbi.nlm.nih.gov/pubmed/24273569

Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system. http://www.ncbi.nlm.nih.gov/pubmed/18296694

[yawnmaster]

200. Here are the 28 countries listed...

Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, Germany,
Greece, Hungary, Ireland, Italy, latvia, Lithuania, Luxembourg, Malta,
Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and UK.

The article that lists these states that there is a problem.

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(12)70017-8/fulltext#tbl1

[abelenkpe]

110. ..

[Avalux]

146. I'm sorry but you can't do this with antibiotics.

None of them would work after awhile and we'd be set back to pre-penicillin days. Millions of people would die.

[grasswire]

156. 28 European countries allow antibiotics with no Rx.

Their experience belies your claim.

Despite the fact that citizens of those countries (many of which are progressive/socialist) can buy antibiotics freely at will, without prescription, only a small percentage of antibiotics are obtained that way. Most people actually DO seek a doctor's rx.

So what are we to think of the claim you have repeated? It's apparently bogus, at root. Millions of Europeans are not dying because of mis-application of antibiotics.

[yawnmaster]

201. Please read this European report on the subject. The vast majority obtain prescription...

this paper is a great survey of who uses the antibiotics and why.
http://ec.europa.eu/health/antimicrobial_resistance/docs/ebs_338_en.pdf

[Avalux]

247. Quit using Europe as justification for unregulated antibiotic use.

Even though you've stated this repeatedly, it doesn't matter what they're doing in Europe and you clearly don't know what you're talking about.

I will say this one more time. Antibiotics must be regulated and only prescribed when absolutely necessary. We must protect the broad spectrum antibiotics we have or they'll be useless sooner than later, and since big pharma isn't putting any money into new antibiotic development, we have nothing in the pipeline to replace them. People will die.

What about that do you not understand?

[nadinbrzezinski]

169. In Europe they STILL write scripts for things like Antibiotics, but I am proof positive you

did not know this.

They also write scripts for other shit like statins, and ADHD meds, and psychiatric meds.

Now in Mexico it used to be the way you advocate, and in some ways still is, and one side effect is that super bugs are even worst than the ones here. So they FINALLY forced people to go to the doctor to get a script for antibiotics.

[grasswire]

176. you didn't read what I wrote

A rx is not necessary for antibiotics in 28 European countries. But most people DO use a script anyway. Fewer than ten percent of the antibiotic prescriptions in those countries are purchased without a prescription. So the common claim that open access to antibiotics will wreak havoc on a country's health is not supported.

The important thing is that each citizen has the choice to obtain a prescription for antibiotic. This means that marginalized people who for one reason or another can not or will not see a physician can obtain advice on their own and treat themselves.

The monopolistic franchise arranged between the government and the medical community forces every citizen to seek an appointment to get a needed (and sometimes life-saving) med. It's an artificial construct. And the arguments against open access to antibiotics are not supported by evidence -- they are simply fearmongering.

[nadinbrzezinski]

185. I fear the WHO is also in the fear mongering business too

Self-prescription of antibiotics boosts superbugs epidemic in the European Region

Copenhagen, 16 November 2012

Antibiotics kill bacteria, not viruses. Viruses, which antibiotics do not affect, cause 9 out of 10 sore throats and 10 out of 10 cases of influenza. Taking antibiotics unnecessarily weakens their ability to work against infections when they are needed. This enables bacteria develop resistance to antibiotics. On European Antibiotic Awareness Day 2012 (1), WHO advises the public to use antibiotics only when and as prescribed by a doctor.

“Since their discovery over 70 years ago, antibiotics have kept most of us alive by overcoming bacterial infections that could otherwise have been fatal. The use of antibiotics – and vaccines – has lengthened our life-spans by 20 years on average,” says Ms Zsuzsanna Jakab, WHO Regional Director for Europe. “If we want to retain this medical miracle, we must fully understand when antibiotics work and do not work, and act accordingly. This is a matter for everybody, from those who set policies and strategies, carry out research, and produce and distribute antibiotics to those who prescribe and use them.”

Awareness of the effects of overusing and misusing antibiotics is higher globally but lower in countries where antibiotics are less regulated and can be obtained over the counter, without prescription: in two out of three countries in the eastern part of the WHO European Region. A global WHO survey indicated that over half of all medicines – including antibiotics – are prescribed, dispensed or sold inappropriately, while half of all patients fail to take medicines correctly. This leads to increased antibiotic resistance and thereby decreases the number of effective antibiotics. In addition, it is alarming that no new antibiotic classes have been discovered in the last 25 years, despite the efforts of research.

The problem has not only enormous health consequences but also large economic effects for both individuals and societies, as resistant infections can be up to 100 times more costly to treat. Incurable or hard-to-treat infections are already found in the European Region. Every year, over 80 000 people develop tuberculosis that is resistant to antibiotics. Some developed European countries recently reported cases of cephalosporin-resistant gonorrhoea, which is extremely difficult to treat.

In this area, one of today’s main threats to the Region is the spread of bacteria that are increasingly resistant to antibiotics of the carbapenems family. These antibiotics are the only available cure for serious diseases such as those from multidrug-resistant Escherichia coli bacteria. Virulent strains of E. coli can cause gastroenteritis, urinary-tract infections and more severe conditions, such as meningitis, haemolytic-uraemic syndrome, septicaemia and pneumonia. In the last two years, resistance to carbapenems has surfaced in several European Union (EU) countries, jeopardizing the ability to treat patients. The easy transmission of carbapenem-resistant bacteria between patients and the increasing introduction of these bacteria into Europe from countries where they are widespread worsen the situation.

Mapping antibiotic use and resistance is a key aspect of the European strategic action plan on antibiotic resistance, endorsed by all Member States in the Region in 2011. On 30 October 2012, WHO/Europe signed an agreement with the National Institute for Public Health and the Environment (RIVM) of the Netherlands and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) to survey, contain and prevent emergence and spread of antibiotic resistance in countries that are in the Region but outside the EU. This complements surveillance conducted in EU countries by the European Centre for Disease Prevention and Control (ECDC) through the European Antimicrobial Resistance Surveillance Network (EARS-Net). A harmonized and coordinated surveillance network in all countries in the European Region is key to protect health from a cross-border threat.

ECDC has coordinated European Antibiotic Awareness Day since 2008. This year, WHO has joined forces with ECDC to extend the event to all 53 Member States in the European Region. For the first time, eastern European and central Asian countries are joining EU countries in activities that promote the prudent use of antibiotics. WHO/Europe and ECDC will host a joint Twitter session, with the support of the European Commission, on 20 November 2012 from 15:00 to 16:00 CET.

For further information, contact:
Danilo Lo Fo Wong
Senior Adviser on Control of Antimicrobial Resistance
Division of Communicable Diseases, Health Security and Environment
WHO/Europe
Tel.: [phone]
E-mail: [email protected]

Cristiana Salvi
Communications Officer
Division of Communicable Diseases, Health Security and Environment
WHO/Europe
Tel.: [phone] (mobile)
E-mail: [email protected]

http://www.euro.who.int/en/media-centre/sections/latest-press-releases/self-prescription-of-antibiotics-boosts-superbugs-epidemic-in-the-european-region


Note to hosts this is a press release.

Sorry, but those of us with a tad of knowledge realize that the abuse of these miracle drugs is leading to the end of the age of antibiotics. There are many things that will come to an end with it, but you are right, we all should be able to self prescribe them for things like the common cold, for which they are all but effective.

[Yo_Mama]

181. Europeans are quite concerned about overuse of antibiotics

In some countries a pharmacist can dispense, but they only do it generally after seeing a patient.

Some people have life-threatening complications from antibiotics, and then the plague of C. Dif. is worsened by too much antibiotics. Antibiotic resistance is a growing issue.

Here's a link:
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19488

[lostincalifornia]

129. Not sure if it is a federal law, but most doctors in the country want to see you before prescribing

any prescription drug

[Avalux]

142. I know you're upset, but there's a good reason for not giving it to you on your word.

Antibiotics ARE over-prescribed. I consider it irresponsible and even harmful for a doc to 'call-in' an antibiotic without examining a patient first (I don't care if they have access to your files). More times than not the illness is viral and antibiotics will not work. There is a looming antibiotic resistance crisis and the docs who prescribe without examination (or because a patient insists they NEED an antibiotic in spite of evidence of a bacterial infection) are contributing to it.

They are not created equal either - broad spectrum heavy hitters will kill just about anything, which makes it easier to give them out, even if a more targeted antibiotic would do the trick. These broad spectrum antibiotics need to be protected from misuse and overuse. Once bacteria become resistant to them, we're screwed.

So maybe there isn't a law and the doc office told you that so you wouldn't give them a hard time. Hopefully you understand why and made an appointment.

[Avalux]

145. A virus is a pathogen.

Antibiotics are not really drugs; they are pieces of bacteria made into a form human bodies can utilize that will kill competing bacteria (just like in nature). They are only effective against bacteria.

[SoCalDem]

152. I think drug stores are behind this, so they are not held liable

I remember reading about these sort of laws recently//

and of course it adds an additional co-pay into the mix, so I suppose insurance companies were happy to push for this law too.

There have been times when I was literally TOO sick to get out of bed & go to a crowded waiting room & sit for an hour...only to get a piece of paper (after paying an additional $20), so I could drive to another place where I would sit on a wooden bench for 45 minutes for a pill that might start making me feel better by tomorrow..

This sort of thing makes me remember how I used to be able to actually talk to a doctor on the phone, and when pharmacies delivered without an additional charge..

[yellowcanine]

157. FL law or not - doctors should not prescribe antibiotics without seeing patients.

Particularly for respiratory infections. This is how we end up with drug resistant TB, etc. And all antibiotics are not the same. The doctor has to try to prescribe the right one and the only way to be sure is to see the patient.

[Aristus]

161. You got that right.

The current indicated treatment for latent tuberculosis infection is isoniazid, which is highly hepatotoxic - really bad for the liver. We prescribe on a month-to-month basis for the 9-month treatment period. Prescription refill requires a clinic visit for assessment of possible symptoms of hepatotoxicity, and a physical exam. Plus, regular liver function tests. Any provider who doesn't require these steps as part of his treatment plan is heading onto shaky ethical ground.

If we didn't require these steps during the treatment period, I guarantee you someone would ask: "Why did they not take the necessary steps to ensure the patient's liver wasn't damaged?"

But when we take solid ethical steps to ensure good practice of medicine, we get the above: bad-tempered complaining because good medical care comes with some inconveniences.

[yawnmaster]

175. Society is harmed greatly by improper use of antibiotics. With antibiotics, in particular,...

one must look beyond the good to the individual and look at the danger or good it does the social community.
The risk of producing a resistant bacteria is just too great for call-in of antibiotics.
It should never be over the counter.
Antibiotics save large number of lives, but over use can make some of them useless, and the rate of discovery of new classes of antibiotics is very low.
The possibility of large loss of life exists if we don't very carefully manage antibiotic use.


Yes, in agriculture, too.

[grasswire]

179. the dangerous overuse of antibiotics....

....comes from agriculture. Not from people getting too much.

As the European stats show, when people of 28 countries are provided freedom to get their own antibiotics or get a prescription, far fewer than 10 percent choose to treat themselves.

So the idea that unregulated antibiotic purchases will create "large loss of life" is slim.

Shut down the agricultural misuse and we would all be safer.

[yawnmaster]

184. absolutely wrong. A resistant form appearing in a human directly affects humans...

and kills.
MRSA kills.
Antibiotics in a human gut can wipe out the beneficial bacteria environment.
If any bacteria in the gut become resistant it can pass resistance to pathogenic bacteria.
It is direct and scientifically documented.

Agricultural use of antibiotics is suspected and some research is showing it as a cause.

Why do I say absolutely wrong?
because it definitely comes from people getting too much, and it is a dis-service to society to deny it.
yes, the overuse in agriculture is definitely looking to be as dangerous, but human overuse IS dangerous.

[Warren DeMontague]

194. The problem is like 90% agriculture, if not more.

However, if it is between inconveniencing the farm lobby and inconveniencing your average Walgreens customer, guess who is going to get inconvenienced?

[yawnmaster]

198. Not seeing that in the literature...

MRSA, resistant staph aureus comes from ag?
don't think so, and these are killers.

there is a correlation between misuse antibiotics, non-ag in this case, and bacterial resistance.

ag use of antibiotics is important but there is just emerging data.
If you do have links to papers supporting the 90% claim, I would like to read them.

[Warren DeMontague]

202. Im not saying prescribing to humans shouldn't be judicious, still

My point About who is likely to be inconvenienced stands.

90% was off the top of my head- You are correct in that the data is not all there, what does seem agreed on is that antibiotic use in livestock is a problem.



http://www.washingtonpost.com/politics/feeding-antibiotics-to-cows-is-bad-for-humans-but-congress-wont-stop-it-new-report-says/2013/10/22/ecd2de08-3afd-11e3-a94f-b58017bfee6c_story.html

[yawnmaster]

239. Don't get me wrong, I agree that prophylactic ag use is definitely a problem...

but I don't want to devalue the issue that human targeted antibiotic overuse is a huge problem.
Because the target is human, the effect on human is much greater than the ag use, even though there is so much more of it.

At this time, and it may change, the human overuse effects are much easier to see. The affects are known and studied.
That said, the ag issue is starting to appear in the literature, and the longer it goes on, the higher the risk of the mutant resistive bacteria arising that enters the human domain.
Right now, though, the human targeted antibiotic use has a higher risk.

[energumen]

195. Just my opinion

but if I'm sick enough to actually need a prescription then I'm sick enough to need to go to a doctor to be checked out.

Also, it appears that laws regarding prescriptions may be changing. My son, who is adhd, has been able to get 3 months worth of prescriptions in one visit. They were carefully dated, to the day, so they could not be filled until the proper time but he did not have to go to the office every month. With some of the changes ostensibly brought about by the ACA, he will now need to go to the doctors office monthly.

[LadyHawkAZ]

210. Er...

no.

[Aerows]

214. I just served on a jury for this one

Might as well advocate flushing one's head in the toilet three times daily, staring at pictures of dead fish or contracting leprosy as an antidote for asthma that take advice from a website that is looking for money based upon what is essentially faith healing mixed with dubious bullshit.

[LadyHawkAZ]

215. I was the one who alerted.

It was a good recipe for dying a slow painful death, but not much else.

[Aerows]

216. Results:

REASON FOR ALERT:

This post is disruptive, hurtful, rude, insensitive, over-the-top, or otherwise inappropriate.

ALERTER'S COMMENTS:

Downright dangerous woo, advising asthma patients to drink more water and quit caffeine.

JURY RESULTS

You served on a randomly-selected Jury of DU members which reviewed this post. The review was completed at Mon Dec 9, 2013, 07:25 PM, and the Jury voted 4-2 to HIDE IT.

Juror #1 voted to HIDE IT and said: No explanation given
Juror #2 voted to HIDE IT and said: Handing out medical advice for a condition as potentially dangerous as asthma is absolutely irresponsible, and unacceptable on DU. Marshal needs to consult her physician, not some unaccountable, anonymous woo-slinger on the internet.
Juror #3 voted to LEAVE IT ALONE and said: No explanation given
Juror #4 voted to HIDE IT and said: Oh Lord. The last thing DU needs is more proselytizers of woo. We have plenty and they are not even as dangerous as this "advice". At least our current ones don't advocate people throw away their asthma medication. Good God. Mirt!
Juror #5 voted to HIDE IT and said: No explanation given
Juror #6 voted to LEAVE IT ALONE and said: It looks a little spammy but nothing over the line.

_______________________

I am not ashamed to be juror #4 this time.

[Barack_America]

231. Antibiotics won't treat your asthma exacerbation, steroids and albuterol will.

Your pulmonologist is not doing you the service you think he is. Antibiotics don't do jack for the bronchospasm and inflammation that define asthma. Calling in a steroid taper for serious asthmatics is appropriate, calling in antibiotics is not.

There is no role for antibiotics in the absence of radiographic evidence of pneumonia or symptoms consistent with a bacterial sinus infection.

If you insist on antibiotics for a viral URI, go to Mexico where you can self-prescribe to your heart's content. Pick any antibiotic, you can't go wrong. All will be equally ineffective at treating your viral infection.

-An actual MD

[kdmorris]

242. Have you been to see them in the last 6 months?

Every single one of my doctors will not prescribe (or refill) ANY drug if I haven't seen them within the last 6 months. I had a c-section in June and at 4 weeks post-partum, I had what was identifiably a staph infection in my incision. My doctor still made me come in because they had to culture it to determine exactly what kind of infection it was (community acquired MRSA) and what antibiotic it was susceptible to (Bactrim).

My body seems to have fought it off by itself, so she was surprised that it had cleared up without the antibiotics. Since it had cleared up on its own, she didn't prescribe any for me, to keep the bug from becoming resistant to anything else.

Sometimes there are reasons... I've never had success with my doctors in just calling them up and saying "give me these drugs" without them seeing me. It's a liability issue. If they prescribe a drug for you and something else was wrong - well, IF they have malpractice insurance, their rates are going to skyrocket after you sue them.

[JCMach1]

254. Why we need to relax the idiotic pharmacy laws in the US

UK and the rest of the world seem to get on fine with pharmacists distributing many drugs...


Of course, will never happen with the medical lobby...