Antibiotics Create False Sense of Security

Aaron CarrollI have lived a long and colorful life — causing myself far more pain that I was born to. Yet the most painful thing I have ever been through was a case of herpes zoster — “shingles.” For five days, I was in so much pain that I did not sleep except for passing out for a few minutes here and there. The thing about shingles is that it is caused by a virus. I finally made it to a doctor on the fifth day and they put me on some kind of antiviral drug. And it was amazing — in its total uselessness.

This only highlights just what amazing things antibiotics are. If it weren’t for antibiotics, I would be dead. At least once they saved my life and maybe more than that. So it truly is remarkable that we have these largely generic drugs that are so highly effective. And it shouldn’t surprise us that doctors give them out like candy. It is a form of defensive medicine that actually has potentially deadly aspects.

I’m not talking about the antibiotic resistance that taking the drug creates, although that is certainly an issue. Instead, I’m talking about an article by Aaron Carroll, On an Antibiotic? You May Be Getting Only a False Sense of Security. In it, he noted that doctors often don’t know if the disease they are treating is caused by bacteria. He started with an extreme example:

The best way to prevent transmission of Ebola in the United States is to identify and quarantine those with the disease as soon as possible. However, the first Ebola patient in this country was, unfortunately, released after going to an emergency room, even though he had symptoms indicative of the disease. He was sent home on antibiotics.

But this seems to be pretty typical. Here, the doctors thought that Thomas Eric Duncan had a sinus infection. The problem with that is that sinus infections are usually viral, not bacterial. So even if Duncan had had a sinus infection, the doctors probably didn’t treat it properly, “Yet antibiotics are regularly prescribed in this manner.” And the issue isn’t just with the people treated.

Carroll is a pediatrician and so he is very familiar with conjunctivitis — “pink eye.” The general rule is that children with this disease are not allowed back at school until they’ve been on antibiotics for 24 hours. One of the problems with this rule is that pink eye is usually caused by a virus. But even when it isn’t, “Drugs simply work differently in different people.” He noted that people with pink eye could be contagious up to ten days after they start a course of antibiotics! The bottom line:

Even in the best-case scenario, being “on an antibiotic” isn’t much protection for others. And often, antibiotics offer no protection at all.

So what do we do about this? Carroll doesn’t have much of a recommendation other than for doctors to recognize that they often prescribe antibiotics more for themselves than for their patients. But I have a thought that has nothing to do with medicine. I think the problem is that our culture has changed in ways that are hurting us. It isn’t just that we pretend that everything must get done now now now! (I have friends who work for content providers and they are on deadline constantly; there is no normalcy.) But the bigger issue, I think, is that now most households have two people who work outside the home. So it is really important to get the kids back to school. It’s madness. And it is probably killing us in more ways than one.

On a personal level, you might want to make sure that what your doctor is giving you is correct. But even if it is, it doesn’t mean you aren’t contagious. Streptococcal pharyngitis – “strep throat” — which is treated really well by antibiotics, doesn’t do much to stop it from spreading from the patient. So try to slow down and spend a little time alone. Learn to meditate. Or start a blog! The two are really not that different.

Afterword

I want to be clear that I think who manages the home ought to be a couple’s choice. But the big problem is that most jobs don’t pay enough to support a family anymore. I find it interesting that conservatives spend so much time whining about the dissolution of the family, yet they aren’t willing to support economic policies that would facilitate family cohesion. Managing a household is a full time job. We have two income families now because the business community wants higher profits and the government has enforced policies to assure that. It isn’t that way because the American family was just itching to have someone else raise its kids.

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