Cal Dept. of Health Epidemiologist on Better Use of Antibiotics

Buried in an article about overuse of the wrong antibiotics creating "super" drug resistant bacteria http://www.latimes.com/news/local/la-me-infection-20110329,0,2329300.story(there is a current outbreak of Klebsiella pneumoniae, or CRKP, affecting at least 356 patients in Southern California in the last year)is this excellent section, What can patients do. However, what is nonsense, in part, is the Dept. of Public Health epidemiologist blaming the victims for the over prescription of antibiotics. Over the past 18 years, I have seen hundreds and hundreds and hundreds of patients pushed by their doctors to take unnecessary antibiotics for viral disorders like bronchitis and ear infections.


Yeah, patients need to be educated not to push for antibiotics. But who should educate them? That is the job of the M.D.'s themselves! Stop pushing drugs, guys? What really needs to change is the M.D.'s themselves who all too often give patients antibiotics "just to safe," while neglecting to advise them on the most basic nursing skills, like getting rest and pushing hot fluids. They are not practicing science-based, evidence-based, medicine.


Moreover, with other disorders, like low back pain, they are all to quick to give drugs like Vicodin and Percocet, which do not even reduce the inflammation that causes the pain (whereas ibuprofen does) which is so idiotic, especially since Vicodin causes constipation, which in turn forces patients to bear down hard with bowel movements, which is itself one of the tests for a bulging disc (called the Valsalva maneuver.) So if you become constipated and you have a mild disc bulge, you could actually worsen it. At least tell your patients to take stool softeners if you give that stuff.

But why not send them for acupuncture? Duh Uh! I had a patient just this week who had been given steroids! Frikkin steroids, which have a host of dangerous side affects. She also had percocet. They were doing nothing. One deep tissue trigger point acupuncture session with me and she was 50% better. Come on, western medicine needs to open its eyes and smell the needles.

Here is the excerpt from the article. The whole thing can be had here: http://www.latimes.com/news/local/la-me-infection-20110329,0,2329300.story
"What can patients do?

It's not right to pressure your doctor to give you antibiotics for a viral infection. We need to be cognizant about limiting the use of antibiotics, period, because we really are going to have problems. CRKP and MRSA (Methicillin-resistant Staphylococcus aureus) are the end result of us using antibiotics perhaps not as well as we should be using them. We have now developed these organisms that know how to combat even our biggest and baddest antibiotics. We cannot have these multi-drug resistant organisms running rampant. It's a good reminder to everyone, patients and providers, that we need to be really prudent when we give antibiotics to everyone, in-patient and outpatient.

What should patients ask their doctors?

Unfortunately, the culture now in these doctors' offices is you go in and say, 'I have bronchitis' and demand antibiotics.
Let's say you have bronchitis and you take [azithromycin]. Most cases are viral. If you had bacteria in your respiratory tract, they may have developed resistance. If you develop bronchitis that is bacterial, the next time you're treated the [azithromycin] might not work.
The public needs to give doctors that option to say that it's a virus instead of demanding antibiotics. We can also help doctors understand that it's OK to tell a patient to go home and rest and you don't have to give them something to make them feel like they got something out of the appointment. That is the culture. What we're trying to do with this initiative is to swing it the other way."


Ayurveda, Acupuncture, and Chinese Medicine in San Diegohttp://www.bodymindwellnesscenter.com

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