to be really annoyed about antibiotics?

[WaterfallsOver]

Or rather their misuse. I have parent friends who run to the GP every time little Billy has a cough, demanding antibiotics, so many people see them as a panacea. I'm not medically trained but I know they don't work on viruses and many illnesses need to run their course with no medical intervention.

The news is telling us antibiotics won't work in a few years due to over/misuse. I feel really angry that selfishness and stupidity mean in a few years people may die from infections resistant to antibiotics :( if they were only used for serious illness perhaps we'd have a chance. There was a guy who died from resistant infection on the news :(

Yes, but the news has been telling us that since I was a kid, so about 40 years.

I am genuinely puzzled as to why it's news, to be honest.

And can the doctors not tell your friends 'no'? That's what my doctor does. 'It's viral. Take some paracetamol.'

5 words. End of problem.

A lot of people do seem to think they are being "fobbed off" if they're told an illness is viral and go back to "demand" abx. Ladt month someone I know had abx prescribed for a viral chest infection

I agree that people who demand them for viruses are bloody stupid. But the GPs who prescribe them are mostly to blame. It is within their capabilities to refuse to write a prescription or give a placebo.

Drs do not (certainly not my ones) prescribe for the sake of it or because they are asked to. My DS has been on them for several weeks for a chest infection, he's 20 months old and unable to shift it himself. So Mind your own business.

The problem here is not so much that we're over-using them, it's that medicine hasn't kept up with us and done enough to create new strains of anti-biotics that can deal with all the different levels of infection that are around these days.

I heard on the radio that sometimes an illness can be either viral or bacterial, and the test to find out which is more expensive than prescribing antibiotics. Not convinced that's a good reason to do it though, if the outcome is that they become ineffective.

It's news because no new types of AB have been discovered since the 80s (?), no new ones are known to be in the pipeline, pathogens continue to develop resistance and there are ever more multi-resistant strains.

It needs to be tackled as a matter of great importance: expectations of prescriptions, prescribing habits, education on the need to finish a course of ABs, and their non-therapeutic use in food production.

If this does not happen, and the evolution of resistant strains continues on its current trajectory, our children will be dying from bacterial infections much as our great-grandparents did.

I think it's probably a mix of the two tbh.

an old lady I used to know told me proudly that her gp would write her a prescription for antibiotics if she just rang "ans not many nowadays will do that"

I also know someone whose parents live abroad where you can purchase them and they bring a stash every time they visit for my friend "just in case"

I think my surgery strikes the right balance, am not keen on antibiotics myself but they have always counselled me strongly towards them when they have been indicated (and I'm glad they did, my gp is ace :)

Agree that medical research isn't doing enough to 1) develop easy tests to determine if an infection is viral or bacterian and 2) develop new antibiotics

It's all pants :(

Bang Goes the Theory on BBC1 last night was about this. Very interesting.

Resistance is due to over use - including antibacterial cleaners - and also the fact that many people do not complete the course when given ABs.

As far as I'm aware, people taking ABs for viral problems has nothing to do with multipleresistant strains, its just pointless as it does nothing, and therefore a waste of money
People not taking ABs properly (when they are needed) is what causes resistant strains

"It is within their capabilities to refuse to write a prescription or give a placebo."

I agree that GPs should be refusing, and usually do so, to prescribe unnecessary antibiotics but we can't prescribe placebos.

There has been a real historic problem of over-using antibiotics, not out of badness on the part of doctors or patients, but because suddenly there was a real treatment for infections so they were used liberally.

BGTT also showed a test being trialled to show whether an infection is viral or bacterial. It depends on the existence of a protein that is only present in one or the other sort of infection rather than growing cultures with takes days.

My DSs have been prescribed antibiotics a lot - I often question the doctor and say I'd rather not have them if they're not necessary, and they always tell me I need to give them.

The DSs get fevers with swollen tonsils - as a previous poster said, I think that this can be viral or bacterial and the doctors don't want the delay/cost of doing a swab and growing a lab culture to find out.

''Ladt month someone I know had abx prescribed for a viral chest infection ''
Without testing, GP would not know if the chest infection is viral or bacterial, symptoms tend to be very similar. However, if the infection seems to worsen it's often assumed it might be bacterial hence the antibiotics.

Only 70 years ago thousands of people died from infections that we consider so minor now. Bacteria and viruses continue to mutate and change. Our antibiosis strategy hasn't kept up, because in spite of all our efforts, we don't have the wherewithall to diagnose and target individual strains quickly, so are forced into using antibiosis with a broad effect, thereby allowing the resistant strain to increase in virulance and prevalence.
Often a patient will present with what is clearly a bacterial infection, and although the doctor could give an antibiotic active against gram-negative bacteria, allowing the positive bacteria to thrive and hold back the (at this stage tiny) population of resistant strain, the patient may not be able to wait 2 or 3 days while a sample is taken and cultured to find out what is the main commensurate bacterium in the sample; therefore we would recommend broad spectrum antibiosis to help the patient while the sample is being cultured, and then a change to a more approriate drug. Please do remember though, that in the absence of antibiosis, flawed as it is, many many more people would die or suffer serious life changing consequences from what are currently easily treatable diseases and injuries.
The good news is that diagnostic techniques are improving. Within the next few years instead of attending the surgery to see a doctor because we have a bad cough, we will be asked to provide a sample/swab and then return later that day or the next day for patient specific personal medication targetting the appropriate infective agent or ailment.

BrainSurgeon Tue 12-Mar-13 10:48:31
Agree that medical research isn't doing enough to 1) develop easy tests to determine if an infection is viral or bacterian and 2) develop new antibiotics
It's all pants

We're doing our best . It's not bacterial or viral which is the issue though, it's which one of each. The fast tests are very sensitive which means that they are confounded by commensurate bacteria rather than showing the causative agent. We will get there, but it is really not a simple task!

I have been struck down by a nasty virus this past week, have felt properly shit with a swollen throat, bad headache, snotty nose, cough the lot and sooo many people have said 'have you been to the doctors yet?' No, I haven't because it is plainly a virus and he will tell me to go home and take some paracetemol. I don't know why people find this so hard to get.

I don't get how people just know it's viral. Without a test you really can't tell, right? So if you've been sick for a couple weeks, why not take ABs if your doctor will give them.

It does become a problem if, like my sister, you have a virus in early December and by Christmas you have a full-blown bacterial infection, and the GP still refuses to prescribe antibiotics.

She ended up having a fortnight off work with a severe chest infection in January which was cleared up by the beginning of February after two courses of antibiotics. She has now lost her voice entirely and has had to be referred to the ENT, and the voice clinic.

All thanks to the GP dismissing her because "It's just a virus".

Until they can properly test whether or not people have a bacterial infection as well as a viral infection (it is possible to have both) then people will suffer unnecessarily.

My DD had a severe ear infection a couple of weeks ago - blood and pus oozing from her ear through the night - and even then the GP was reluctant to prescribe antibiotics.

I think people have forgotten that people used to die through simple, untreated infections such as a dental abcess.

I wonder why other countries where antibiotics are more readily available don't seem to have our problems with antibiotic-resistant hospital-borne infections - which is what this "concern" stems from!

Doctors were warned when antibiotics were introduced that misuse would lead to resistance. It was obvious then - let alone now, we're already having to use far higher doses than we did when they were first introduced.

Trouble is there isn't enough clarity within the system. When ds1 was little he was given antibiotics for every ear infection he had (which caused him a lot of damage and took years to sort out). DS3 then had repeated ear infections and burst ear drums - he was hospitalised during an early one as he'd had a seizure and the paediatricians were very clear that they do not give antibiotics for ear infections however bad, except in very special cases (and not without a swab). I know fewer GP's prescribe antibs for ear infections these days, but a lot still do and well repeat x1000 really.

The govt seems keen to interfere in pretty much ever aspect of GP practice so I don't know why they haven't in this case really.

But expectations need to change as well. Sometimes you can't get instantly well.

This news has coincided with ds1 having his first set of antibiotics in ten years (am gutted actually, but I do think they're probably necessary).

talk for anyone interested in resistance.

You can buy them over the counter in some countries. My db and sil stock up when they go to visit family in Spain, and give them to their children at the hint of a sniffle. Makes me v v v cross.

And they pump them into cows etc to make them grow faster in some places as well. The news is right that there needs to be a global understanding really.

But expectations need to change as well. Sometimes you can't get instantly well.

I don't think anyone expects to get "instantly well" but they do expect their illness to be treated to avoid further severe illness which can cost them their long-term health and even their job!

It's all very well to blame the medics or blame the pharmacologists or even blame one's neighbours and friends. How many of use regularly use antibiotics in our homes just to keep them clean? Our immune systems are becoming less able to cope with diversity as we are exposed to less strains of bacteria and viruses. I work in this field and am amazed by how many people who work to develop cytostatic or cytotoxic agents don't realise that 'antibacterial' means the same thing!!