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 :(

"seeker there's nothing wrong in being open to new ideas , garlic was used against the plague in the middle ages very successfully. " this is where the Black Death references came from.

Sadly though olgaga the pharma tests can't test for every type of body weight\ lifestyle of each person who takes the drug. Maybe they test on different body types of mice I don't know . i DO know that we aren't mice or rats and the problem with thalidomide was down to that very reason.

Ppeatfruit- that's what clinical trials are for.

seeker Did they test those anti depressants that made some people commit suicide in clinical trials then ?? VERY EFFICIENT

olgaga Have they got a 'cure' for cancer then? Why did no one tell me?

Not quite sure what your point is.

Properly run clinical trips are the best way we have at the moment to test the efficacy and safety of medicines. They aren't always properly run.

Not particularly my area of expertise, but i think when drugs are tested in randomised control trials they go through different phases of development. First small sample, ever increasing numbers taking into account exactly things like weight, lifestyle and any other factors which might have an influence. They record these variables and by having sufficient numbers in their sample populations to give enough statistical power to the end data they can check the effects of different factors.

Thalidomide as far as I know wasn't because tests were based solely on animal studies but more that there was no regulation back in the day to ensure that the proper scientific process of clinical trials had taken place. Because of the thalidomide disaster the uk (and others) but into places statutory regulatory bodies to ensure that standards were adhered to.

Clinical testing also doesn't test how they might be used in combination with other antibiotics. Ds1's damage ( agreed by his doctors btw) was because of the frequency with which they were used (and prob in part by coming up against resistant strains). It's why, although I think they are miraculous drugs, I prefer to only take them for severe infections.

Yes maybe things like garlic will eventually be tested (it'll be slow though - there's no money in it, but I suppose they might do if they run out of other options). - but in the meantime it is possible to say 'hmm do I want to sit this out and wait and see if it goes away it gets so bad I need antib's, or shall I try garlic in the meantime?'

A bit like the diet we used with ds1. The evidence at the time was there - not trialled, but there was evidence. We were laughed at. Ten years later there isn't much more evidence really - not in a clinical setting although there is more research into why it might work. And I find paediatricians and neurologists recommending it. I suppose they think a) there's never going to be clinical trials b) there is a theoretical basis as to why it might work and c) it's not going to do any harm. Seems good doctoring to me - better than the first paediatrician's ridiculing.

" Ten years later there isn't much more evidence really"

Why not? If people have been using the diet for 10 years and it gets consistently measurably good results then there would be a body of evidence in the children's medical records.

Your point about the antidepressants is possibly down to having to need a large enough sample to show up problems. If it wasn't shown up in the trials it is a rare side effect. Trouble is trying to tease out causal effect from coinciental. They have a system to red flag all the reported side effects and investigate them. Might cause them to be withdrawn or just a warning put on them for dr's and patients to weigh up the cost/benefit in each circumstance.

10 years isn't long in terms of epidemiological research. Funding issues. And also (possibly mainly) getting ethical approval for any sort of trials for drugs treatments etc for children is phenomenally difficult .

Those A.D.'s that caused a WORSENING of the illness they were being taken for in some patients were much more recently "tested' though weren't they Nipit?

seeker what I'm trying to say is there should be tests run by neutral bodies who have the humility to admit that nothing is entirely trustworthy.

Yes they would. But, and I'm not familiar with the literature on it at all, but as it wasn't shown up in the trials it could be a rare occurrence (so only came to light when millions of people started taking it) or to nit be causally linked. There will be a proportion of people in whom the symptoms would have got worse or new symptoms develop that it's often human nature to attribute to something new you're exposed to. I would imagine there have been studies done to test this (though don't know what results are). But yes, I guess what you're saying is that the clinical tests aren't infallible?

Just had v quick look and came across a feb 2012 clinical trial comparing Paxil (which I take it is the one reported in the media as a problem) with another antidepressant and found that it was associated with increased tendency have suicidal thoughts. But interestingly my assumption that must be loads of research on this could be wrong as the article starts by saying that clinical trials in depressed patients for increased suicude risk are rare - which I guess is due to ethical issues (ie outcome is suicide so unethical to apportion patients to effective vs hypothetically ineffective treatment eg)

"seeker what I'm trying to say is there should be tests run by neutral bodies who have the humility to admit that nothing is entirely trustworthy."

Like who?

Yes Nipit IMO NOTHING is infallible and the sooner people realise that they may not demand ABs for ridiculous reasons.

It might make them actually take responsibilty for their OWN health . Mind you there I really am being naive !!

But also what I'm saying is that the pharma companies are under strict regulatory control nowadays. So the tests are overseen by an independent body.

Hm according to Saint Ben Goldacre pharmaceutical companies are still hiding results. Just google Big Pharma blog Ben Goldacre.

I suppose we can sneer at garlic, or onions, but might be worth remembering this quote from the BBC website:

Dr Ibrahim Hassan, a consultant microbiologist at Wythenshawe Hospital in Manchester, said there are more cases of patients with bacterial infections resistant to antibiotics - meaning there are fewer treatment options "All you can hope of is a bit of holy water because you don't have too much option in terms of treatment. "We're beginning to see that in some hospitals, patients coming in with this infection with no antibiotic that can be used to treat them^

If you have better ideas than garlic or onions I'm sure Dr Hassan will be pleased to hear them. (The Chief Medical Officer seems to be leaning towards 'force the drugs companies to develop new antibiotics, but Andrew Read's TEDMED talk explains why he thinks that's a mistaken approach).

I think up a few posts, someone said that scientist know that they don't know. I think this is very true. I don't think anyone should be sneery about the usage of garlic or other natural remedies. But the point is that just because they have known (or 'scientifically unknown') antimicrobial properties in vitro or in an animal model, or even given orally to humans, doesn't mean that it will be effective at all anatomical sites, or whether it might cause harmful effects. That's why the active ingredients would need to be isolated and testing done to determine its efficacy and safety, even if it is a natural product around used for many years.

And its not just drug companies that work to develop new antimicrobials - the academic community also aim to do that. And I would imagine that they have all been doing exactly that for many, many years. There are new things around (cationic antimicrobial peptides, eg), but there's just nothing that is capable of the phenomenal impact as antibiotics - its not for want of trying though!

That type of evidence is regarded as anecdotal seeker (who is going to be recording this stuff and collating data anyway?)

That type of evidence was around when the paediatrician laughed at me. Parent report is how I found out about the diet. You can't do double blind trials on diet.

I don't know what happened in ten years to mean that the paediatrician and neurologist suggested it (although I did almost fall off my chair.) It may be because researchers started looking at reasons why the parents were reporting changes and found that there were underlying issues as to why that might be the case (but even in that case one of the biggest research institutes focussing on this area had to be funded by a parent - there was no interest in pursuing parent anecdote - even when lots of people were reporting this). Gradually the word has got out I guess.

Anyway good it's being suggested now my senior clinicians. And glad I made my own decision in 2001 and didn't wait for them to decide it was ok to try

I'm sure there is a PhD student working somewhere on the antimicrobial properties of garlic, but it's a long way from that to something clinical (and my point remains, if you have a minor infection now and your choice is a) wait it out b) use garlic c) use antibiotics then if it's somewhere accessible/appropriate I'll try garlic.

And this isn't about whether garlic is better than antibiotics (or vice versa) this is about Dr Hassan saying We're beginning to see that in some hospitals, patients coming in with this infection with no antibiotic that can be used to treat them and Andrew Read saying that in 2011 100,000 Americans died from infectious diseases that were easily treated 20 years ago.

We could carry on the way we have been - but I suspect if we do that 100,000 figure will get higher.

I agree it's anecdotal. But anecdote backed up with medical records is one step on from straight anecdote. If the diet had been making significant differences to these children, then their medical records would show it. And as far and I know, it doesn't.

I think deaths from previous "treatable" infections will rise.
They already are, probably.
Also, I really think that lifestyle/affluence has a key part it play here too.
For example, on 2011 a child born in Glasgow had a life expectancy of 13 years less than a child born in Kensington.
A child with a poor/weakened immune system from a poor diet/lack of adequate care wil be far more likely to succumb to such illnesses.
:(

A PubMed search retrieves 111 articles on "antimicrobial properties of garlic", 40 in the last 5 years and 73 in the last 10 years.

About garlic and the common cold:
Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database Syst Rev. 2012 Mar 14;3:CD006206

" Of the six trials identified as potentially relevant from our searches, only one trial met the inclusion criteria. The number of days to recovery from an occurrence of the common cold was similar in both groups (4.63, garlic, versus 5.63, placebo). Adverse effects included rash and odour. :)
AUTHORS' CONCLUSIONS:
There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. Claims of effectiveness appear to rely largely on poor-quality evidence."

So are you saying the paediatrician and neurologist were wrong to recommend it? They were both very senior, well respected, NHS clinicians who knew more about autism than many of the doctors I've seen over the years. They must have seen some evidence to believe it worth mentioning. I didn't bring it up, they did.

Why would I have even reported on the effects of the diet to his doctors? He never sees a GP (too hard to take him - he went last week for the first time in 7 years because we had no choice) and he has a review with a paediatrician (and maybe specialist referrals as a result of that) once a year. When I mentioned the diet to his original paediatrician I was laughed at, why would I talk to him about it? Who is going to be doing a detailed recording of notes to collate data about a diet?

Anyway here's a recent paper about the diet (although that was published after they made their recommendation)

Or maybe we could do what we did, realise it wasn't going to be dangerous, give it a go and see what happened. It helped him enormously. So thank goodness we didn't wait ten years for the doctors to decide it wasn't to be laughed at anyway.