Wednesday, January 09, 2008

Brits love a healthy debate...

From Britain's Telegraph, news on a new government program to reduce antibiotic prescriptions as a way to reduce the superbug cycle. I've included a snippet of the article. It is the responses to the article that are just as interesting. In response to this topic, readers blame doctors, politicians and patients for the problem. These comments show the complexity of the issue and the passion of those seeking a solution. My favorite response is listed below in which the writer tells people to stop being wimps, suck it up and go to the doctor's office less.

Stop giving antibiotics for colds, doctors told

By Rebecca Smith, Medical Editor
Last Updated: 12:09pm GMT 09/01/2008

Doctors are to be told to stop prescribing antibiotics for coughs, colds and sore throats because over-use of the drugs is fuelling the spread of killer hospital superbugs.

  • Alan Johnson, the Health Secretary, says it is time to end the unnecessary use of penicillin and other commonly-prescribed pills, which cost the NHS £1.7 billion a year.

    Using antibiotics too liberally has led to bugs such as MRSA becoming resistant to treatment with the drugs. Most colds, coughs and flu are caused by viruses, which cannot be treated with antibiotics anyway, Mr Johnson points out.

    Announcing a £270 million campaign against superbugs, to be launched next month, he says it is vital that doctors adopt "less of a knee-jerk reaction to prescribing".

    The campaign, called Clean, Safe Care, will also include an extra £45 million for hospitals to spend on infection control nurses or antibiotic specialist pharmacists. All patients going into hospital will be screened for MRSA by 2009.


    Antibiotics fight "bugs", not viruses, so the basic premise is absolutely correct. Do not give antibiotics merely for colds or flu. BUT post viral conditions such as chest infection, infected sinuses and catarrh (and real sore throats) DO need antibiotics and I hope this will not change under the new guidelines. Perhaps doctors could prescribe a placebo antibiotic to anyone insisting on antibiotics who merely has a viral infection.
    Posted by graham wagner on January 9, 2008 9:59 AM

    Antibiotics are not the cure for superbugs, cleanliness is - and the hospitals simply aren't clean enough in the UK. Accountability is needed, not money, run a hospital like a fast food joint. "Clean as you go" and it is all staff's responsibilty to clean up, not delegated to the lowest bidder.
    Posted by Craig Douglas on January 9, 2008 9:55 AM

    So what is Alan Johnson's next big idea? Now wash your hands? Make sure you're wearing your face-mask? Or is he going to go round every surgery and tell the doctors what medicine to prescribe? What a joke! The trouble is this joker is in charge of the health service! That is more frightening than any superbug.
    Posted by Pinkie on January 9, 2008 9:27 AM

    The best solution for colds and viruses is to stop giving them to everyone else!
    If people stayed at home and looked after themselves when they became ill there would be a lot less general illness in the community, rather than battling on and infecting all and sundry.
    Surely we all know by now that antibiotics are not given out by GPs for colds - that has been common knowledge for decades - hence the barrage of cold 'cures' on the shelves.
    Posted by Annie on January 9, 2008 9:25 AM

    I am a GP and we know that we should not give antibiotics in the circumstances described; the patients do not always know this and it does not matter how many times we inform them they will keep coming back until they get them, in these circumstances another approach needs to be adopted and a debate needs to be taken on what this might be.
    Posted by Jonathan Allcock on January 9, 2008 8:50 AM

    Simple - don't go to your doctor - it's dangerous. I've been telling my patients this for years. The whole ludicrous thing is compounded by several factors: the great unwashed believe it's their god given right to be ill on a regular basis, a health service that is free at the point of delivery (if you offer free beer there's a queue that stretches round the corner and up the road), and a partially educated, disinterested and overpaid workforce.
    Posted by Andrew Renaut, Associate Professor of Surgery, Brisbane on January 9, 2008 8:36 AM

    The crux of the issue lies in the fact that many people are greedy and want immediate satisfaction. I have wrestled with people who demanded antibiotics for simple viral illnesses. The the patient wants to leave with something in his/her pocket and they are willing to go to any means to acquire it.
    There are also legal implications that are caused by the system. If a patient complains of not receiving the desired medication or a rationalized "standard of care", the legal system automatically demonizes the medical practitioner.
    I am all for placebo's in this instance.
    Posted by James on January 9, 2008 7:51 AM

    Yes suck it up. It is called illness. We are made of flesh and blood and mortal. It is normal for people to get sick off and on. You must endure illness sometime. If you find yourself going to the doc everytime you feel unwell then you likely are a mental case ie "nervous nelly". Anxiety /depression are a big reason why folks can't cope w/ minor illnesses. Quick being a wimp
    Posted by ER doc on January 9, 2008 6:59 AM

    Again the real cause of hospital infection is ignored. Unsustainable bed occupancy ratios, and out- sourcing of hospital cleaning. Blaming GPs is an irrelevant political ploy. Fight the real battle please.
    Posted by John Powell on January 9, 2008 6:47 AM

    Most experts talk around the Problem of Antibiotic Resistance. Your article headlines should say "ALL COLDS ARE VIRUSES, ANTIBIOTICS DO NOT KILL VIRUSES, THEREFORE YOU(DOCTORS) MUST NOT USE/ ANTIBIOTICS and start from there. Bacteria and viruses are as different as Gold and Lead. It is possible that a virus can make a person sick and that because of a compromised Immune System bacterial Infections can follow which can then require antibiotics to heal, It should also be pointed out that antibiotics tend to kill many neccessary bacterial species in the body and so lead to further problems-(example,life on the toilet) and Candida infections
    Posted by declan mansfield on January 9, 2008 6:13 AM


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