7 ms·

They should be blaming doctors and people for using them incorrectly. Doctors used to give them to people because they had a cold, for example. People insisted

by melling 10y ago

They should be blaming doctors and people for using them incorrectly. Doctors used to give them to people because they had a cold, for example. People insisted on being given some sort of medicine. In India, you can still buy antibiotics over the counter. http://www.npr.org/sections/goatsandsoda/2015/09/17/441146398/why-india-is-a-hotbed-of-antibiotic-resistance-and-sweden-is-not http://www.npr.org/sections/goatsandsoda/2015/09/17/44114639...

douche 10y ago
Unfortunately, that does work in most cases. I'm curious what the success rates would be if all zithromax (?) prescriptions were replaced with sugar pills. I've gotten that drug many times for what may or may not have been strep or bronchitis.
- Fomite 10y ago
  There is actually a company doing this. They were handing out samples at IDWeek. It's called the "ZeePack" or something of the sort (a play on the the azithromycin/zithromax 'Z-Pak') and is essentially vitamins and herbal supplements you can give to cold patients so they feel like they have been given something.
- rscho 10y ago
  The "success" rate would still be very high, as most people would surmount the infection. However, the "failure" rate (people dying) would be much higher as well... I am sure you can see that would be an ethical and practical problem. Where would you put the "safety" cutoff of not giving zithromax?
  - douche 10y ago
    Really, what are the rates on people dying from tier 1 infections like that
    - rscho 10y ago
      https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm That kind of rates. In the 1918 influenza pandemics for example, many people died of a bacterial pneumonia following the flu infection. So you see, the impact of "1-tier" infections is very real without antibiotics. EDIT: by all means, downvoters, make your point explicit!
- fuzzfactor 10y ago
  Perhaps healthier hearts? http://www.fda.gov/Drugs/DrugSafety/ucm341822.htm http://www.fda.gov/Drugs/DrugSafety/ucm341822.htm Seems like one of the primary features of this antibiotic was to have a chemical that was new at the time, so patent protection could be enjoyed from that point forward. Different features can have different priorities at different times, sometimes there's nothing "engineering" can do about it, it's a marketing thing. Wherever cardiac health might fall on the priorities list, it's probably not way up there for this compound. disclaimer: haven't worked for a drug producer since I was first out of college
rscho 10y ago
This issue is not as easy as it seems. Doctors used to give them for a cold, and still do (even in the best medical practices). There are two important things to be aware of: - Differentiating "common cold" (viral infection) from a bacterial infection, which would be a correct indication for antibiotics, is often impossible. If you want the best chance for your particular patient, what will you do? Now, if you want the best chance for the whole patient population, what will you do? Not the same thing. - If you don't give antibiotics, things turn wrong, and the patient's family comes back wielding pitchforks, what do you do? This is less of a problem nowadays, but in small communities and rural environments can still be a very real question. This is also a bit of a cultural issue. Now, I agree completely that OTC antibiotics make no sense at all.
- pmiller2 10y ago
  Both your points are technically correct (the best kind of correct), but miss the mark in practice. There's no real reason most of the time to differentiate between the common cold and other upper respiratory infections, unless complications ensue. Simply put, a healthy, non-immunocompromised person will fight off basically any upper respiratory infection without a problem.
  - rscho 10y ago
    A healthy person, absolutely if he is 30 years old. Now how will you handle the healthy 80 yo patient? Will you take the risk of a bacterial infection that may kill him, although he is now perfectly healthy and still doing hiking on a regular basis? Now what, if he is 1 year old? I think you underestimate the potential impact of common infections. This is a grey zone. There is no correct answer. Everything depends on where you put your safety/futility cutoff for the treatment decision, which is what doctors are paid for.
    - mst 10y ago
      Had my father made it to 80, I strongly suspect he'd've wanted to take the risk to help preserve the antibiotics for younger people. Of course this doesn't necessarily generalise, but there's plenty of older english people with the "I don't want to be a bother" mindset so it might do better than you think.

by melling 10y ago

douche 10y ago

Unfortunately, that does work in most cases. I'm curious what the success rates would be if all zithromax (?) prescriptions were replaced with sugar pills. I've gotten that drug many times for what may or may not have been strep or bronchitis.

Fomite 10y ago
There is actually a company doing this. They were handing out samples at IDWeek. It's called the "ZeePack" or something of the sort (a play on the the azithromycin/zithromax 'Z-Pak') and is essentially vitamins and herbal supplements you can give to cold patients so they feel like they have been given something.
rscho 10y ago
The "success" rate would still be very high, as most people would surmount the infection. However, the "failure" rate (people dying) would be much higher as well... I am sure you can see that would be an ethical and practical problem. Where would you put the "safety" cutoff of not giving zithromax?
- douche 10y ago
  Really, what are the rates on people dying from tier 1 infections like that
  - rscho 10y ago
    https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm That kind of rates. In the 1918 influenza pandemics for example, many people died of a bacterial pneumonia following the flu infection. So you see, the impact of "1-tier" infections is very real without antibiotics. EDIT: by all means, downvoters, make your point explicit!
fuzzfactor 10y ago
Perhaps healthier hearts? http://www.fda.gov/Drugs/DrugSafety/ucm341822.htm http://www.fda.gov/Drugs/DrugSafety/ucm341822.htm Seems like one of the primary features of this antibiotic was to have a chemical that was new at the time, so patent protection could be enjoyed from that point forward. Different features can have different priorities at different times, sometimes there's nothing "engineering" can do about it, it's a marketing thing. Wherever cardiac health might fall on the priorities list, it's probably not way up there for this compound. disclaimer: haven't worked for a drug producer since I was first out of college

rscho 10y ago

This issue is not as easy as it seems. Doctors used to give them for a cold, and still do (even in the best medical practices). There are two important things to be aware of: - Differentiating "common cold" (viral infection) from a bacterial infection, which would be a correct indication for antibiotics, is often impossible. If you want the best chance for your particular patient, what will you do? Now, if you want the best chance for the whole patient population, what will you do? Not the same thing. - If you don't give antibiotics, things turn wrong, and the patient's family comes back wielding pitchforks, what do you do? This is less of a problem nowadays, but in small communities and rural environments can still be a very real question. This is also a bit of a cultural issue. Now, I agree completely that OTC antibiotics make no sense at all.

pmiller2 10y ago
Both your points are technically correct (the best kind of correct), but miss the mark in practice. There's no real reason most of the time to differentiate between the common cold and other upper respiratory infections, unless complications ensue. Simply put, a healthy, non-immunocompromised person will fight off basically any upper respiratory infection without a problem.
- rscho 10y ago
  A healthy person, absolutely if he is 30 years old. Now how will you handle the healthy 80 yo patient? Will you take the risk of a bacterial infection that may kill him, although he is now perfectly healthy and still doing hiking on a regular basis? Now what, if he is 1 year old? I think you underestimate the potential impact of common infections. This is a grey zone. There is no correct answer. Everything depends on where you put your safety/futility cutoff for the treatment decision, which is what doctors are paid for.
  - mst 10y ago
    Had my father made it to 80, I strongly suspect he'd've wanted to take the risk to help preserve the antibiotics for younger people. Of course this doesn't necessarily generalise, but there's plenty of older english people with the "I don't want to be a bother" mindset so it might do better than you think.