5 ms·

I bet all those antibiotics prescribed for covid didn't help as well. That was happening on a massive scale in my country

eschaton 4y ago
Why were doctors prescribing antibiotics for COVID?!
- pram 4y ago
  I think some of those 'kits' countries were distributing to people early-on (before the vaccine) contained stuff like doxycycline.
- AustinDev 4y ago
  Secondary infections of bacterial pneumonia were common with COVID iirc.
  - dopylitty 4y ago
    A study just came out showing that co-infections weren't common [0] 0: https://academic.oup.com/ofid/article/9/Supplement_2/ofac492.046/6902149 https://academic.oup.com/ofid/article/9/Supplement_2/ofac492...
- anbende 4y ago
  When I was in Peru, they kind of prescribed antibiotics for everything. Persistent cold? Antibiotics. Like that. Source: lived there with Peruvian partner for 18 months.
  - getoj 4y ago
    Same deal in Japan, every time my kid has a cold her mum takes her to the doctor and comes home with antibiotics. When I get a cold the first thing anyone asks is whether I went to the doctor yet. For what? “Medicine.”
  - friendlyHornet 4y ago
    I'm Jordanian and it's the same in Jordan; it feels like people take antibiotics like candy in Jordan
  - lucb1e 4y ago
    Germany/Netherlands also from my limited experience.
- eftychis 4y ago
  Death from COVID, and other pneumonic (pulmonary) diseases, can be commonly a result of secondary infection by bacteria. Our bodies are not the best at handling two different types of threats at the same time. See https://www.nature.com/articles/s41598-021-92220-0 https://www.nature.com/articles/s41598-021-92220-0 for instance. P.S. Note that the situation was unclear in 2020-2021 -- for instance from a quick lookup see https://pubmed.ncbi.nlm.nih.gov/34354682/ https://pubmed.ncbi.nlm.nih.gov/34354682/. So patient management was different per region -- as it was a guess.
- xvilka 4y ago
  Some of the antibiotics have also proven antiviral and/or immunomodulatory effect, e.g. azithromycin [1] or levofloxacin [2]. [1] https://pubmed.ncbi.nlm.nih.gov/34015317/ https://pubmed.ncbi.nlm.nih.gov/34015317/ [2] https://pubmed.ncbi.nlm.nih.gov/32546446/ https://pubmed.ncbi.nlm.nih.gov/32546446/
silisili 4y ago
Even in the US, pre COVID, every time I went to to doctor with a bad cold/flu, they'd just give you a Z Pak(antibiotics) and say...if it's bacterial this will kill it, if it's viral it'll work itself out. So I can definitely see how they're overprescribed.
- seunosewa 4y ago
  They are cheaper than the tests to determine whether they're needed.
  - mschuster91 4y ago
    And yet, people will demand an antibiotic from their doctor even with a test showing it's viral. Partially because school science ed doesn't cover that topic at all, partially because of "folk tales" aka learning from parents who didn't know better, partially because of placebo effect... and ultimately, because people want/need to feel better soon because they can't afford being too sick to work or having to take care for sick children. In the end it dwarfs against antibiotics in agriculture anyway, but if we want to fix the issue of antibiotic overusage on humans, we need to completely re-think our relationship to work and sickness.
- zw7 4y ago
  Z-pak (azithromycin) is not the recommended antibiotic for bacterial sinus infections nor pneumonia (common bacterial infections associated with upper respiratory infections) per most guidelines. Interestingly though, it does have anti-inflammatory properties in addition to its main antibacterial effect. When I see a clinician prescribe a Z-pak (urgent cares are notorious for having a low threshold for prescribing Z-paks), part of me wonders if it's to avoid overuse and potential resistance to appropriate antibiotics and placate patients who want a quick fix. The downside is that since they feel better from the anti-inflammatory effect, its supports their initial thought they needed antibiotics and in the future will always think they need them, even though they very likely only have a viral infection.
  - christkv 4y ago
xahrepap 4y ago
I’m still amazed at how many people are able to get their dr to prescribe them antibiotics just by asking. I knew someone who had a cold and said “but I asked my Dr for some antibiotics and I’m taking DayQuil so I’ll be better in a day or two” Im always left open mouthed gaping at them like… even if YOU don’t know. But at least the Dr should …
- YLYvYkHeB2NRNT 4y ago
  US doctors have to do everything to keep patients happy. CMS rules their careers with satisfaction metrics. Hospital ADMINS really push it on them. Complaints lead to job loss.
  - ghastmaster 4y ago
    Liability, standard of care, patient happiness, insurance compensation, and stupidity all come to my mind when considering why they do it.
- samsa 4y ago
  I saw a Dr the other week (to rule out Covid and strep) and despite testing negative for both and telling me I just had a cold she offered me antibiotics. I declined, not wanting to be part of this problem, but was taken aback that she would basically try to push them on me.
- skeletal88 4y ago
  This is just weird. Not living on the US and people here take taking antibiotics seriously, because they often have nasty side effects like messing around with digestion, making you otherwise feel like shit. People don't ask for strong antibiotics just for a common cold or the flu.
- ThrowawayR2 4y ago
  The way it was explained to me is that the physicians know it very well but they're exhausted from arguing with patients who demand antibiotics anyway.
mschuster91 4y ago
The biggest risk factor when it comes to infection in general is agriculture: - We encroach ever closer and closer to reservoirs of animal illnesses, which is how we got OG SARS, MERS and Covid. - We give farm animals prophylactic antibiotics to promote growth or, worse, keep them alive in completely unsanitary conditions, and the conditions in slaughterhouses are often horrible as well. That is not just plain horrible from an animal welfare aspect, but risks breeding superbugs on one side and severe complications should someone not properly cook their meat and not kill off all the bacteria. - We spread manure from farm animals over produce fields, which regularly causes e.coli / EHEC outbreaks Antibiotic overuse in humans is only a small part of the problem, simply because the agriculture scale is so much bigger, and even people who go vegan/vegetarian because they want to avoid all the issues with meat production still can't avoid their produce being contaminated.
- salawat 4y ago
  >We spread manure from farm animals over produce fields You do not want to stop this. Topsoil is a damn complicated thing, and bacteria and other decomposers are critical to freeing up and breaking down organic material to keep the nutrient cycle going. Try growing a plant in a sterile soil, and you end up having to maintain it on artificial fertilizers instead of being able to let microbiota do their thing. I've got a hunch part of our degradation in crop nutrition and loss of topsoil quality is probably stemming from overuse of chemical fertilizer, as well as fundamental microbiome depletion from overuse of antibiotics in industrial farming processes. The unfortunate part being there may not be much to be done about it if there is a desire to maintain our current population carry capacity, because replenishing of it would require reversion to less short-term efficient agriculture, but more long term sustainable methods.
Fomite 4y ago
Having looked at the data on this, the change in antibiotic prescribing was extremely heterogeneous. It absolutely crashed in some areas, and went up in others.

eschaton 4y ago

Why were doctors prescribing antibiotics for COVID?!

pram 4y ago
I think some of those 'kits' countries were distributing to people early-on (before the vaccine) contained stuff like doxycycline.
AustinDev 4y ago
Secondary infections of bacterial pneumonia were common with COVID iirc.
- dopylitty 4y ago
  A study just came out showing that co-infections weren't common [0] 0: https://academic.oup.com/ofid/article/9/Supplement_2/ofac492.046/6902149 https://academic.oup.com/ofid/article/9/Supplement_2/ofac492...
anbende 4y ago
When I was in Peru, they kind of prescribed antibiotics for everything. Persistent cold? Antibiotics. Like that. Source: lived there with Peruvian partner for 18 months.
- getoj 4y ago
  Same deal in Japan, every time my kid has a cold her mum takes her to the doctor and comes home with antibiotics. When I get a cold the first thing anyone asks is whether I went to the doctor yet. For what? “Medicine.”
- friendlyHornet 4y ago
  I'm Jordanian and it's the same in Jordan; it feels like people take antibiotics like candy in Jordan
- lucb1e 4y ago
  Germany/Netherlands also from my limited experience.
eftychis 4y ago
Death from COVID, and other pneumonic (pulmonary) diseases, can be commonly a result of secondary infection by bacteria. Our bodies are not the best at handling two different types of threats at the same time. See https://www.nature.com/articles/s41598-021-92220-0 https://www.nature.com/articles/s41598-021-92220-0 for instance. P.S. Note that the situation was unclear in 2020-2021 -- for instance from a quick lookup see https://pubmed.ncbi.nlm.nih.gov/34354682/ https://pubmed.ncbi.nlm.nih.gov/34354682/. So patient management was different per region -- as it was a guess.
xvilka 4y ago
Some of the antibiotics have also proven antiviral and/or immunomodulatory effect, e.g. azithromycin [1] or levofloxacin [2]. [1] https://pubmed.ncbi.nlm.nih.gov/34015317/ https://pubmed.ncbi.nlm.nih.gov/34015317/ [2] https://pubmed.ncbi.nlm.nih.gov/32546446/ https://pubmed.ncbi.nlm.nih.gov/32546446/

silisili 4y ago

Even in the US, pre COVID, every time I went to to doctor with a bad cold/flu, they'd just give you a Z Pak(antibiotics) and say...if it's bacterial this will kill it, if it's viral it'll work itself out. So I can definitely see how they're overprescribed.

seunosewa 4y ago
They are cheaper than the tests to determine whether they're needed.
- mschuster91 4y ago
  And yet, people will demand an antibiotic from their doctor even with a test showing it's viral. Partially because school science ed doesn't cover that topic at all, partially because of "folk tales" aka learning from parents who didn't know better, partially because of placebo effect... and ultimately, because people want/need to feel better soon because they can't afford being too sick to work or having to take care for sick children. In the end it dwarfs against antibiotics in agriculture anyway, but if we want to fix the issue of antibiotic overusage on humans, we need to completely re-think our relationship to work and sickness.
zw7 4y ago
Z-pak (azithromycin) is not the recommended antibiotic for bacterial sinus infections nor pneumonia (common bacterial infections associated with upper respiratory infections) per most guidelines. Interestingly though, it does have anti-inflammatory properties in addition to its main antibacterial effect. When I see a clinician prescribe a Z-pak (urgent cares are notorious for having a low threshold for prescribing Z-paks), part of me wonders if it's to avoid overuse and potential resistance to appropriate antibiotics and placate patients who want a quick fix. The downside is that since they feel better from the anti-inflammatory effect, its supports their initial thought they needed antibiotics and in the future will always think they need them, even though they very likely only have a viral infection.
- christkv 4y ago

xahrepap 4y ago

I’m still amazed at how many people are able to get their dr to prescribe them antibiotics just by asking. I knew someone who had a cold and said “but I asked my Dr for some antibiotics and I’m taking DayQuil so I’ll be better in a day or two” Im always left open mouthed gaping at them like… even if YOU don’t know. But at least the Dr should …

YLYvYkHeB2NRNT 4y ago
US doctors have to do everything to keep patients happy. CMS rules their careers with satisfaction metrics. Hospital ADMINS really push it on them. Complaints lead to job loss.
- ghastmaster 4y ago
  Liability, standard of care, patient happiness, insurance compensation, and stupidity all come to my mind when considering why they do it.
samsa 4y ago
I saw a Dr the other week (to rule out Covid and strep) and despite testing negative for both and telling me I just had a cold she offered me antibiotics. I declined, not wanting to be part of this problem, but was taken aback that she would basically try to push them on me.
skeletal88 4y ago
This is just weird. Not living on the US and people here take taking antibiotics seriously, because they often have nasty side effects like messing around with digestion, making you otherwise feel like shit. People don't ask for strong antibiotics just for a common cold or the flu.
ThrowawayR2 4y ago
The way it was explained to me is that the physicians know it very well but they're exhausted from arguing with patients who demand antibiotics anyway.

mschuster91 4y ago

The biggest risk factor when it comes to infection in general is agriculture: - We encroach ever closer and closer to reservoirs of animal illnesses, which is how we got OG SARS, MERS and Covid. - We give farm animals prophylactic antibiotics to promote growth or, worse, keep them alive in completely unsanitary conditions, and the conditions in slaughterhouses are often horrible as well. That is not just plain horrible from an animal welfare aspect, but risks breeding superbugs on one side and severe complications should someone not properly cook their meat and not kill off all the bacteria. - We spread manure from farm animals over produce fields, which regularly causes e.coli / EHEC outbreaks Antibiotic overuse in humans is only a small part of the problem, simply because the agriculture scale is so much bigger, and even people who go vegan/vegetarian because they want to avoid all the issues with meat production still can't avoid their produce being contaminated.

salawat 4y ago
>We spread manure from farm animals over produce fields You do not want to stop this. Topsoil is a damn complicated thing, and bacteria and other decomposers are critical to freeing up and breaking down organic material to keep the nutrient cycle going. Try growing a plant in a sterile soil, and you end up having to maintain it on artificial fertilizers instead of being able to let microbiota do their thing. I've got a hunch part of our degradation in crop nutrition and loss of topsoil quality is probably stemming from overuse of chemical fertilizer, as well as fundamental microbiome depletion from overuse of antibiotics in industrial farming processes. The unfortunate part being there may not be much to be done about it if there is a desire to maintain our current population carry capacity, because replenishing of it would require reversion to less short-term efficient agriculture, but more long term sustainable methods.

Fomite 4y ago

Having looked at the data on this, the change in antibiotic prescribing was extremely heterogeneous. It absolutely crashed in some areas, and went up in others.