4 ms·

1/3 of the population in one year? That's insane. I've only taken antibiotics once in my entire life, and can count on my fingers the amount of times someone me

1/3 of the population in one year? That's insane. I've only taken antibiotics once in my entire life, and can count on my fingers the amount of times someone mentioned taking them in the last decade. Are doctors prescribing antibiotics for the flu?

siquick 3y ago
Lived in Australia for over 10 years and can confirm that GPs here are, on the whole, pretty useless. Most appointments last under 2 minutes and end with a script, usually antibiotics of some kind. I had covid recently and a woman at work who had identical symptoms but wasn’t testing positive went to the GP and was prescribed antibiotics.
- tppiotrowski 3y ago
  I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. In the US, you would demand them from your doctor and they would say no. Whether it was placebo or not, it did usually seem to make me feel better.
  - ykonstant 3y ago
    > I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. Those two sentences contradict each other; it is a very irresponsible thing to do. Also, yes, if every time you have a cold, you get antibiotics and they make you feel better, it is placebo.
    - fl0ki 3y ago
      An even simpler explanation is return to mean. They were going to get better in a few days anyway, with or without antibiotics. But if they keep getting antibiotics each time, they're always going to think that they helped. Confirmation bias comes in here too, why not. What's even worse is that unnecessary use of antibiotics can affect someone's gut biome and leave them worse off for months, in some extreme cases years. I have had antibiotics only a couple of times in my life (for bleeding injuries) and I noticed the effect on my gut each time. To think that people create this problem when they don't have to is alarming. I hope for their sake their doctors _are_ prescribing them placebos so it's harmless ignorance.
      - tppiotrowski 3y ago
        I took 1000mg of amoxicillin twice a day for about 6 months. I was terrified that it would destroy my gut flora and I would contract cdiff but in the end I didn't notice any adverse effects. Many people take yogurt with antibiotics but I didn't do that nor take probiotics. Walking out of the pharmacy with 8 boxes of antibiotics at a time was a fun experience. I can't remember but in Australia I think it was less than $5 a box without insurance.
      - cycomanic 3y ago
        > An even simpler explanation is return to mean. They were going to get better in a few days anyway, with or without antibiotics. But if they keep getting antibiotics each time, they're always going to think that they helped. Confirmation bias comes in here too, why not. Yes there's the saying among doctors, for patients with a cold who want medication (e.g. antibiotics): "You can either wait and feel better in a week, or I give you medication and you feel better in 7 days."
    - zw7 3y ago
      > if every time you have a cold, you get antibiotics and they make you feel better, it is placebo. Not necessarily. Azithromycin, a common antibiotic used for upper respiratory infections, has anti-inflammatory effects separate from it's antibacterial effects[1]. So it may make patients feel better even if they have a viral infection. Thus perpetuating the patient's belief that they "needed" antibiotics. [1]: https://pubmed.ncbi.nlm.nih.gov/15590715/ https://pubmed.ncbi.nlm.nih.gov/15590715/
  - sossles 3y ago
    Who goes to a GP for a cold? Your symptoms would have to be pretty severe to do that wouldn't they? And if so, maybe it's not just a cold.
    - ungamedplayer 3y ago
      Gp visit is free. Often need doctor cert for work to take more than a day or two off.
      - dugite-code 3y ago
        This hasn't been the case for most GP's for a while now. Bulk billing is becoming quite rare if you're not a pensioner.
        ungamedplayer 3y ago
        Mine still is shrug
    - tap-snap-or-nap 3y ago
      Almost all workplaces I have worked in insisted on having a sick certificate even for a single day. Several times I was asked to come to work for a few hours even when quite visibly ill.
      - sossles 3y ago
        Wow, that's terrible. That would be nearly impossible for me to produce, because GPs around me are sometimes booked out a week in advance.
- KennyBlanken 3y ago
  Viral infections generally don't last past a certain amount of time, so when someone who is not immunocompromised clearly has an infection past a certain point, it is assumed to be bacterial. It's also not unusual for someone to end up with a bacterial infection because their immune system is weakened from the viral infection. Your coworker almost certainly didn't repeat everything the doctor said or did, nor should she have to; mind your own business. It's wild that you were not there, don't posses any medical training, but consider yourself more qualified...
  - Amezarak 3y ago
    That’s not true at all; you can’t generally distinguish viral infections from bacterial infections by the length of illness. [charitably, this is somewhat a useful rule of thumb for many cold like illnesses, but the GP knew how long they were sick…and Covid is a good example of something some people are very sick from for a long time.] Why do you think any real expertise is required for a situation like this? It’s a simple reality that medicine, like any field, is brimming with practitioners who do not follow best practices and even many that are not good at their job. Doctors make terrible decisions all the time. I can give you numerous anecdotes in my life where doctors were dangerously wrong even when presented with very clear evidence.
    - collaborative 3y ago
      I am a person with a history of pleuro pneumonia. Doctors holding out on antibiotics twice nearly took my life (not exagerating, this was said by doctors) It's very hard for me to get antibiotics and at the same time I have a high chance of getting nasty bacterial infections with each cold. The last infection 2 years ago has caused me to have a permanent cough. Just wish antibiotics weren't so vilified, they actually serve a purpose. Why can't we reduce use in livestock first?
- sossles 3y ago
  Just counter this with a little more anecdata, I'm a regular GP visitor in Australia and have found them to be great. The only antibiotics I've been prescribed in the past decade were for a particularly persistent parasite infection.
  - deleted 3y ago
    [deleted]
  - Amezarak 3y ago
    Out of curiosity, what sort of parasite? I did not know there were parasitic infections that could be treated with antibiotics as opposed to an anti-parasitic drug like mebendazole.
- deleted 3y ago
  [deleted]
dj_mc_merlin 3y ago
Here in Germany doctors only give them for bad infections that have the potential to turn worse. Cat scratches (actually quite dangerous!), bad throat or stomach infections. I've only taken them 2-3 times this decade I guess but I've seen them mentioned way more often than you. People and doctors here prefer natural recovery with some tea and vitamins to pills if possible, which is nice.
- alkonaut 3y ago
  "Bad infections" I really hope you mean bad bacterial infections. If doctors give antibiotics for viral infections (e.g. respiratory infections they fear will become bacterial secondary infections) then we in the rest of the world really need to tell Germany to stop it. Preventive antibiotics is useful for the really vulnerable and chronically ill only. Here they even stopped for many bacterial infections e.g. typical strep infections and so on, so long as the body takes care of it. I.e. no antibiotics just to shorten the disease period.
  - timeagain 3y ago
    The reality on the ground for a doctor is that they don’t always have time to do fancy microscope/lab testing. Skin sore looks infected? Antibiotics. If there’s a 30% likelihood it is a bacterial infection and a .0000000001% chance that the patient develops super-MRSA, the choice is clear.
    - alkonaut 3y ago
      In my (quite limited) experience the prescription of topical antibiotics like that is not down as much as the oral and injected. Not sure why. Perhaps because because the diagnostics is difficult. Or it's because that kind of antibiotics have lower risk of aiding the development of resistant bacteria. Or there just aren't as many alternatives.
    - BobaFloutist 3y ago
      Ah yes a .0000000001% chance that the patient develops super-MRSA, the disease that gets its characteristic deadliness from Multiple Resistances to antibiotics, which bacteria develop when antibiotics are overused. Sounds like a great reason to over prescribe antibiotics.
foobar1962 3y ago
From the article: > ... more than one-third (36.6%) of the population had at least one antimicrobial prescription subsidised by the Australian government in 2022... of antibiotics and antifungals... The prescriptions were for antibiotics AND antifungals. So any prescription treatment for thrush, athletes foot or similar yeast infections were included in the statistics. Also from the article is that Australia ranks 7th in the list of over-users. There are 6 other countries that are doing worse.
billfruit 3y ago
Tonsillitis seems a common reason for giving antibiotics, as it is very effective against bacterial tonsillitis. May be it is more common in warmer countries.
jliptzin 3y ago
Is there any harm in taking antibiotics if you have a viral infection? Does an antibiotic resistant strain of bacteria spawn out of nowhere just from taking antibiotics in the absence of a bacterial infection? I thought the problem was not finishing a prescribed course of antibiotics when there is an active bacterial infection?
- logicchains 3y ago
  Frequent antibiotics use is associated with a small increase in the lifetime risk of various cancers: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721461/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721461/
- graeme 3y ago
  It kills your native bacteria and can cause long run issues. Some also have severe side effects such as the fluoroquinolone family. Like most medicines if you need them you really ought to have them and if you don’t then you shouldn’t.

siquick 3y ago

Lived in Australia for over 10 years and can confirm that GPs here are, on the whole, pretty useless. Most appointments last under 2 minutes and end with a script, usually antibiotics of some kind. I had covid recently and a woman at work who had identical symptoms but wasn’t testing positive went to the GP and was prescribed antibiotics.

tppiotrowski 3y ago
I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. In the US, you would demand them from your doctor and they would say no. Whether it was placebo or not, it did usually seem to make me feel better.
- ykonstant 3y ago
  > I thought the GPs were just fine but it's true that they do offer antibiotics almost every time you have a cold. Those two sentences contradict each other; it is a very irresponsible thing to do. Also, yes, if every time you have a cold, you get antibiotics and they make you feel better, it is placebo.
  - fl0ki 3y ago
    An even simpler explanation is return to mean. They were going to get better in a few days anyway, with or without antibiotics. But if they keep getting antibiotics each time, they're always going to think that they helped. Confirmation bias comes in here too, why not. What's even worse is that unnecessary use of antibiotics can affect someone's gut biome and leave them worse off for months, in some extreme cases years. I have had antibiotics only a couple of times in my life (for bleeding injuries) and I noticed the effect on my gut each time. To think that people create this problem when they don't have to is alarming. I hope for their sake their doctors _are_ prescribing them placebos so it's harmless ignorance.
    - tppiotrowski 3y ago
      I took 1000mg of amoxicillin twice a day for about 6 months. I was terrified that it would destroy my gut flora and I would contract cdiff but in the end I didn't notice any adverse effects. Many people take yogurt with antibiotics but I didn't do that nor take probiotics. Walking out of the pharmacy with 8 boxes of antibiotics at a time was a fun experience. I can't remember but in Australia I think it was less than $5 a box without insurance.
    - cycomanic 3y ago
      > An even simpler explanation is return to mean. They were going to get better in a few days anyway, with or without antibiotics. But if they keep getting antibiotics each time, they're always going to think that they helped. Confirmation bias comes in here too, why not. Yes there's the saying among doctors, for patients with a cold who want medication (e.g. antibiotics): "You can either wait and feel better in a week, or I give you medication and you feel better in 7 days."
  - zw7 3y ago
    > if every time you have a cold, you get antibiotics and they make you feel better, it is placebo. Not necessarily. Azithromycin, a common antibiotic used for upper respiratory infections, has anti-inflammatory effects separate from it's antibacterial effects[1]. So it may make patients feel better even if they have a viral infection. Thus perpetuating the patient's belief that they "needed" antibiotics. [1]: https://pubmed.ncbi.nlm.nih.gov/15590715/ https://pubmed.ncbi.nlm.nih.gov/15590715/
- sossles 3y ago
  Who goes to a GP for a cold? Your symptoms would have to be pretty severe to do that wouldn't they? And if so, maybe it's not just a cold.
  - ungamedplayer 3y ago
    Gp visit is free. Often need doctor cert for work to take more than a day or two off.
    - dugite-code 3y ago
      This hasn't been the case for most GP's for a while now. Bulk billing is becoming quite rare if you're not a pensioner.
      - ungamedplayer 3y ago
        Mine still is shrug
  - tap-snap-or-nap 3y ago
    Almost all workplaces I have worked in insisted on having a sick certificate even for a single day. Several times I was asked to come to work for a few hours even when quite visibly ill.
    - sossles 3y ago
      Wow, that's terrible. That would be nearly impossible for me to produce, because GPs around me are sometimes booked out a week in advance.
KennyBlanken 3y ago
Viral infections generally don't last past a certain amount of time, so when someone who is not immunocompromised clearly has an infection past a certain point, it is assumed to be bacterial. It's also not unusual for someone to end up with a bacterial infection because their immune system is weakened from the viral infection. Your coworker almost certainly didn't repeat everything the doctor said or did, nor should she have to; mind your own business. It's wild that you were not there, don't posses any medical training, but consider yourself more qualified...
- Amezarak 3y ago
  That’s not true at all; you can’t generally distinguish viral infections from bacterial infections by the length of illness. [charitably, this is somewhat a useful rule of thumb for many cold like illnesses, but the GP knew how long they were sick…and Covid is a good example of something some people are very sick from for a long time.] Why do you think any real expertise is required for a situation like this? It’s a simple reality that medicine, like any field, is brimming with practitioners who do not follow best practices and even many that are not good at their job. Doctors make terrible decisions all the time. I can give you numerous anecdotes in my life where doctors were dangerously wrong even when presented with very clear evidence.
  - collaborative 3y ago
    I am a person with a history of pleuro pneumonia. Doctors holding out on antibiotics twice nearly took my life (not exagerating, this was said by doctors) It's very hard for me to get antibiotics and at the same time I have a high chance of getting nasty bacterial infections with each cold. The last infection 2 years ago has caused me to have a permanent cough. Just wish antibiotics weren't so vilified, they actually serve a purpose. Why can't we reduce use in livestock first?
sossles 3y ago
Just counter this with a little more anecdata, I'm a regular GP visitor in Australia and have found them to be great. The only antibiotics I've been prescribed in the past decade were for a particularly persistent parasite infection.
- deleted 3y ago
  [deleted]
- Amezarak 3y ago
  Out of curiosity, what sort of parasite? I did not know there were parasitic infections that could be treated with antibiotics as opposed to an anti-parasitic drug like mebendazole.
deleted 3y ago
[deleted]

dj_mc_merlin 3y ago

Here in Germany doctors only give them for bad infections that have the potential to turn worse. Cat scratches (actually quite dangerous!), bad throat or stomach infections. I've only taken them 2-3 times this decade I guess but I've seen them mentioned way more often than you. People and doctors here prefer natural recovery with some tea and vitamins to pills if possible, which is nice.

alkonaut 3y ago
"Bad infections" I really hope you mean bad bacterial infections. If doctors give antibiotics for viral infections (e.g. respiratory infections they fear will become bacterial secondary infections) then we in the rest of the world really need to tell Germany to stop it. Preventive antibiotics is useful for the really vulnerable and chronically ill only. Here they even stopped for many bacterial infections e.g. typical strep infections and so on, so long as the body takes care of it. I.e. no antibiotics just to shorten the disease period.
- timeagain 3y ago
  The reality on the ground for a doctor is that they don’t always have time to do fancy microscope/lab testing. Skin sore looks infected? Antibiotics. If there’s a 30% likelihood it is a bacterial infection and a .0000000001% chance that the patient develops super-MRSA, the choice is clear.
  - alkonaut 3y ago
    In my (quite limited) experience the prescription of topical antibiotics like that is not down as much as the oral and injected. Not sure why. Perhaps because because the diagnostics is difficult. Or it's because that kind of antibiotics have lower risk of aiding the development of resistant bacteria. Or there just aren't as many alternatives.
  - BobaFloutist 3y ago
    Ah yes a .0000000001% chance that the patient develops super-MRSA, the disease that gets its characteristic deadliness from Multiple Resistances to antibiotics, which bacteria develop when antibiotics are overused. Sounds like a great reason to over prescribe antibiotics.

foobar1962 3y ago

From the article: > ... more than one-third (36.6%) of the population had at least one antimicrobial prescription subsidised by the Australian government in 2022... of antibiotics and antifungals... The prescriptions were for antibiotics AND antifungals. So any prescription treatment for thrush, athletes foot or similar yeast infections were included in the statistics. Also from the article is that Australia ranks 7th in the list of over-users. There are 6 other countries that are doing worse.

billfruit 3y ago

Tonsillitis seems a common reason for giving antibiotics, as it is very effective against bacterial tonsillitis. May be it is more common in warmer countries.

jliptzin 3y ago

Is there any harm in taking antibiotics if you have a viral infection? Does an antibiotic resistant strain of bacteria spawn out of nowhere just from taking antibiotics in the absence of a bacterial infection? I thought the problem was not finishing a prescribed course of antibiotics when there is an active bacterial infection?

logicchains 3y ago
Frequent antibiotics use is associated with a small increase in the lifetime risk of various cancers: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721461/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721461/
graeme 3y ago
It kills your native bacteria and can cause long run issues. Some also have severe side effects such as the fluoroquinolone family. Like most medicines if you need them you really ought to have them and if you don’t then you shouldn’t.