3 ms·

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 stomac

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.
    - Vecr 3y ago
      He's saying that they weigh some chance of increasing antibiotic resistance against the expected value of giving the antibiotic. Depending on your decision theory and utility that may be the right move.
- dj_mc_merlin 3y ago
  Yes, obviously. They're doctors, they understand that.
- JTbane 3y ago
  My anecdote from the US is that usually my primary care doctor will do a rapid streptococcus test if I come in with a sore throat, and only prescribe antibiotics if it comes back positive. That seems responsible enough for me.
  - alkonaut 3y ago
    Yeah mine would say "you are in your 40's and healthy so I won't prescribe antibiotics unless it doesn't get better in a week". But that as I said is fairly new and quite specific to sore throat from streps.
dotnet00 3y ago
Similarly, here in the US the only time I was precribed antibiotics this decade was when I had a severe enough bacterial infection that the doctor took one look at my vitals and had me taken to the ER at a nearby hospital. Meanwhile, my family in India are so used to getting antibiotics and overmedicating in general for everything that they find it weird that doctors here just prescribe basic OTC stuff and rest for a basic viral cold. When I recently went to the doctor for a cold, they did a strep test which came out negative and handed me a "prescription" of lozenges and an OTC decongestant.

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.
  - Vecr 3y ago
    He's saying that they weigh some chance of increasing antibiotic resistance against the expected value of giving the antibiotic. Depending on your decision theory and utility that may be the right move.
dj_mc_merlin 3y ago
Yes, obviously. They're doctors, they understand that.
JTbane 3y ago
My anecdote from the US is that usually my primary care doctor will do a rapid streptococcus test if I come in with a sore throat, and only prescribe antibiotics if it comes back positive. That seems responsible enough for me.
- alkonaut 3y ago
  Yeah mine would say "you are in your 40's and healthy so I won't prescribe antibiotics unless it doesn't get better in a week". But that as I said is fairly new and quite specific to sore throat from streps.

dotnet00 3y ago

Similarly, here in the US the only time I was precribed antibiotics this decade was when I had a severe enough bacterial infection that the doctor took one look at my vitals and had me taken to the ER at a nearby hospital. Meanwhile, my family in India are so used to getting antibiotics and overmedicating in general for everything that they find it weird that doctors here just prescribe basic OTC stuff and rest for a basic viral cold. When I recently went to the doctor for a cold, they did a strep test which came out negative and handed me a "prescription" of lozenges and an OTC decongestant.