Did I Mention Something About Antibiotics and Viral Infections?

I've discussed before how the misdiagnosis of viral infections, typically respiratory illnesses, leads to massive improper use of antibiotics. It's a problem in the UK too. From ScripNews (subscription only):

Antibiotics are prescribed to treat up to 80% of cases of sore throat, otitis media, upper respiratory tract infections and sinusitis in England and Wales, even though official guidance advises against this, a study published in the Journal of Antimicrobial Chemotherapy has revealed.

The study was undertaken on behalf of the specialist advisory committee on antimicrobial resistance (SACAR), which was established in 2001 to advise on problems regarding antimicrobial resistance. Data were gathered using the general practice research database of consultations and prescriptions with researchers examining all consultations between 1998 and 2001.

Although the prescribing of antibiotics to treat respiratory tract infections fell in the 1990s, doctors continued to prescribe them to treat apparently virus-induced conditions, says the study. This practice contributes to the increasing resistance of disease-causing bacteria to drugs. According to the study, GPs often consider whether the patient has been prescribed antibiotics in the past for the same condition to determine whether or not to prescribe an antibiotic.

[the noise you're hearing is the Mad Biologist banging his head against the table]

But it gets better (italics mine):

Another study undertaken on behalf of SACAR and sponsored by the department of health (and published in the same journal) revealed that patient awareness of the problems of prescribing antibiotics for viral infections was not associated with a lower likelihood of being prescribed an antibiotic. This study--in which 7,120 patients took part--also showed that good understanding of how to take antibiotics did not necessarily correspond to correct compliance. For example, patients who knew that the full course of antibiotics should always be completed said that they would keep left over antibiotics for subsequent use.

And now my head does this:



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hehehe Youll love this story:
A few months ago I got mono (EBV) really bad. 103 temp for about a week, all of my lymph nodes were swollen (it was like gravel was stuck under my skin), hell.

So I go to the doc, not having a clue what was wrong, and she ordered a ton of lab tests to try to figure it out. Negative on the mono. So she gave me amp and said "If your temp doesnt go down in 48 hours, go ahead and take these."

Well, temp didnt go down, so I took them... a couple days after that I got a call "Youve got mono-- you just tested negative on the fast test". Bad news: if you have mono, and you take an antibiotic related to amp, you get a rash that makes you look like a pink alligator.

I even had the rash in my mouth. Took about two weeks for it to completely go away.

Good times. Good times with antibiotics for viral infections...

I went to the doctor yesterday for a sore on my leg that would not heal. I was concerned because a similar sore on a co-worker's arm turned out to be MRSA and took major intervention to fix. He said it was an allergic reaction because bacterial would last for weeks. "I just told you it's been like that for three weeks," I said. Short story; I left with steroid cream. So at least some doctors are being pretty darn careful about over-prescribing antibiotics.

But since you're writing on antibiotic abuse, I do have a question. Farm animals basically grow up on antibiotics, because this increases their weight for some reason. It seems to me that would cause pathogens to select for antibiotic resistance. Do any human pathogens become resistant through farm use of antibiotics? Or could animal pathogens confer resistance to human pathogens?

My 17 year old son developed a macular rash of tiny dots over his entire body except for palms of hands and soles of feet which itched, also had no energy and sore throat. Mono test negative 3x. No diagnosis. Three weeks later, one of his friends presented same symptoms. No meds were prescribed, but I gave him Benadryl which only addressed the itchy rash. Rash and sore throat lasted 3 weeks, lack of energy lasted 3 months. Didn't request antibiotics due to no diagnosis and my belief that antibiotics are only effective on bacterial issues. What do you do in a situation where doctors are at a loss as to diagnosis?

Actually, the antibiotics for food-producing animals is used because sick animals don't gain weight, so they try to head off any illness. The main reason is that the huge feed-lots of factory-farms give their livestock grain feed almost exclusively in their "confined animal feeding operations". This causes horrible germ breeding grounds, massive ulcers, and other assorted problems that are combated with antibiotics. Animals raised "free range" supposedly don't have this problem, like grass-fed beef, but unless the stamp says 'No Antibiotics', I wouldn't believe it.

ERV, you have my full sympathies. About 13 years back in college, I came down with Mono, got some Amp before it was fully diagnosed and came down with a very similar rash to yours, 'cept mine was a creeper -- started on my head (ever have your ears swell to become convex? not fun) and eventually settled in my legs, causing blood to pool in the rash every time I stood up.

Misery, thy name is Mono + Amp.

By G Barnett (not verified) on 20 Aug 2007 #permalink

Thanks Marlana. Are the antibiotics similar to ones used on humans? Do we have a public-health rationale to forbid "confined animal feeding operations"?

I always pay extra for eggs from "cage free chickens". Hope it's true that they treat the chickens better. I eat little meat and would gladly pay more if I knew the animals were treated better.

i support u r oppenion that ampi is given u rash,is not that only because all gps uses antibiotics in there practise in viral fever and give rash in children i see in my self practise as some practioner usen pt. came in my opd.

By dr.vilas jagdale (not verified) on 12 Sep 2010 #permalink