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Let's do that weird thing where we talk about this as a weird personal responsibility thing where we blame individuals or some nebulous evil group of family doctors even though the drugs involved are never ever ever handed out to people for mundane diseases.
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Feb 9, 2017 03:17
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Chard posted:I don't think anyone's doing that? Overprescription and using antibiotics for no real purpose except "shut up go away" is like, the reason this is a thing. The drug in this story is an Iv drug that gives you nerve and kidney damage when you use it. No one is taking this for a cold. People do not get given this to make them go away.
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Feb 9, 2017 04:56
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pidan posted:In theory, the solution to this problem is really easy: Don't give people antibiotics for minor infections that will go away on their own, or for infections that aren't bacterial to begin with. Is there any evidence this happens with IV antibiotics basically ever? Especially commonly enough to cause antibiotic resistance.
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Feb 9, 2017 21:07
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reagan posted:MIC creep with vancomycin isn't caused by giving colistin to pigs, so yes I believe it has. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426332/ The glycopeptide avoparcin was first introduced for growth promotion in 1975 (37). At that time it was used extensively in most parts of Europe and the rest of the world with the notable exception of Canada and USA where avoparcin never has been approved for animals (38). Avoparcin was mainly used for broilers and pigs but to some extent also for turkeys, veal calves and other animals (37, 39, 40). The extent of avoparcin use is demonstrated by data from Denmark where 24 kg of vancomycin was used in human medicine in 1994, and in the same year more than 24,000 kg of avoparcin was used for growth promotion (39). A similar example is Australia, where from 1992 to 1996 less than 600 kg of vancomycin but over 62,000 kg of avoparcin was imported (41). As avoparcin confers cross-resistance to vancomycin the (mis)use of avoparcin selected for VRE (42). Hence, VRE, i.e. E. faecium carrying the vanA genotype was common in the intestinal flora of farm animals in Europe during the 1990s (43, 44). By contrast, since avoparcin has never been approved in Canada and USA, VRE had until 2008 never been isolated from farm animals in USA (45).
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Feb 10, 2017 04:07
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HelloSailorSign posted:I mean I've got an anecdote about use of IV antibiotics inappropriately but I don't know about studies. Why is that a story about inappropriate use? You denied a doctor recommended treatment then you accepted it when it was physically nearer to you.
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Feb 10, 2017 21:22
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HelloSailorSign posted:Because it was the doc's plan to use it while it wasn't actually indicated. I wasn't exactly in a good state to sit there arguing about it either and felt that I should point out the fact that they didn't connect up the thing that was running (that they were charging me for). What are you basing any of this on?
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Feb 10, 2017 23:25
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cowofwar posted:Antibiotic overprescription is a minor cause compared to agriculture. The amount of antibiotic from farm run-offs entering the environment is astronomical. The way to evolve resistance is chronic low level exposure and that is basically what farms do in huge radii around their point locations. The antibiotic overprescription boogieman seems like such a transparent plot to shift the blame to individuals and low level family doctors. And it sucks, because it's building up this narrative of "trust doctors about viruses and vaccines but also they all are trying to POISON OUR COMMUNITY with HARMFUL ANTIBIOTICS that you don't even need and will KILL YOUR CHILDREN so just say no to their murder shots! They just lie to you about you needing them anyway".
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Mar 14, 2017 16:27
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aparmenideanmonad posted:Plenty of countries without well developed health care systems or standards let people obtain and use a lot of antibiotics however they want. Feel sick? Here's some IM penicillin, have fun! Dosing and use are completely up to regular people, so, while they will take them for appropriate poo poo like strep throat, they will also do things like stop short of a full course, take them for influenza or a rhinovirus, or use them prophylactically for all sorts of medically unsound reasons. That really does sound like "turn off the water while you brush your teeth" sort of advice. Like it's technically true, but personal abuse is just such a tiny tiny factor. Like there is no realistic amount of antibiotics a person is going to casually take for colds or something that comes anywhere close to the damage they do eating a single bacon burger for lunch or something. Like don't be an rear end and abuse antibiotics also, but it's a really tiny amount of the problem.
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Mar 15, 2017 16:01
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