[Liz]

Half of Antibiotics Prescriptions Are Unnecessary

If your doctor orders this for you, be sure to ask enough questions before you take the drug

HealthZette
by Sara Hermanson
Updated 12 May 2017 at 7:53 PM

Excerpt:

Millions of people visit a doctor’s office each year for nonbacterial, upper respiratory infections such as the common cold. And while some leave with a prescription for rest and plenty of fluids, many others leave — and head straight to the pharmacy with a prescription for antibiotics.

Why the difference? That’s a question researchers and those in the medical field have been asking for years. Now a study published this month in the Annals of Internal Medicine, from the Institute for Clinical Evaluative Sciences (ICES) in Canada, looked at why nearly one of every two seniors in Ontario (who visited a family doctor for a non-bacterial infection) received an unnecessary antibiotic prescription.

The study — which was actually conducted in 2012, but just published this week — included 185,014 low-risk Ontarian seniors (65 years and older) who were sick with a nonbacterial, upper respiratory infection such as the common cold (53 percent), acute bronchitis (31 percent), acute sinusitis (14 percent) or acute laryngitis (2 percent).

The researchers found that 85,538 of the 185,014 patients were prescribed an antibiotic.

“About 46 percent of people who were felt by their physician to not have a bacterial upper respiratory tract infection still received a prescription for an antibiotic,” said Dr. Michael Silverman, author of the study, who is a Lawson scientist and chief of Infectious Diseases for London Health Sciences Centre and St. Joseph’s Health Care London.

That’s nearly one in two seniors prescribed an antibiotic. The results from this study add to the concern that antibiotics are prescribed too often and for conditions that are not warranted, which researchers and medical professionals say can lead to resistance of these drugs, among other issues.

According to a piece in ScienceDaily, the majority of the prescriptions were for broad-spectrum antibiotics (70 percent). In addition to an increase in the development of antibiotic resistance, these are also associated with a greater risk of adverse patient outcomes such as: clostridium difficile (inflammation of the colon), diarrhea, heart problems, tendon ruptures, allergic reactions, and more.

*snip*

Full Story

[zurg]

One, it's Canada, to be precise, and while the data may extrapolate to the US, it also may not, in the same amounts.

Two, immunity isn't always simple. Fighting disease takes energy and resources in the body. While antibiotics may not attack the exact agent causing the present infection, they can still help by preventing a secondary bacterial attack and thus help improve immunity to the primary (viral) agent being fought.

I'm not in favor of excessive antibiotic prescriptions, but just saying that there may be more to decisions to prescribe them than this study authors understand or accept.

This post has been edited by zurg: 13 May 2017 - 07:42 AM

[Dutch13]

I have taken my kids to the doctors countless time for sinus infections (my wife insists on it) and while I was waiting, read the literature on the walls that clearly stated that antibiotics do not work on a sinus infection because it is viral, not bacterial. The doctor knows there is nothing they can do (I hope) but they prescribe an antibiotic anyway.

As the doctor is telling me they are going to prescribe the antibiotic, I always make several glancing gestures toward the poster in their office that is contradicting them.

Most of the time, I don't even get it filled and the sinus infection clears up with a little sinus rinse and gargling salt water.

This post has been edited by Dutch13: 13 May 2017 - 08:13 AM

[Severian]

Sinus infections are always viral...Bull. Flu and colds are viral, but the lack of proper drainage caused by the swelling and inflammation makes sinuses the perfect incubator for a subsequent bacterial infection. Happens very often to me as I have allergies and mucked up sinuses anyway. It's easy for me to tell when it's crossed over, and I will not get better without antibiotics. I've had times when it took weeks and no improvement until I got in to see a doc and get antibiotics.

[Dean Adam Smithee]

Heck, pick ANY class of medications from antibiotics to antidepressants to painkillers to whatever and you could write exactly the same article about them being over-prescribed.

Big Pharma sold $424 Billion worth of medications in 2015, or roughly $1,320 worth for every man, woman, and child in the country. As such, Americans must be either the sickest people on the planet or the most over-medicated. Compare to, say, Germany which at €623.687 ($681.91) is the highest in Europe and 30% greater than the OECD average...but still just barely over half that of the USA per person.

http://pharmaceuticalcommerce.com/wp-content/uploads/Sales-by-chanel-chart-fig1.jpg

IMS 2015 Use of Medicines report: US sales reach $424.8 billion

This post has been edited by Adam Smithee: 13 May 2017 - 10:28 AM

[Natural Selection]

Do doctors profit personally either directly or indirectly from writing prescriptions? If so, that would seem to be a conflict of interest.

[Dean Adam Smithee]

Natural Selection, on 13 May 2017 - 10:39 AM, said:

Do doctors profit personally either directly or indirectly from writing prescriptions? If so, that would seem to be a conflict of interest.

In a word: YES

[Rock N' Roll Right Winger]

Natural Selection, on 13 May 2017 - 10:39 AM, said:

Do doctors profit personally either directly or indirectly from writing prescriptions? If so, that would seem to be a conflict of interest.

That answer is YES.

[Natural Selection]

Adam Smithee, on 13 May 2017 - 11:00 AM, said:

In a word: YES

That link makes me sick. It's safe to say I won't be seeing a doctor about it.

[zurg]

Natural Selection, on 13 May 2017 - 10:39 AM, said:

Do doctors profit personally either directly or indirectly from writing prescriptions? If so, that would seem to be a conflict of interest.

The answer is actually mostly: NO.

[Natural Selection]

Adam Smithee, on 13 May 2017 - 11:00 AM, said:

In a word: YES

Rock N, on 13 May 2017 - 11:07 AM, said:

That answer is YES.

zurg, on 13 May 2017 - 11:45 AM, said:

The answer is actually mostly: NO.

That's 2 for yes and 1 for no. Yes wins?

[Dean Adam Smithee]

Natural Selection, on 13 May 2017 - 11:50 AM, said:

That's 2 for yes and 1 for no. Yes wins?

Probably somewhere in between. I'll note that Zurg said "mostly" no and I'll concede that it's not 100% "yes".

I'm sure there are good honest doctors out there. But... how do you KNOW anymore? And there's AT LEAST enough corruption to be suspicious of anyone you don't know.

Back in the day it was easier. As a kid on the eastside of Toledo OH in the '60s, it was Dr. Q-------. because we'd gone there and/or he came to our house since, like, forever. He'd been my grandparents' doctor since probably the '30s or '40s. He was probably 190 years old or so when I was the third generation to be treated by him, or so it seemed to me a kid at the time. As a teen is small-town southern Indiana in the '70s it was Dr. W------. Because we knew him, for a time members of the same church, and I went to Jr. High and High School with his son.

These days? How the heck do I know? Pick a name of the insurance company's list, and next year or the year after do it all over again when you have to change insurance companies to keep costs down. I can't remember the last time I could say I actually KNEW the doctor; It's been probably at least 15 or 20 years.

[Liz]

Adam Smithee, on 13 May 2017 - 04:00 PM, said:

. . .Back in the day it was easier. As a kid on the eastside of Toledo OH in the '60s, it was Dr. Q-------. because we'd gone there and/or he came to our house since, like, forever. He'd been my grandparents' doctor since probably the '30s or '40s. He was probably 190 years old or so when I was the third generation to be treated by him, or so it seemed to me a kid at the time. As a teen is small-town southern Indiana in the '70s it was Dr. W------. Because we knew him, for a time members of the same church, and I went to Jr. High and High School with his son. . .

Now that you mention it, it was easier. My uncle was a doctor, a cardiologist but when we were kids, he treated us for everything, gave us our shots, etc. I felt like a human pin cushion but we loved and trusted him and he never let us down.

[Dean Adam Smithee]

Liz, on 13 May 2017 - 04:37 PM, said:

Now that you mention it, it was easier. My uncle was a doctor, a cardiologist but when we were kids, he treated us for everything, gave us our shots, etc. I felt like a human pin cushion but we loved and trusted him and he never let us down.

That would've been like Dr Q------. I've no idea what his 'specialty' was, but he removed my tonsils once during a case of tonsillitis. In his "Clinic" which was the basement of his house at 1949 Starr Avenue Toledo OH. I've no complaints.

[Rock N' Roll Right Winger]

Natural Selection, on 13 May 2017 - 11:50 AM, said:

That's 2 for yes and 1 for no. Yes wins?

I know that it's a "YES" out of personal experience when my father was battling prostate and bone cancer.

I got to know the drug rep who was providing my dad the meds through his doctor and saw them interact with one another right in front of me and my father.

So not only do I say just "Yes" they do, but up that to a "HELL YES" that they do get kickbacks for writing prescriptions.

I can honestly place the blame at the feet of big pharma and doctors for accelerating the deaths of both of my parents and other family and friends with utterly useless dangerous cancer drugs. I have learned this the hard way and I don't trust any doctor anymore and I have been injured myself more than once by incompetent ones. I can go on for many hours with true life experiences.

Everyone who believes that most (not all) doctors really know what they're doing and aren't consciously putting money ahead of their patients well being are woefully ignorant.

Most people are not even aware at how grossly incompetent and ignorant that most doctors actually are.

This post has been edited by Rock N' Roll Right Winger: 14 May 2017 - 01:10 AM

[Rock N' Roll Right Winger]

[Natural Selection]

Rock N, on 14 May 2017 - 12:53 AM, said:

I know that it's a "YES" out of personal experience when my father was battling prostate and bone cancer.

I got to know the drug rep who was providing my dad the meds through his doctor and saw them interact with one another right in front of me and my father.

So not only do I say just "Yes" they do, but up that to a "HELL YES" that they do get kickbacks for writing prescriptions.

I can honestly place the blame at the feet of big pharma and doctors for accelerating the deaths of both of my parents and other family and friends with utterly useless dangerous cancer drugs. I have learned this the hard way and I don't trust any doctor anymore and I have been injured myself more than once by incompetent ones. I can go on for many hours with true life experiences.

Everyone who believes that most (not all) doctors really know what they're doing and aren't consciously putting money ahead of their patients well being are woefully ignorant.

Most people are not even aware at how grossly incompetent and ignorant that most doctors actually are.

I know what you mean about doctors being incompetent. My Mother was diagnosed with lung cancer that had spread to her brain. They decided to put her in the machine below. It was supposed to shrink the tumors in her head. They never told us it would knock the life out of her. A couple days after she stuck her head in that machine she could hardly move. Just standing up took all her energy. Before her "treatment" she was completely normal except for a nagging cough. She never recovered from her "treatment" and died one month later. Who knows...they probably received kickbacks for using that damn thing.

http://s12.postimg.org/tn3lg4wst/DSC00846.jpg

[zurg]

Most (>90%) of doctors are good, helpful people, who aren't bought off by drug companies. Who follow rules that don't allow them to get a cut of drug sales. That's highly illegal too. The ability of drug companies to legally buy off doctors with dinners and trips, including their families, is completely gone. Thus, engaging in such funny business is entirely illegal. I'm not saying there aren't schemes that some bad greedy doctors take part in. Of course there are. But it's not rampant.

A good doctor is busy with patients from 7am (rounding at a hospital) until 6pm, plus call every few days. Docs make a good living but no more than a director or VP of a company. Rather than being worried about doctors being crooks in the pockets of drug companies, I'm worried about eroding standards of training and thus quality of the doctor base who'll be taking care of America in about a decade or two.

[Natural Selection]

zurg, on 14 May 2017 - 01:39 PM, said:

Rather than being worried about doctors being crooks in the pockets of drug companies, I'm worried about eroding standards of training and thus quality of the doctor base who'll be taking care of America in about a decade or two.

Great point. I suspect affirmative action has reared its ugly head in the medical field as well.

[Dean Adam Smithee]

zurg, on 14 May 2017 - 01:39 PM, said:

Most (>90%) of doctors are good, helpful people, who aren't bought off by drug companies. Who follow rules that don't allow them to get a cut of drug sales. That's highly illegal too. The ability of drug companies to legally buy off doctors with dinners and trips, including their families, is completely gone. Thus, engaging in such funny business is entirely illegal. I'm not saying there aren't schemes that some bad greedy doctors take part in. Of course there are. But it's not rampant.

Yes, it's highly illegal. That why they don't call it "getting a cut of the drug sales" any more. But it still exists, just framed differently.

One way to frame it is as a 'study'. Pay a doctor to 'study' the effects of a drug; create reports showing efficacy and side-effects and whatever. Naturally, you can't study a drug without prescribing it.

Legally, they're not being paid to write the prescription. There is absolutely zero incentive for that (And if you believe THAT then I've got a piece of the I-85 bridge in Atlanta for sale.). HOWEVER, if the doc out of sheer random chance just happens to prescribe the drug, they'll pay for the 'work product' of analyzing the outcome.

I will agree that SOME doctors are "good, helpful people, who aren't bought off by drug companies". Perhaps even MANY. I'm just not sure if I can get to "Most (>90%)". As I'm mentioned before, Mrs. Smithee is a physiologist and I've heard WAY too many war stories to accept that this is all-but-nonexistant.