Says Whitecoat, ranting about the indiscriminate use of antibiotics, and I couldn’t agree more.  In the last five years I’ve seen cipro transform from a “big gun” to a throwaway antibiotic, useless against skin infections and ineffective (at least locally) in one of four UTI’s.

So I too try to do my part.  No shots of rocephin or Z-paks for the various ways viruses decide to show up in my ER: bronchitis, sinusitis, gastroenteritis, or my personal favorite: the all encompassing “viral syndrome.”  Strep throat?  Penicillin works just fine, thank you very much.  Ditto amoxicillin for toddler pneumonia.  No you don’t need anything “stronger,” there’s really no such thing, what you think of as stronger is really broad-spectrum, killing more varieties of bacteria, but unnecessary when we have a pretty good idea of what’s causing the infection.

So I feel good about my practice of medicine in this respect.  Then again, I also feel good about taking the recyclables out to the curb, but for neither do I harbor any illusions of making a real difference.  Just as your spouse might cancel out your vote this November, so too are my puny efforts negated many times over across the country in various pediatrician’s offices, family practice clinics, urgent care centers, and ER’s.

Not to mention there are ways of getting antibiotics without a prescription (my professional advice: don’t take fish antibiotics).  But despite all the leaks in the system, and all the problems it has spawned, at least we still have some regulation.  Many African, Asian, and Latin American countries sell antibiotics directly to the public, no script required.  My eyes were opened to this long ago, during a spring break trip to Matamoras where I saw dozens of antibiotics available over the counter as if I was channeling directly into some uptight soccer mom’s wet dream.  (I also saw a stand where you could buy ten tacos for a dollar, but that’s another story.)  I would never profess to be any kind of expert on Mexican culture, but when you live in a county where one person out of every three is Latino you are bound to learn a thing or two.  And what I’ve learned, not surprisingly, is that when antibiotics are readily available they are taken with alarming frequency.  Throughout life for every symptom imaginable or even just for general health maintainance they are a country stuffing themselves with antibiotics like farm raised cattle.

But the problem with too many people is if they’re not ignorant, then they just can’t see past the boundries of their own skin to the greater good.  And as bacterial resistance increases at ever alarming rates, new antibiotic technology emerges slower than ever (guess what: pharmaceutical companies care about developing drugs that you take for a lifetime, not for a week).  We may very well be headed back to the abyss Alexander Fleming pulled us from eighty years ago, where people die from routine infections as we, despite all of our 21st century technology, can do nothing but stand idly by.   

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