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When No Medicine Is the Best Medicine

Monday, January 4, 2010, 17:50 EST Leave a comment Go to comments

Methicillin-resistant Staphylococcus aureusAntibiotic-resistant bacteria are a growing problem in the United States. Microevolution explains why: species adapt to environmental changes in order to survive, and when the species are microbes, one such adaptation involves developing resistance to pharmaceutical therapies. Drug advertising and first-dollar insurance coverage have combined to encourage patients to demand that their doctors “do something” when they are sick, and for chest congestion or a sore throat or a low-grade fever, the “something” they demand is often an antibiotic—even for infections that would successfully resolve without one. We all know people who get sick and call their doctor “to get a script,” never considering that it may not be necessary or even warranted. Many of us also know doctors who will write the prescription because they feel it will placate the patient and ultimately won’t do any harm.

Almost reflexively, I avoid the tendency to call the doctor for symptoms I know from experience are viral. I have also learned to recognize the signs of a bacterial infection (higher fever, white patches in the throat, greenish mucus). My attitude is that if I’m wrong, I’ll find out soon enough, and waiting an extra day or two before starting an antibiotic is not going to cause any long-term damage. (That doesn’t mean I don’t get myself to a doctor if I don’t get better in reasonable time or take antibiotics when I need them. I learned a valuable lesson from a college friend who refused to go to the infirmary for a vicious sore throat and fever that he insisted would go away on its own, which it did after about two misereable weeks. His body did indeed fight what turned out to be a strep infection, but not before it caused permanent kidney damage.) They key is to be prudent and reasonable, which is the happy medium between ignoring a problem and demanding instantaneous relief.

Who knew my common-sense approach was the stuff of medical genius? It turns out that medical officials in Norway have adopted just such a strategy on a massive scale to successfully combat at least one devastating Staphylococcus bacterium, the dreaded MRSA, and it’s a strategy that may hold the key to other tough infections as well.

Twenty-five years ago, Norwegians were also losing their lives to this bacteria. But Norway’s public health system fought back with an aggressive program that made it the most infection-free country in the world. A key part of that program was cutting back severely on the use of antibiotics.

Now a spate of new studies from around the world prove that Norway’s model can be replicated with extraordinary success, and public health experts are saying these deaths — 19,000 in the U.S. each year alone, more than from AIDS — are unnecessary.

[ . . . ]

The World Health Organization says antibiotic resistance is one of the leading public health threats on the planet. A six-month investigation by The Associated Press found overuse and misuse of medicines has led to mutations in once curable diseases like tuberculosis and malaria, making them harder and in some cases impossible to treat.

Keep this in mind the next time you are tempted to ask for penicillin for that miserable cold.

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