Posted on 09/22/2010 5:26:39 PM PDT by decimon
Doctors frequently misuse antibiotics when treating patients hospitalized with respiratory tract infections (RTIs), according to a study to be published in the November issue of Infection Control and Hospital Epidemiology.
The study, which tracked patients in two Pennsylvania hospitals, found that doctors often use antibiotics to treat patients whose infections are known to be caused by viruses. The findings are alarming because antibiotics are not effective against viruses, and antibiotic overuse has been linked to the development of resistant bacterial strains.
"[T]hese data demonstrate at least one area where antibiotics are commonly used in hospitalized patients without clear reason," write the study's authors, Kevin T. Shiley, Ebbing Lautenbach and Ingi Lee, all from the University of Pennsylvania School of Medicine. "Recognition of this may be helpful in developing interventions to limit inappropriate antibiotic use in the future."
In recent years, new diagnostic tests have been developed to distinguish infections caused by viruses from those caused by bacteria. In theory, more definitive diagnoses should reduce the inappropriate use of antibiotics in patients with viral infections. But that does not appear to be happening, according to Shiley and his colleagues.
The researchers looked at data on RTI patients admitted to two hospitals over a two-year period. Of 196 patients who were diagnosed with viral infections, 125 remained on antibiotics after their diagnoses. It would be understandable to keep a patient on antibiotics if an abnormal chest x-ray suggests a concurrent bacterial infection, the researchers said. However, only 37% of these patients had abnormal chest x-rays. "It is less clear why the remaining 63% of patients with normal chest imaging were prescribed antibiotics," Shiley and his colleagues write.
NO CLINICAL BENEFIT
Patients in the study who remained on antibiotics did not benefit from the treatment, the researchers found. In fact, antibiotics may have led to harm in some cases. For example, a significant number of antibiotic patients developed Clostridium difficile diarrhea, a condition linked with antibiotic use.
On average, the antibiotic group had longer hospital stays and higher mortality rates than the non-antibiotic group. While those poorer outcomes cannot be attributed directly to antibiotic treatment, they do suggest that there was no clinical benefit, the researchers say.
"This study highlights the crucial role of antimicrobial stewardship in improving patient care," said Neil O. Fishman, M.D. at the University of Pennsylvania and president of the Society for Healthcare Epidemiology of America. "Appropriate use of antibiotics is not only essential to limiting emergence of resistance, but also may help improve clinical outcomes."
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Kevin T. Shiley, Ebbing Lautenbach, and Ingi Lee, "The Use of Antimicrobial Agents after the Diagnosis of Viral Respiratory Tract Infections in Hospitalized Adults: Antibiotics or Anxiolytics?" Infection Control and Hospital Epidemiology 31:11 (November 2010). The study will publish online next week.
Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. It is published by a partnership between The Society of Healthcare Epidemiology of America and The University of Chicago Press.
All the sinus wash does is to clear out the infected mucus that is living in her sinuses(and spreading downward). It gets the bacterial infection over sooner instead of hanging on. She could wash first and then use the nasal spray. My E&T highly recommends it.
you think any dr. in his right mind would not order antibiotics IF they knew they would be sued repeatedly for any complication that came along....
people want drs to act doctorly, but they don't really want them to on the other hand...they want it both ways..
I knew you were going to ask. LOL! She is itching and scratching a little right now even thought she had a bath today. She has been very VERY good until now.
This is about patient who are HOSPITALIZED with respiratory infections.
The MDs prescribe antibiotics in these situaions to hellp prevent a bacterial infection from taking advantage of the virally-weakened individual.
Yeah, I know, no time. But you can whip up a pitcher of smoothie in about three minutes. Orange juice, some packets of carnation instant breakfast (Vanilla), bananas, yogurt, honey, maybe some ground flax seed. Pour it in a bottle and you have breakfast for two or more days. Yummy, full of vitamins and easy to sip on.
2.) Get some sleep. The antihistamine did help you sleep so start taking one at night. Also drink a cup of hot water with some honey and lemon juice at night before bed. Sleep on two or more pillows to prop you up at night.
3.)Neti pot. The cough is likely caused by drainage. Cleaning out the sinuses can help.
There is also oil of oregano or olive leaf extract that can help an infection.
When is the last time you had it xrayed?
Well, bless her heart. Might be habit. She’s still looking better, from outward appearance?
So much better! It’s like having a new dog. She seems to have lost some weight or it might just be fluid because of the steroids she had been on for so long.
Oil of oregano is a great one, but caution is in order, it’s pretty powerful stuff and more isn’t necessarily better.
What is not mentioned is that many of the viral infections are accompanied by bacterial infections that are cured by the antibiotics. So the viral sinus infection will “go away” in two weeks, but the hellish sore throat is cured by the antibiotic.
One wonders what the clowns are smoking.
Look at the source — University of CHICAGO. No more money for health care PING! Get strep throat and die PING!
Steroids can do a lot of good, but they do tend to chunk you up, dogs too. Glad to hear she’s coming along nicely.
So much better! It’s like having a new dog. She seems to have lost some weight or it might just be fluid because of the steroids she had been on for so long.
Antibiotics don’t work on virii; I suggest long hot soaks up to the chin, with some bath salts (Epson salts which are magnesium sulfate, not sodium, and cheap; or Bicarb, which is also cheap, can be had in big bags at the warehouse clubs), and have something to sip close by. Another thing that seems to work for aches and pains and whatnot is crushing a bunch of cheap aspirin tablets and dissolving those in the tub as it fills.
And rest.
Need I say it — chicken soup? May not help, but it can’t hoit.
And I don’t even play a doctor on tv.
All noted, thank you very much for the advice.
Oh, and I swear by those saline nose rinse things. Those clean up and sooth the tissues. If I’ve got a sinus infection (I go by feel, and am prone to them) I first give it a shot of (brace yourself) hydrogen peroxide. Walmart has pump bottles of that, very handy, and it doesn’t take much to bitch-slap the critters that are buggin’ ya nose. Then a minute or so later (whenever it feels ready), gently blow out everything, and when the head feels clearer, the saline rinse. The saline is okay as directed on the package (can’t do much harm), but I don’t recommend using the peroxide more than once every day or two, it’s hard on the tissues.
I am not sure he has a infection as a root cause. Sounds more like allergies that irritate until an infection begins.
The honey should sooth as well as being a mild antibacterial, the smoothie and extra sleep should help build him up, the neti pot should help with the drainage that seems to be happening.
If that helps but does not end the problem then he should try one drop of oil of oregano in a cup of warm water.
On the other hand if his fever spikes to over four degrees above his normal then forget the self treatment, he should head for the doctor asap.
One real problem is they cannot prescribe them things that might help because they are not drugs.
Prescribe them Echinacea, Goldenseal, Ginseng, Eleuthero, Oil of Oregano,, garlic, zinc, a good B-complex vitamin, vitamin C, D, E, and other immune system boosters.
They aren’t drugs, unless they are naturopathic doctors they won’t even consider that. You can’t bill for this stuff, so it will never be prescribed. If they could, then people could feel like the doctor ‘did something’.
It burns, but it works. I swear by it. Haven’t been sick in years since I went back to grandma’s remedy.
Hydrogen Peroxide in the ears for 5 minutes a side works wonders as well.
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