Speakin' of dumb doctors: Antibiotics!!??!
Trispoke
Just to talk about SOMETHING other than the latest doping scandal:
Why the HELL are antibiotics so grossly overused by Euro pros, and evidently,
by their doctors? Most recently, in a report on Riis' being unlikely to ride
the Tour, it was stated that "despite two heavy courses of antibiotics, he has
been unable to get rid of a respiratory VIRAL infection" (my caps). Well duh,
didn't you just answer your own question?
If it's a viral infection, then it's not a bacterial infection, and thus
antibiotics won't help. And this is not an isolated case, it seems that every
time I read an interview with a rider they will mention some time they were
sick with the flu (a viral infection) or something similar and took
antibiotics, but strangely it didn't clear up any faster. Team doctors are
handing out antibiotics to every rider with a cough, without doing a culture,
for no good reason, when it doesn't help cure most of the sicknesses and only
helps to create antibiotic-resistant drugs.
I know it's tempting to feel like you are doing something to get better, but
STOP THE INSANITY!!
There, I feel better.
-Ian
Andrew Albright
: Just to talk about SOMETHING other than the latest doping scandal:
: Why the HELL are antibiotics so grossly overused by Euro pros, and evidently,
: by their doctors?
It isn't just them. I have talked to plenty of people with various
illnesses who are on antibiotics even when bacterial infections have been
ruled out. I think it makes the doctor feel like they are doing
something.
JAVAEYE
>antibiotics won't help. And this is not an isolated case, it seems that every
>time I read an interview with a rider they will mention some time they were
>sick with the flu (a viral infection) or something similar and took
>antibiotics, but strangely it didn't clear up any faster.
I also enjoy comments by people like Paul Sherwin referring to riders having
"blood disorders." It seems that culturally many Europeans are either not well
versed in modern medicine as consumers of medical treatment or perhaps certain
quaint 18th century medical terms just die hard over there. I wonder if the
team physicians examine the riders' stools each morning ala the Madness of King
George.
Brian Lafferty
Rod lawson
actually one of the trickier things in medicine to do, to have someone come
and ask for help to get well quicker, and to tell them there's nothing you
can do to speed nature along. Now that doesn't make it correct to take the
path of least resistance, but it's often why it happens, and I should
imagine particularly true if you are being paid by sponsors to make sure
that there team is out there on the road.
Andrew Albright <alb...@mail.med.upenn.edu> wrote in message
news:7ha4m6$fih$1...@netnews.upenn.edu...
Jessica L. Mosher
Rod lawson wrote:
>
> I should
> imagine particularly true if you are being paid by sponsors to make sure
> that there team is out there on the road.
This is why I never would want to be a professional cyclist...suddenly,
my body is part of someone's business. I wonder if you have to resign
yourself to this fact in order to have a European racing career. Or, if
this is not true in American professional racing, if it's one of the
reasons why bicycle racing isn't as popular here, and perhaps one of the
reasons why riders such as Malcolm Elliot choose to complete their
careers in American racing.
David L. Johnson
> It isn't just them. I have talked to plenty of people with various
> illnesses who are on antibiotics even when bacterial infections have been
> ruled out. I think it makes the doctor feel like they are doing
> something.
That's right, they are doing something. Helping to create drug-resistant
bacteria is what they are doing. This is almost SOP for pediatricians -- kid
has a cold, parents are bummed, give kid amoxicillin just in case. Doesn't
help, but parents feel they are doing something, doctor gets family out of
office, everybody wins.
--
David L. Johnson david....@lehigh.edu
Department of Mathematics http://www.lehigh.edu/~dlj0/dlj0.html
Lehigh University, 14 E. Packer Avenue, Bethlehem, PA 18015-3174
You will say Christ saith this and the apostles say this; but what canst
thou say? -- George Fox.
John Forrest Tomlinson
start a thread with "Star Trek" in the subject line, but I was
recently watching an episode from the original series and it was
remarkable how doped up the crew was supposed to be. Dr. McCoy was
constantly running around giving people stimulants or sedatives
depending on the moment or the situation.
And if you watch any kind of commercial TV it's remarkable how many
advertisements there are for various sorts of medications.
JT
****************************************
Remove "removethis" to reply
Visit http://www.jt10000.com/
Cycling, Food and Stories
****************************************
Harley S
>Hey all,
>
>Just to talk about SOMETHING other than the latest doping scandal:
>Why the HELL are antibiotics so grossly overused by Euro pros, and
evidently,
ride
>the Tour, it was stated that "despite two heavy courses of antibiotics, he
has
>been unable to get rid of a respiratory VIRAL infection" (my caps). Well
duh,
>didn't you just answer your own question?
>
>antibiotics won't help. And this is not an isolated case, it seems that
every
>time I read an interview with a rider they will mention some time they were
>sick with the flu (a viral infection) or something similar and took
>handing out antibiotics to every rider with a cough, without doing a
culture,
>for no good reason, when it doesn't help cure most of the sicknesses and
only
>helps to create antibiotic-resistant drugs.
>
>I know it's tempting to feel like you are doing something to get better,
but
>STOP THE INSANITY!!
>
>There, I feel better.
>
>-Ian
>
It's not just a Euro-thing - check out this from Lance's Q&A page:
___________________________________________________
Lance, With such a demanding racing/traveling schedule, you must get a cold
(or worse) now and then. Do you try to train through it if it is minor or do
you wait until you are practically bed ridden before easing up?
--Dave in Minneapolis
--I definitely ease up when I feel something coming on. If it still
progresses then I will go for the anti-biotics.
___________________________________________________
But don't just blame the doctors - some patients can be a real pain in the
ass demanding what they 'know' will help...
Andrew Albright
have been well ahead of their time. And they would have been a
well-rounded team. I am sure Captain Kirk would have been quite a man for
the classics and Dr. Spock probably would have kicked some ass in
the Grand Tours...I bet he could time trail the bejesus out of his
competition, in the vein of Indurain.(come to think of it, Indu does look
like he might have a little Vulcan in his). And lastly, as you point out,
Dr. McCoy would all have them on a "program" that would have put Will
Voet to shame.
Andrew Albright
John Forrest Tomlinson (j...@removethisjt10000.com) wrote:
: I don't know what thread to put this in and I'm too embarrassed to
Steve Hemminger
must really hurt the pro riders.
- With heavy training, the body is more prone to infection. Plus what
does all that other "medical treatment" cause? Perhaps, the antibiotics
are being perscribed to prevent/avoid a cold from turning into lingering
bronchitis or sinus infection.
Andrew Albright
: - Antibiotics seem to reduce my energy and absorption of food. This
: must really hurt the pro riders.
Why would your mental state hurt pro riders' [performance].
Andrew Albright
Roger Hughes
Albright) wrote:
>Trispoke (tris...@aol.com) wrote:
>: Just to talk about SOMETHING other than the latest doping scandal:
>: Why the HELL are antibiotics so grossly overused by Euro pros, and evidently,
>: by their doctors?
>
>It isn't just them. I have talked to plenty of people with various
>illnesses who are on antibiotics even when bacterial infections have been
>ruled out. I think it makes the doctor feel like they are doing
>something.
Naah, it makes the _patient_ feel like the doctor is doing something;
people don't like being sent home with "don't worry about it, it'll
get better by itself", they want to be *treated*. There has been
massive overprescription of antibiotics for years more or less as a
placebo, not just in Europe AFAIK.
Ch
Roger Hughes, Gembloux, Belgium
Six day schedules: http://users.skynet.be/rohughes/cycling/six.htm
Robert Molle
bob
Steve Hemminger wrote:
>
> - Antibiotics seem to reduce my energy and absorption of food. This
> must really hurt the pro riders.
>
MGS
viral infection.
The first is that the medication given during a severe virus may not be an
anti-biotic, but an anti-viral medication specifically to shorten or lessen
the effects of the flu. The media and the biker may assume that this
medicine is an anti-biotic, but it is specifically an anti-viral medication.
These medicines, when taken during the prodrome period of influenza have
been shown to effectively lessen syptoms and duration of illness.
The second is someone who has a viral infection but is developing secondary
bronchitis or sinusitis from congestion or airway obstruction. In those
cases an anti-biotic will improve syptoms and hasten recovery. Often, a
worsening of a viral infection is a sign to start a broad spectrum
anti-biotic in order to treat an impending upper airway infection.
The third reason is to prophylactically cover a young or physically stressed
out individual who is at risk of developing a secondary infection.
Physicians are as a rule not idiots, and talking to your doctor as to why an
anti-biotic is prescribed should clarify the reason.
It appears to be an easy shot to insult any large group of professionals.
It accomplishes very little. If one has a question about treatments, they
can be raised without disparaging remarks.
David Stanley
>
>- Antibiotics seem to reduce my energy and absorption of food. This
>must really hurt the pro riders.
No, this is not what antibiotics do. What reduces your energy level is
the bacteria that caused you to need antibiotics in the first place.
And how do you know that your food absorption is altered? Do you have
diarrhea? Again, probably the bug, but there are instances where the
antibiotics wipe out the indigenous flora of your gut, and that can give
you the trots.
DnF
"I am satisfied- I see, dance, laugh, sing..."
-Walt Whitman
David Stanley MXQ...@prodigy.com
Jason Alcock
Unfortunantly for _me_ if i get a viral infection, I very often get my usual
sinus infection.
According to my GP this is fairly common .
So it may work that way in general. Don't be too quick to dismiss.
I don't and would not recomend taking antibiotics before infections sets in,
but I don't believe it to be totally stupid. Particularly if your livelyhood
depends on your health.
Jason Alcock
jda@not iafrica.com
(remove not to email me)
Robert Molle wrote in message <373A0799...@home.com>...
>no, thats not how it works.
>bob
>
>Steve Hemminger wrote:
>>
>> - Antibiotics seem to reduce my energy and absorption of food. This
>> must really hurt the pro riders.
>>
Andrew Albright
: hi bob
: Unfortunantly for _me_ if i get a viral infection, I very often get my usual
: sinus infection.
Are you implying that viruses can't infect your "sinuses" or even that an
immune response to a viral infection can't cause "sinus" problems?
: According to my GP this is fairly common .
What is common?
Andrew Albright
Jason Alcock
Andrew Albright wrote in message <7hed7e$ccu$2...@netnews.upenn.edu>...
>Jason Alcock (j...@not.iafrica.com) wrote:
>: hi bob
>
>: Unfortunantly for _me_ if i get a viral infection, I very often get my
usual
>: sinus infection.
>
>Are you implying that viruses can't infect your "sinuses" or even that an
>immune response to a viral infection can't cause "sinus" problems?
The diagnosis for the sinus problem is bacterial infection - "sinusitis",
this was due to a number of symptoms.
The symptoms of the viral infection (average once a year) changes, yet the
sinus symptoms remain constant.
The doc thinks that untreated the bacterial infection would linger, which is
my experiance if I try to let it go. If I take the antibotics it does not
linger.
I have been though this enough times to feel that it is worth considering.
Obviously a proper statistical analysis is now called for.......
>: According to my GP this is fairly common .
>
>What is common?
A secondary bacterial infection occurring during a viral illness.
I am against the frivolous use of antibiotics, and **preventing** a
secondary infection may fall into that category.
However curing a secondary infection I think is valid.
There may(?) be some validity for a Pro to take preventative antibiotics if
they have a history of secondary infections. At the least it is better than
some of the other stuff they do take :-)
Jason
Trispoke
<<Physicians are as a rule not idiots, and talking to your doctor as to why an
anti-biotic is prescribed should clarify the reason.
It appears to be an easy shot to insult any large group of professionals.
It accomplishes very little. If one has a question about treatments, they
can be raised without disparaging remarks.>>
I'm sorry if my original post seemed insulting. I was merely riffing on the
numerous recent comments on "Doctor" Sainz, who I realize is in fact not a
licensed physician, and was trying to note what appears to me to be a very
widespread problem. No offense meant.
I do stand by my comments that it seems that many European riders are taking
WAY too many antibiotics, in situations where it is unlikely to help, and these
drugs are usually prescribed by the team physician. The same problem seems to
exist in the USA, in which patients might demand SOMETHING for their money, and
I can readily understand giving a patient some amoxicillin so they'll quit
pestering me about a viral infection for which the only known treatment is rest
and time.
Another explanation IS possible:
A Spanish/German doctor I worked with in a research lab in Boston once offered
to help me with a persistent urticaria problem (a malady which is rarely cured)
by picking me up some antibiotics when at home in Spain. I assumed that she
meant that, since she was not medically licensed in the US, that she could only
prescribe them in Spain, but she told me (and I have not confirmed this) that
many antibiotics are available over the counter there. I know that in many
other countries in the world, antibiotics are available over the counter, and
those who do not understand the principle of their use are likely to purchase
much less than a full course of the drug. This can readily lead to
antibiotic-resistant bugs, same as their prescription by M.D.'s in situations
where they are not warranted.
BTW, as I'm sure you know, I'm not the first person to bring this up as a
problem throughout the world, but I'm sorry if the "Dumb doctors" headline
rankled you (and others).
Yours in health,
Ian
Andrew Albright
: The second is someone who has a viral infection but is developing secondary
: bronchitis or sinusitis from congestion or airway obstruction. In those
: cases an anti-biotic will improve syptoms and hasten recovery.
Could you please provide some references for this point of view. My
opinion is that antibiotics are used too frequently and in many cases
where they are not necessary. However, I have searched the literature
(not exhaustively) and I can only find refs to support my view and none to
support yours.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9004313&form=6&db=m&Dopt=b
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9531910&form=6&db=m&Dopt=b
: Physicians are as a rule not idiots, and talking to your doctor as to why an
: anti-biotic is prescribed should clarify the reason.
They may not be idiots, but many are overprescribing antibiotics.
I also feel that many probably are pretty lazy with regard to educating
themselves in current literature, especially the general practioner.
(Nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for
children with colds, upper respiratory tract infections, and
bronchitis. JAMA 1998; 279: 875-877)
: It appears to be an easy shot to insult any large group of professionals.
Actually, if you read the first post, the insult was directly specifically
at team doctors of pro cyclists, many of whom are injecting their athletes
illegally and unethically.
Back to the point of over-prescription of antibiotics, here is a nice
abstract I found on the subject:
BMJ 1998;317:668-671 ( 5 September )
Education and debate
Strategies for promoting judicious use of antibiotics by
doctors and patients
Edward A Belongia, senior epidemiologist, a Benjamin Schwartz, medical
epidemiologist. b
a Epidemiology Research Centre, Marshfield Clinic, Marshfield, WI, USA, b
Respiratory Diseases Branch,
Disease Control and Prevention, 1600 Clifton Road, MS E-61, Atlanta, GA
30333, USA
Correspondence to: Dr Schwartz bx...@cdc.gov
Recent antibiotic use is a well documented risk factor for infection or
colonisation with
resistant pathogens.1-7 Despite this recognition, unnecessary antibiotic
prescribing remains
common. In the United States more than a fifth of all antibiotic
prescriptions for children and
adults are written for upper respiratory tract infections or bronchitis,
conditions that are
almost always viral. 8 9 Similar rates of unnecessary antibiotic use have
been described in Britain.10 These findings are consistent with results
from focus groups among doctors, in which participants have estimated that
10% to 50% of outpatient antibiotic prescriptions are unnecessary.11
Only limited data are available to evaluate whether reducing antibiotic
prescribing will reduce the spread of resistance. In Finland the
proportion
of group A streptococcal infections resistant to macrolides was nearly
halved after a successful campaign to reduce the use of macrolide
antibiotics.12 A cross sectional survey in Iceland found that carriage of
penicillin resistant pneumococci was strongly associated with both
individual and community-wide levels of antimicrobial use,13 and there is
some evidence 》hat ∥n intervention programme has decreased the
proportion of pneumococcal infections caused by penicillin resistant
strains.14
Andrew Albright
: : bronchitis or sinusitis from congestion or airway obstruction. In those
: : cases an anti-biotic will improve syptoms and hasten recovery.
: Could you please provide some references for this point of view. My
: opinion is that antibiotics are used too frequently and in many cases
: where they are not necessary. However, I have searched the literature
: (not exhaustively) and I can only find refs to support my view and none to
: support yours.
Here is the best that I can do on the subject of chronic bronchitis:
Acute bronchitis is >90% viral. Chronic Bronchitis is very frequently
(50-75%) bacterial; however, if you read the literature prescription of
antibiotics for all patients with chronic bronchitis is not readily
accepted. (reference below-review.) And whether a healthy athlete would
ever need antibiotic treatment for this looks very dubious. (Smokers and
old people look to be better candidates for antibiotic use).
My impression from all this is that if you have bronchitis, you are much
better off resting and going easy for a couple of weeks. This is going to
get you back to racing much faster than trying to take antibiotics and
keep riding hard/training/racing.
Semin Respir Infect 1993 Dec;8(4):254-8
Con: antibiotic use in exacerbations of chronic bronchitis.
Nicotra MB, Kronenberg RS
University of Texas Health Center at Tyler 75710.
An acute exacerbation of chronic bronchitis represents one of the most
common illnesses treated by physicians. In spite of this, the role of
infection in general, and bacterial infection in particular, is difficult
to establish. Clinical signs and symptoms in patients with bacterially
associated disease are not separable from those in patients without
bacterial infection. Studies evaluating the efficacy of antibiotics in
this setting,
though suggesting that antibiotics are useful, do not provide sufficient
benefit to justify routine antibiotic use. Further, these studies have not
defined a subpopulation for whom antibiotics are necessary. Routine
antibiotic use may delay diagnosis of other serious disease and is
unequivocally very expensive, primarily because of the use of the newer
and higher-cost drugs. In some situations, such as severe infection or
associated with surgery, routine antibiotic use may be justified, but the
use of sputum culture to guide antibiotic choice is recommended. A well
designed study to finally settle the issue of antibiotic need in acute
exacerbations of chronic bronchitis is badly needed.
Tom Kunich
>MGS (moi...@isoc.net) wrote:
>
>: The second is someone who has a viral infection but is developing
secondary
>: cases an anti-biotic will improve syptoms and hasten recovery.
>
>Could you please provide some references for this point of view. My
>opinion is that antibiotics are used too frequently and in many cases
>where they are not necessary.
I have heard this again and again. Yet in the last four occasions that I've
been injected with antibiotics it was the last thing that they tried and had
been obviously necessary to me for weeks.
Just this last bout with that strange flu resulted in a bacterial infection
in my lungs that was present for two months before the doctor would
prescribe antibiotics. Finally a shot and some pills and I began to get
better and could breath again. Shortly thereafter they got the picture
and began treating this stuff aggressively since the viral infection seemed
to be setting everyone up for respiratory infections.
I had to go to the emergency room at 2:00 in the morning and there was
a full house all with the same hacking cough I had and they all were given
antibiotics.
All of this crap about over-treatment is fine when it refers to getting
shots
for the common cold, but there are all sorts of illnesses that aren't being
treated properly because of the claim for over-prescription of antibiotics.