My comments about preventive antibiotics, part 2 of 3
The problem I have with this issue Dr. L brought up is that many docs would currently rather nuke everybody with AB because they are so fearful of liability and a very rare complication. They’d rather blanket us all in drugs as a preventative, rather than trust the immune system and deal with that rare complication. (Of course, this isn’t because the doctors are bad–it’s because of the current climate of fear and risk management they must live in because of several trends on a macro level, not least of which is litigation.)
(By this logic, I shouldn’t ski. There’s a very small outside possibility that I’ll break a limb. More likely, though, I’ll enjoy fresh air and beautiful scenery and endorphins—and my bones will be stronger for the mild-impact exercise and sunshine.)
The consequence of the “preventative AB” trend is MRSA infections and many other “superbugs” that are antibiotic-resistant. Plus a host of yeast problems and gut issues related to all the natural flora being destroyed in the gut from even one dose of antibiotic.
(This is a reality, and in my mind, a bigger collective risk than a very rare joint infection. I would want to know real statistics on how many have serious or fatal joint infections who don’t take AB. I’d ask hard questions about what happens if there IS a joint infection. What is the fatality risk? 1 in 10? 1 in 1 million? If the doctor cannot answer my questions, or if the risk is remote, I would not likely take the AB. Make educated decisions, rather than head-in-the-sand, knee-jerk reactions.)
Healthy flora–our best defense against viruses and bacteria–are much more susceptible to death by AB, than the bad bacteria is. That said, you can build up your body’s “friendly bacteria and yeast” with dedicated daily use of fermented foods such as kefir, raw sauerkraut, and kombucha.
This antibiotic thing isn’t a hill I want to die on. But in general, I’ve gotten increasingly mistrustful of the horribilizing and scare tactics of practitioners who want us to take antibiotics for just EVERYTHING. Increasing, systematic codification of medical practice, IMO, isn’t always a positive thing. That’s where all doctors are told “in the book” what to do in every instance. A few thousand codes billable to insurance companies dictate the entirety of acceptable medical practice.
Those protocols Dr. L refers to shift constantly, depending on what’s popular, the opinion of who’s in charge of the committee, or the latest study (which may not be reliable relative to other past or future studies).
I agree with Dr. L’s suggestion that there are times an antibiotic may be appropriate. I think it’s a once-or-twice in-a-lifetime thing, though, not before and after virtually every procedure. We now have antibiotics prescribed or recommended so often, for increasingly minor reasons, that we HAVE to take a stand and say no, some or most of the time. Otherwise we will default into contributing to the current AB crisis.
Tomorrow, why I don’t value “standards of care” all that much, and then some great points made by readers on this topic.
Posted in: Research