I believe we have a responsibility to steward the planet for future generations. Obviously if we all die from infections because we saved all our antibiotics for the future that wouldn't be good stewardship. But the way we hand out antibiotics to prevent a potential infection or to fatten up livestock seems to be a poor use of our resources.
“I’ll piss in my shoe to get warm now. The reduced capacity to keep warm will be me-in-5-minutes’ problem I guess. Yes I should clean up after myself but I should also suspect that future me find the will to survive.”
Story time: A few years ago while I was in Uni, I came down with a sore throat. Strep throat had been going around, so I assumed that was it. I went to the college clinic to get a doctor's opinion and medication. I told him that I thought it was strep, but the doctor wanted to run some tests to see what it was specifically, but he also said, "In the meantime, I'm going to prescribe a large doses of penicillin to get a head start and kill it since it's definitely bacterial." Fast forward a few days and I'm even sicker.
The doctor called saying the tests were negative and we wanted to test to see if it was viral instead. Nothing came back. Then, he wanted to test to see if it was STD, but the tests take longer to come back. While waiting for results and continuing to take penicillin per my doctor's directions, I continue to get sicker. The infection had moved from my throat to my gums, then to my lips, then to a couple of fingers (that I accidentally slammed between a door) and my genitals.
At this point, the doctor is convinced I have an STD because it's on my genitalia despite insisting that it started in my throat. He said it could've been transmitted orally. He runs every STD test under the sun, although he sent the samples in for the wrong tests the first time, and everything comes back negative. Since they all come back negative, he is convinced I have HIV considering how quickly it spread. He orders that test.
A few days later while bedridden and during finals week, I get a call from a new doctor saying the HIV test came back negative and to come in so she could examine me herself. Considering how sick I was and for how long, she said that I clearly should have been hospitalized, despite the previous doctor that I saw nearly everyday and saw how long I had a fever for (2 weeks straight) kept telling me to just get rest. She also said that he never tested for strep throat, despite me insisting that's what I thought it was on the first visit.
The new doctor says that she thinks it's strep throat too (which the previous doctor ruled out without testing) and she runs as many tests against it as possible. Turns out that I had antibiotic-resistant strep throat that became resistant due to the penicillin that the previous doctor was so quick to prescribe to "get a head start". It turns out that the doctor had been fired and she was his replacement...for good reason.
Anyways, antibiotic-resistant infections are no joke. They get real bad, real quick. Plus, a shitty doctor can create it by prescribing medication nilly willy and force a potential HIV scare that you have to deal with for like a week. Those three weeks were the worst of my life, not just because of how sick I was, but also because I was convinced (since the doctor was) that I had HIV, forced to confront the person I assumed I contracted it from, and go through the worst pain in my life every time I had to take a piss.
I don’t understand, how did it become resistant due to the penicillin? And it seems you’re blaming the doctor for this, but penicillin would be the natural first course of treatment here.
I mainly blame the doctor for not testing for strep and the multiple times he was "convinced" it was something else without testing for it. Under no circumstances should a doctor say "I'm convinced you have HIV. The tests will confirm this".
Furthermore, penicillin is only suggested for group A strep, which has already been declining in effectiveness since the 80s. It also shouldn't be given simply as a precaution until you know what bacteria you're dealing with. It was probably already a resistant strain of strep, but the way the following doctor explained it to me was that by introducing the penicillin, it made it more resistant to other antibiotics that I should've taken instead. The only course of action I had was to wait it out. She said she could have tried other antiobiotics, but there was no way to tell if it would work. Luckily, I was already recovering by the time we got the results back for strep throat.
P.S. The person I contracted the strep throat from was fine after about a week of clindamycin.
EDIT: I’m no doctor myself. I’m just going based on what I was told. If the second doctor gave me bad information, then I’ll be happy to assume that both were shitty doctors. That wasn’t the only time I had horrible experiences with that clinic (completely forgot to document multiple doctor’s visits and weeks of PT I had in relation to a sports injury and I lost my redshirt eligibility as a result as there was no proof of the injury). That clinic was the only option I had with student-athlete health insurance. But, I’m not changing my mind on the first doctor after everything else, regardless of the penicillin.
I'm going to go out on a limb here and assume that lab tests for other bacteria need to be cultured as well, such as staph, which he did request labs for. Again, I'm not saying penicillin wasn't appropriate because I'm not a doctor. However, he continued to test everything but the one thing I asked him to, which it turned out I had. As I also said in another comment, he told me to continue using the high doses of penicillin (500mg IIRC) throughout him being convinced I had something viral, then an STD, and then HIV without ever changing the dosage and despite my condition getting progressively worse. There's multiple things I blame him for, the most upsetting being the statement-of-fact that I had HIV when I didn't. I also don't believe he was fired for no reason.
Starting with penicillin is standard practice for some infections - it’s called empiric treatment - you start with the weakest antibiotic and work your way up, you reserve the strongest antibiotics for those cases where the infection isn’t getting better.
In some cases resistance is so widespread that they skip the weakest and just right to the stronger antibiotics.
I'll just refer to my other comment. It may very well have been the right treatment, but I also don't think it's the right move make a patient continue using it and not even change the dosage when it's doing no good. I was instructed to continue to take it despite him eventually moving on to viral, then STD, then HIV, despite my condition getting progressively worse.
The use of antibiotics is actually very institution specific. Hospital usually have antibiotic protocols - the tests that should be run and what drugs are used 1st line, 2nd line, etc.
Antibiotic resistance can be really high at one hospital and really low at another hospital down the street.
He ran tests for staph and something else that I don't remember since it was a few years ago, but strep wasn't one of them. I specifically asked for him to test strep, but he said "That doesn't look like strep to me". I also tried to repeat to him on return visits that the person I thought I got sick from had strep, but he continued with the viral tests and said that the penicillin would have stopped it if it was strep. He told me to continue using the penicillin anyway when he started testing for other things, specifically herpes and shingles (IIRC) due to it becoming a skin infection. I generally don't remember that week very well considering I was trying to study for finals and trying to prepare for a foreign language interview for a class that I was struggling in all year. I just tried to follow his directions and keep my mouth shut after the first week. I really didn't have the energy to do otherwise anyways.
As an introvert and someone with Social Anxiety Disorder, I don't say much (hence my username) and I don't ask too many questions in person. This was also before I got treatment for major depressive disorder and SAD, so I spoke even less then. But, I was at least concerned enough to request he test for strep and to try to insist that I thought it was strep I got from someone else too, which was quickly diminished into disregard each time I tried. I pretty much kept my mouth shut after out of embarrassment. In the beginning things felt questionable, like the staph test (like why staph?), but I stopped questioning after I felt embarrassed. It wasn't until the second doctor that I questioned everything else he did, including the viral tests.
It was a bad experience I had and I'm salty about it. I may be putting blame or wrongdoing where I shouldn't due to said saltiness. A lot of the things he said and did were questionable though and I blame him in the least for making every visit and those 3 weeks as difficult as possible for me, when I feel there were at least some better options he could have chosen and the second doctor confirmed that to me.
No. We shouldn't be wasting resources on developing new antibiotics, because their effectiveness will be relatively short lived. We should focus on alternative sources, such as plants found in rainforests that are rapidly disappearing.
They're not just less useful. You're creating new superbugs in the process. Meanwhile, rainforests are disappearing, which likely have plants that offer sustainable solutions.
You're heading down an unwinnable path with antibiotics, and creating new superbugs. You're running out of time to discover a real fix, because rainforests are rapidly disappearing. So yeah, the analogy is apt.
