History Main / MagicalAntibiotics

1st May '16 6:47:18 PM MsChibi
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[[folder: Other]]
* There is a legend about some grave robbers during TheBlackDeath. Despite robbing, you know, ''plague victims'', they never got sick. When they were finally caught, they were asked to reveal their secret. It turns out that one of the grave robbers was a doctor or herbalist, and had fixed up some type of protection using herbs and spices [[ScienceMarchesOn that were later found]] to have antibiotic properties. (They didn't know that, but they ''did'' know that using these plant parts tended to result in less sickness.) It isn't known whether or not this was an actual event (hence its placement here), but the story ''did'' inspire (and/or has been used to promote) [[https://www.youngliving.com/en_US/products/thieves-essential-oil an essential oil blend called "Thieves."]]
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24th Dec '15 6:39:09 AM Prioris
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** It's worth pointing out that antibiotic resistance is complicated. It's not like all bacteria resist the same things. Penicillin is often useless against ''Staphylococcus aureus'' but great for ''Streptococcus pyogenes'' pharyngitis (a/k/a "strep throat")... but useless again for ''S. mitis.'' Tigecycline is rarely resisted but won't work against any ''Pseudomonas'' due to quirks of the bacteria's biology; cefepime is quite commonly resisted by many bacteria but works great against ''Pseudomonas.'' Giving clindamycin to a patient can actually increase the risk of ''Clostridium difficile'' infection. You treat ''C. difficile'' with metronidazole, and metronidazole is used for vaginosis as well... and may cause ''Mobiluncus'' vaginosis. And so on. Treatment isn't easy or obvious.

to:

** It's worth pointing out that antibiotic resistance is complicated. It's not like all bacteria resist the same things. Penicillin is often useless against ''Staphylococcus aureus'' but great for ''Streptococcus pyogenes'' pharyngitis (a/k/a "strep throat")... but useless again for ''S. mitis.'' Tigecycline is rarely resisted but won't work against any ''Pseudomonas'' due to quirks of the bacteria's biology; cefepime is quite commonly resisted by many bacteria but works great against ''Pseudomonas.'' Giving clindamycin to a patient can actually increase the risk of ''Clostridium difficile'' infection. You treat ''C. difficile'' with metronidazole, and metronidazole is used for ''Candida'' vaginosis (yeast infection) as well... and may cause ''Mobiluncus'' vaginosis. And so on. Treatment isn't easy or obvious.
24th Dec '15 6:37:49 AM Prioris
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Any time a character develops an illness of any variety whatsoever, the medical provider will immediately insist upon throwing all manner of high-powered antibiotics at the patient in order to treat the "infection." This is a colossal fail, as there are thousands of species and dozens of classes of infectious organisms - bacteria, viruses, protozoans, fungi, yeasts, helminths [worms], parasites not otherwise specified, and so on. Of those, only bacteria are susceptible to antibiotics, and then only if that particular bacterial strain is sensitive to the prescribed antibiotic (notable examples include MRSA, methicillin-resistant ''Staphylococcus aureus,'' and VRE, vancomycin-resistant ''Enterococcus'').

to:

Any time a character develops an illness of any variety whatsoever, the medical provider will immediately insist upon throwing all manner of high-powered antibiotics at the patient in order to treat the "infection." This is a colossal fail, as there are thousands of species and dozens of classes of infectious organisms - bacteria, viruses, protozoans, fungi, yeasts, helminths [worms], parasites not otherwise specified, and so on. Of those, only bacteria are susceptible to antibiotics, and then only if that particular bacterial strain is sensitive to the prescribed antibiotic. Bacterial populations also evolve rapidly with time and drug exposure, giving rise to resistant infections - in which a bug [[NoSell no-sells]] what ''should'' be an effective course of antibiotic (notable therapy. Notable examples of these nasties include MRSA, methicillin-resistant ''Staphylococcus aureus,'' and VRE, vancomycin-resistant ''Enterococcus'').''Enterococcus''.



** Choosing antibiotic therapy for as-yet unidentified infections poses yet another wealth of traps for the physician. For example, vancomycin, commonly used as a one-stop bug bomb for skin and soft tissue infections, is deadly to practically all Gram-positive organisms but practically no Gram-negatives. The choice of antibiotics for pneumonia changes quite a bit depending on whether the patient has recently spent time in a hospital or nursing home. Gastrointestinal organisms behave very differently in skin and soft tissue versus their home tract. The general wisdom is to treat with the most effective and narrowest spectrum antibiotic you can; when you don't know the specific infection's resistance, you use whatever it's known to have very low rates of resistance to. And when you don't even know what the infecting organism is, you use broad-spectrum antibiotics, often in combination, until you do.
** It's worth pointing out that antibiotic resistance is complicated. It's not like all bacteria resist the same things. Penicillin is often useless against Staph aureus but great for Strep pyogenes pharyngitis (that's Strep throat)... but useless again for Strep mitis. Tigecycline is rarely resisted but won't work against any Pseudomonas due to quirks of the bacteria's biology; cefepime is quite commonly resisted by many bacteria but works great against Pseudomonas. Giving clindamycin to a patient can actually increase the risk of C. difficile infection. You treat C. difficile with metronidazole, and metronidazole is used for vaginosis as well... and may cause Mobiluncus vaginosis. And so on. Treatment isn't easy or obvious.
* Many people will demand antibiotics from doctors for common ailments like colds or influenza. Although those are viral and antibiotics won't help, doctors often give in.

to:

** Choosing antibiotic therapy for as-yet unidentified infections poses yet another wealth of traps for the physician. For example, vancomycin, commonly used as a one-stop bug bomb for skin and soft tissue infections, is deadly to practically all Gram-positive organisms but practically no Gram-negatives. The choice of antibiotics for pneumonia changes quite a bit depending on whether the patient has recently spent time in a hospital or nursing home. Gastrointestinal organisms behave very differently in skin and soft tissue versus their home tract. The general wisdom is to treat with the most effective and narrowest spectrum antibiotic you can; when you don't know the specific infection's resistance, you use whatever it's known make an educated guess as to have very low rates of resistance to. And when you don't even know what which antibiotics should cover the infecting organism is, you use broad-spectrum antibiotics, often most common causative organisms. (Hospitals are GenreSavvy to this, and one of the jobs of the hospital's infection control department is to create and publish an "antibiogram" - a comprehensive chart of the most common bugs in combination, until you do.
the community and which drugs they're sensitive and resistant to.)
** It's worth pointing out that antibiotic resistance is complicated. It's not like all bacteria resist the same things. Penicillin is often useless against Staph aureus ''Staphylococcus aureus'' but great for Strep pyogenes ''Streptococcus pyogenes'' pharyngitis (that's Strep throat)... (a/k/a "strep throat")... but useless again for Strep mitis. ''S. mitis.'' Tigecycline is rarely resisted but won't work against any Pseudomonas ''Pseudomonas'' due to quirks of the bacteria's biology; cefepime is quite commonly resisted by many bacteria but works great against Pseudomonas. ''Pseudomonas.'' Giving clindamycin to a patient can actually increase the risk of C. difficile ''Clostridium difficile'' infection. You treat C. difficile ''C. difficile'' with metronidazole, and metronidazole is used for vaginosis as well... and may cause Mobiluncus ''Mobiluncus'' vaginosis. And so on. Treatment isn't easy or obvious.
* Many people will demand antibiotics from doctors for common ailments like colds or influenza. Although those are viral and antibiotics won't help, are completely useless, doctors often give in.
22nd Mar '15 12:43:48 PM Morgenthaler
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* Antiviral rather than antibiotic, but in ''{{Outbreak}},'' Robbie contracts the Motaba virus and is on the brink of death before they administer the virus' antiserum. She is almost completely recovered after only a day. In reality, this is far too soon to recover from a hemorrhagic fever, which causes massive internal bleeding and organ failure.

to:

* Antiviral rather than antibiotic, but in ''{{Outbreak}},'' ''Film/{{Outbreak}},'' Robbie contracts the Motaba virus and is on the brink of death before they administer the virus' antiserum. She is almost completely recovered after only a day. In reality, this is far too soon to recover from a hemorrhagic fever, which causes massive internal bleeding and organ failure.
28th Nov '14 1:56:47 PM Prioris
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* Sadly prevalent in real life medicine, as providers frequently don't want to wait to culture an organism before attempting to treat it. A major cause of the explosion in the rates and severity of multidrug-resistant bacterial infections.
** Furthermore, it looks kind of bad if your patient dies of his infection before the culture comes back. Generally, doctors will prescribe the weaker broad-specturm antibiotics such as Amoxicillin or Azithromycin as empiric therapy, and only moving on to the harder and more specific drugs (like Vancomycin) when the culture comes back or if the patient fails to respond the therapy
*** That's not quite right. Vancomycin is actually not very powerful, but it's very broad (sort of—it covers almost all gram positive bacteria but no gram negatives). The problem is that amoxicillin is a penicillin and thus many common bacteria are resistant. Vancomycin is used in so-called empiric therapy: when you don't know what it is, you treat it with what you'll be sure will work. When the culture comes back you may switch to nafcillin (for non-MRSA). Doxycycline is also very broad spectrum, but not used quite as often in unknown illness because, again, resistance is rampant. The general wisdom is to treat with the most effective and narrowest spectrum antibiotic you can; when you don't know the specific infection's resistance, you use whatever it's known to have very low rates of resistance to. And when you don't even know what the infecting organism is, you use broad-spectrum antibiotics, often in combination, until you do.

***** Wrong , Vancomycin is a very specific drug, given only to specific organisms like Enterococcus, MRSA(Meticillin Resistant Staph-Aureus) etc. Its costly too. No one prescribes it empirically, and if they did, they are very bad doctors. Amoxyxillin and Ampicillin on the other hand are "expanded spectrum penicllins"(note that they are only expanded spectrum and not a full blown broad spectrum antibiotics) and are effective against Gram positive organisms(like usual narrow spectrum penicillins) and some gram negative organisms too like E.coli, Salmonella(and hence the term expanded spectrum antibiotics). One problem though is that resistance to Amoxycillin(and indeed the Penicillin) is so widespread that they are no loner effective on their own and are often combined with Clavulunic acid(which has no antibiotic action on its own but offers some protection against the enzymes which degrade Penicillins and hence make them active). But there are some Gram positive bacteria which have developed resistance to the entire family of penicillins as such- Namely the Meticillin resistant Staph Aureus or MRSA. Now Vancomycin is used in case of MRSA. Unfortunately, due to over use of Vancomycin, Even Vancomycin Resitant Staph Aureus(VRSA) have emerged. They are treated with Linezolid.
*** One basic case is when someone is dragged into an ER unconscious, in apparent septic shock. They're dying, and you need to treat bacteremia immediately. What do you do? Throw several broad-spectrum antibiotics at it, even when the side effects are significant.
*** It's worth pointing out that antibiotic resistance is complicated. It's not like all bacteria resist the same things. Penicillin is often useless against Staph aureus but great for Strep pyogenes pharyngitis (that's Strep throat)... but useless again for Strep mitis. Tigecycline is rarely resisted but won't work against any Pseudomonas due to quirks of the bacteria's biology; cefepime is quite commonly resisted by many bacteria but works great against Pseudomonas. Giving clindamycin to a patient can actually increase the risk of C. difficile infection. You treat C. difficile with metronidazole, and metronidazole is used for vaginosis as well... and may cause Mobiluncus vaginosis. And so on. Treatment isn't easy or obvious.
** Treating before culturing plays a small role in the spread of resistance. As long as all the bacteria die, though, it's not so bad. Starting a treatment and failing to finish the course is much worse.

to:

* Sadly prevalent in real life medicine, as providers frequently don't want to wait to culture an organism before attempting to treat it. A major cause of the explosion in the rates and severity of multidrug-resistant bacterial infections.
** Furthermore,
infections. However, since a culture & sensitivity requires anywhere from one to five days to result and it looks [[{{Understatement}} kind of bad bad]] if your patient dies of his infection before the culture C&S report comes back. Generally, doctors will prescribe back, "empiric therapy" - prescribing a broad-spectrum antibiotic "cocktail" and narrowing it down when the weaker broad-specturm C&S results - is common. This treatment is always prescribed in conjunction with a "pan culture" - culturing samples of the patient's blood, urine, stool, sputum, occasionally cerebrospinal fluid, and any wounds they might have, in order to pinpoint a source of infection. The classic example of this scenario is when someone is dragged into an ER unconscious, running a high fever and in apparent septic shock. They're dying, and you need to treat bacteremia immediately. What do you do? Bomb the infection with as broad-spectrum a cocktail as is reasonable, and hope the drugs kill the bugs before fatal damage results.
** Choosing antibiotic therapy for as-yet unidentified infections poses yet another wealth of traps for the physician. For example, vancomycin, commonly used as a one-stop bug bomb for skin and soft tissue infections, is deadly to practically all Gram-positive organisms but practically no Gram-negatives. The choice of
antibiotics such as Amoxicillin or Azithromycin as empiric therapy, and only moving for pneumonia changes quite a bit depending on to the harder and more specific drugs (like Vancomycin) when the culture comes back or if whether the patient fails to respond the therapy
*** That's not quite right. Vancomycin is actually not
has recently spent time in a hospital or nursing home. Gastrointestinal organisms behave very powerful, but it's very broad (sort of—it covers almost all gram positive bacteria but no gram negatives). The problem is that amoxicillin is a penicillin differently in skin and thus many common bacteria are resistant. Vancomycin is used in so-called empiric therapy: when you don't know what it is, you treat it with what you'll be sure will work. When the culture comes back you may switch to nafcillin (for non-MRSA). Doxycycline is also very broad spectrum, but not used quite as often in unknown illness because, again, resistance is rampant.soft tissue versus their home tract. The general wisdom is to treat with the most effective and narrowest spectrum antibiotic you can; when you don't know the specific infection's resistance, you use whatever it's known to have very low rates of resistance to. And when you don't even know what the infecting organism is, you use broad-spectrum antibiotics, often in combination, until you do.

***** Wrong , Vancomycin is a very specific drug, given only to specific organisms like Enterococcus, MRSA(Meticillin Resistant Staph-Aureus) etc. Its costly too. No one prescribes it empirically, and if they did, they are very bad doctors. Amoxyxillin and Ampicillin on the other hand are "expanded spectrum penicllins"(note that they are only expanded spectrum and not a full blown broad spectrum antibiotics) and are effective against Gram positive organisms(like usual narrow spectrum penicillins) and some gram negative organisms too like E.coli, Salmonella(and hence the term expanded spectrum antibiotics). One problem though is that resistance to Amoxycillin(and indeed the Penicillin) is so widespread that they are no loner effective on their own and are often combined with Clavulunic acid(which has no antibiotic action on its own but offers some protection against the enzymes which degrade Penicillins and hence make them active). But there are some Gram positive bacteria which have developed resistance to the entire family of penicillins as such- Namely the Meticillin resistant Staph Aureus or MRSA. Now Vancomycin is used in case of MRSA. Unfortunately, due to over use of Vancomycin, Even Vancomycin Resitant Staph Aureus(VRSA) have emerged. They are treated with Linezolid.
*** One basic case is when someone is dragged into an ER unconscious, in apparent septic shock. They're dying, and you need to treat bacteremia immediately. What do you do? Throw several broad-spectrum antibiotics at it, even when the side effects are significant.
***
do.
**
It's worth pointing out that antibiotic resistance is complicated. It's not like all bacteria resist the same things. Penicillin is often useless against Staph aureus but great for Strep pyogenes pharyngitis (that's Strep throat)... but useless again for Strep mitis. Tigecycline is rarely resisted but won't work against any Pseudomonas due to quirks of the bacteria's biology; cefepime is quite commonly resisted by many bacteria but works great against Pseudomonas. Giving clindamycin to a patient can actually increase the risk of C. difficile infection. You treat C. difficile with metronidazole, and metronidazole is used for vaginosis as well... and may cause Mobiluncus vaginosis. And so on. Treatment isn't easy or obvious.
** Treating before culturing plays a small role in the spread of resistance. As long as all the bacteria die, though, it's not so bad. Starting a treatment and failing to finish the course is much worse.
obvious.
24th Dec '13 7:27:01 PM karstovich2
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** Note: This doesn't apply to hand sanitizer. The active ingredient in most hand sanitizers is alcohol; your typical sanitizer is basically 80 proof vodka turned into a gel. [[CaptainObvious Almost needless to say]], we've been using alcohol to kill microbes for millennia (without realizing it for most of that time), and none of the critters has ever developed a resistance to ''that''. The same goes for bleach, ammonia, peroxide, and acid (none of which you should get on your hands!).
* In some parts of the world, some doctors really ''do'' prescribe antibiotics for everything. Typically these are older doctors in developing countries, from a time when indiscriminate prescription of antibiotics was seen as harmless-resistant bacteria hadn't popped up yet. However, even though doctors their age in the rich world have stopped this practice, they haven't--largely because wealthy countries tend to impose fairly rigorous continuing medical education (CME) requirements to ensure that doctors keep up with the state of medicine, while poorer countries either don't have CME requirements or cannot enforce them. So the doctor keeps handing out antibiotics like it's candy, not realizing that this has been a terrible idea for at least the last 30 years.
27th May '13 8:24:53 AM MadIndian
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**** Wrong , Vancomycin is a very specific drug, given only to specific organisms like Enterococcus, MRSA(Meticillin Resistant Staph-Aureus) etc. Its costly too. No one prescribes it empirically, and if they did, they are very bad doctors. Amoxyxillin and Ampicillin on the other hand are "expanded spectrum penicllins"(note that they are only expanded spectrum and not a full blown broad spectrum antibiotics) and are effective against Gram positive organisms(like usual narrow spectrum penicillins) and some gram negative organisms too like E.coli, Salmonella(and hence the term expanded spectrum antibiotics). One problem though is that resistance to Amoxycillin(and indeed the Penicillin) is so widespread that they are no loner effective on their own and are often combined with Clavulunic acid(which has no antibiotic action on its own but offers some protection against the enzymes which degrade Penicillins and hence make them active). But there are some Gram positive bacteria which have developed resistance to the entire family of penicillins as such- Namely the Meticillin resistant Staph Aureus or MRSA. Now Vanco mycin is used in case of MRSA. Unfortunately, due to over use of Vancomycin too, Even Vancomycin resitant Staph Aureus have emerged.

to:

****
*****
Wrong , Vancomycin is a very specific drug, given only to specific organisms like Enterococcus, MRSA(Meticillin Resistant Staph-Aureus) etc. Its costly too. No one prescribes it empirically, and if they did, they are very bad doctors. Amoxyxillin and Ampicillin on the other hand are "expanded spectrum penicllins"(note that they are only expanded spectrum and not a full blown broad spectrum antibiotics) and are effective against Gram positive organisms(like usual narrow spectrum penicillins) and some gram negative organisms too like E.coli, Salmonella(and hence the term expanded spectrum antibiotics). One problem though is that resistance to Amoxycillin(and indeed the Penicillin) is so widespread that they are no loner effective on their own and are often combined with Clavulunic acid(which has no antibiotic action on its own but offers some protection against the enzymes which degrade Penicillins and hence make them active). But there are some Gram positive bacteria which have developed resistance to the entire family of penicillins as such- Namely the Meticillin resistant Staph Aureus or MRSA. Now Vanco mycin Vancomycin is used in case of MRSA. Unfortunately, due to over use of Vancomycin too, Vancomycin, Even Vancomycin resitant Resitant Staph Aureus Aureus(VRSA) have emerged.emerged. They are treated with Linezolid.
27th May '13 8:21:54 AM MadIndian
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**** Wrong , Vancomycin is a very specific drug, given only to specific organisms like Enterococcus, MRSA(Meticillin Resistant Staph-Aureus) etc. Its costly too. No one prescribes it empirically, and if they did, they are very bad doctors. Amoxyxillin and Ampicillin on the other hand are "expanded spectrum penicllins"(note that they are only expanded spectrum and not a full blown broad spectrum antibiotics) and are effective against Gram positive organisms(like usual narrow spectrum penicillins) and some gram negative organisms too like E.coli, Salmonella(and hence the term expanded spectrum antibiotics). One problem though is that resistance to Amoxycillin(and indeed the Penicillin) is so widespread that they are no loner effective on their own and are often combined with Clavulunic acid(which has no antibiotic action on its own but offers some protection against the enzymes which degrade Penicillins and hence make them active). But there are some Gram positive bacteria which have developed resistance to the entire family of penicillins as such- Namely the Meticillin resistant Staph Aureus or MRSA. Now Vanco mycin is used in case of MRSA. Unfortunately, due to over use of Vancomycin too, Even Vancomycin resitant Staph Aureus have emerged.
21st Apr '13 1:25:32 PM Quanyails
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* In the last section of ''Literature/TheStand'', Stu Redman comes down with the flu. Tom Cullen, on the advice of his dead friend, finds some antibiotics and cures him. While Tom saving Stu's life is a CrowningMomentofHeartwarming, antibiotics don't cure the flu (a viral infection), and the antibiotics would be several months out of date, as it's after TheEndofTheWorldAsWeKnowIt.

to:

* In the last section of ''Literature/TheStand'', Stu Redman comes down with the flu. Tom Cullen, on the advice of his dead friend, finds some antibiotics and cures him. While Tom saving Stu's life is a CrowningMomentofHeartwarming, antibiotics don't cure the flu (a viral infection), and the antibiotics would be several months out of date, as it's after TheEndofTheWorldAsWeKnowIt.
TheEndofTheWorldAsWeKnowIt.
[[/folder]]
2nd Apr '13 12:35:35 AM shamblingdead
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[[folder:Literature]]
* In the last section of ''Literature/TheStand'', Stu Redman comes down with the flu. Tom Cullen, on the advice of his dead friend, finds some antibiotics and cures him. While Tom saving Stu's life is a CrowningMomentofHeartwarming, antibiotics don't cure the flu (a viral infection), and the antibiotics would be several months out of date, as it's after TheEndofTheWorldAsWeKnowIt.
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