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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
antifungal, antiviral and antiparasitic drugs, but these are hardly ever mentioned in fiction (except in medical fiction where they're likely to be a plot point). See also Magic Antidote
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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.
- In the last section of The Stand, 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 Crowning Momentof Heartwarming, antibiotics don't cure the flu (a viral infection), and the antibiotics would be several months out of date, as it's after The Endof The World As We Know It.
Live Action TV
- Played with on House: first prescribe the most widely useful antibiotics, then find out what they actually have before the patient's kidneys shut down because of the antibiotics.
- This trope also applies to cancer treatments. While in reality there are dozens of families of antineoplastic drugs, any of which is only effective and used on a handful of specific cancers, House's team is fond of using one-size-fits-all chemotherapy.
- House is one of those rare examples in fiction that acknowledges the existence of separate treatments for fungal and parasitic infections.
- Averted in a Jon Pertwee Doctor Who story which has a major subplot about a deadly plague being released by the story's antagonists. The Doctor and Liz Shaw eventually find a cure by literally going through every single available antibiotic drug to see if it works in lab conditions. In the meantime the best they can do is use high doses of broad-spectrum antibiotics which are just effective enough to delay the plague's symptoms, and a character notes that this policy is causing severe side effects.
- Averted in Combat Hospital. In the second episode, the antibiotics the hospital staff keep doling out have no effect on a local strain of bacteria.
- 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.
- 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.
- Dr. Drew Pinsky noted on an episode of Loveline that azithromycin (known best under the brand name Zithromax) is frequently given as a catch-all treatment, and estimated that it was the appropriate treatment for maybe 10% of those cases in which he's seen it prescribed.
- The 1918 influenza pandemic. At least in the US, doctors tended to jab untested or marginally tested "vaccines" into as many arms as they could manage in the hopes that this time, they had it right. (Given that medical science of the early 1900s assumed that influenza was a bacterial disease, any cures would have been accidental.)
- Related are anti-bacterial soaps or cleaning agents. They are claimed to wipe out infectious bacteria, but the only way to guarantee killing bacteria is to maintain 20 minutes of exposure. Washing your hands or 30 seconds only destroys bacteria with the weakest resistance, and later generations of bacteria will evolve with better resistance to them.
- 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. 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.