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	<title>Comments on: Antibiotics or Else</title>
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	<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/</link>
	<description>A blog from inside the emergency department</description>
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		<title>By: tammy</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-7860</link>
		<dc:creator>tammy</dc:creator>
		<pubDate>Sat, 11 Apr 2009 11:28:05 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-7860</guid>
		<description>Very nice information. Thanks for this.its great to see someone with a like mind.</description>
		<content:encoded><![CDATA[<p>Very nice information. Thanks for this.its great to see someone with a like mind.</p>
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		<title>By: Dan</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6690</link>
		<dc:creator>Dan</dc:creator>
		<pubDate>Fri, 06 Feb 2009 16:20:18 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6690</guid>
		<description>Antibiotic resistance is a bad thing:

Sometimes, Death Is Good- For A Vicious Unicellular Microorganism

There are a variety of different types of foreign bacterial infections one can get from many different sources, yet some are more common than others.  If they are not beneficial for your physiology, they all should die in order to restore your health.
Bacteria are a simple life form, yet are incredibly productive and efficient.  As with other life forms, it exists to reproduce.  To do this, it fully utilizes all available resources and energy to develop the protein that is essential for its survival, and bacteria have the ability to adapt as needed to assure this happens. 
 It needs exactly 7 genes to produce the essential ribosomes for this to occur.  Any more or less genes than 7, the bacteria is not maximizing its efficiency to survive and reproduce.  Amazing.
Strept infections are caused by what are called gram positive bacteria, and are unique that these bacteria grow in pairs.  Staph bacterial invasions are gram positive as well, yet it is the MRSA, Methicillin Resistant Staff Aureous microbes of this type often are very difficult to treat normally when a patient suffers from their damage from being invaded by these bacteria.  Another difficult situation is when a patient is infected by VRE, Vancomycin Resistant Enterococci, as well.
 These MRSA and VRE pathogenic or disease causing bacteria are the ones that are the most clinically concerning for the health care provider.  
Group A strep infections can cause diseases such as strep throat and pneumonia.  Since there are several types of bacteria, a diagnostic test called a culture and sensitivity is usually performed to assure the correct antibiotic is selected for treatment, as the bacteria are identified with this method. 
Typically, fluid from the area suspected of being infected is obtained from the patient suspected to have an infection and smeared on what is called a petrie dish.  And then these dishes are incubated for 2 to 3 days.  Gram positive bacteria stain during this process a dark violet or blue. Gram negative bacteria would be pink in color, and are capable of harm as well to a human being.
When the culture is complete, technology offers recommendations on the appropriate class or brand of antibiotic for this bacteria present in another person- presuming the bacteria will not be resistant to the antibiotic recommended, as this happens on occasion.
Usually, classes of antibiotics that are used to treat gram positive strep infections that are not VRE or MRSA are cephalosporins, macrolides, or general penicillins.  If the microbe that is causing the infection is resistant to the antibiotic from such classes that are administered to the infected patient, particularly with methicillin and vancomycin, which is the case with VRE and MRSA bacteria, then there are other more aggressive antibiotics that will be chosen for this patient.  
Such brands and types of antibiotics for MRSA and VRE bacteria include Zyvox, which has both IV and oral dosage options.  There are also other antibiotics, such as Cubicin.  However these antibiotics for antibiotic resistant bacteria are given usually due to infections that have progressed to a more serious nature within a patient infected in such a way.  
Progressive medical conditions include sepsis, or blood infection, osteomyelitis, or bone infection, or Pneumonia, which is a serious lung infection.  A hospital stay is normally required with such patients, as the last antibiotics mentioned for MRSA and VRE bacterial infections are given by IV administration initially for several days, if not several weeks.  
There are numerous classes and types of antibiotics available, yet bacterial resistance to most of these antibiotics constantly remains serious concern for the health care provider, and the infected patient, with MRSA at the top of the list of concerns for the health care providers. 
Dan Abshear</description>
		<content:encoded><![CDATA[<p>Antibiotic resistance is a bad thing:</p>
<p>Sometimes, Death Is Good- For A Vicious Unicellular Microorganism</p>
<p>There are a variety of different types of foreign bacterial infections one can get from many different sources, yet some are more common than others.  If they are not beneficial for your physiology, they all should die in order to restore your health.<br />
Bacteria are a simple life form, yet are incredibly productive and efficient.  As with other life forms, it exists to reproduce.  To do this, it fully utilizes all available resources and energy to develop the protein that is essential for its survival, and bacteria have the ability to adapt as needed to assure this happens.<br />
 It needs exactly 7 genes to produce the essential ribosomes for this to occur.  Any more or less genes than 7, the bacteria is not maximizing its efficiency to survive and reproduce.  Amazing.<br />
Strept infections are caused by what are called gram positive bacteria, and are unique that these bacteria grow in pairs.  Staph bacterial invasions are gram positive as well, yet it is the MRSA, Methicillin Resistant Staff Aureous microbes of this type often are very difficult to treat normally when a patient suffers from their damage from being invaded by these bacteria.  Another difficult situation is when a patient is infected by VRE, Vancomycin Resistant Enterococci, as well.<br />
 These MRSA and VRE pathogenic or disease causing bacteria are the ones that are the most clinically concerning for the health care provider.<br />
Group A strep infections can cause diseases such as strep throat and pneumonia.  Since there are several types of bacteria, a diagnostic test called a culture and sensitivity is usually performed to assure the correct antibiotic is selected for treatment, as the bacteria are identified with this method.<br />
Typically, fluid from the area suspected of being infected is obtained from the patient suspected to have an infection and smeared on what is called a petrie dish.  And then these dishes are incubated for 2 to 3 days.  Gram positive bacteria stain during this process a dark violet or blue. Gram negative bacteria would be pink in color, and are capable of harm as well to a human being.<br />
When the culture is complete, technology offers recommendations on the appropriate class or brand of antibiotic for this bacteria present in another person- presuming the bacteria will not be resistant to the antibiotic recommended, as this happens on occasion.<br />
Usually, classes of antibiotics that are used to treat gram positive strep infections that are not VRE or MRSA are cephalosporins, macrolides, or general penicillins.  If the microbe that is causing the infection is resistant to the antibiotic from such classes that are administered to the infected patient, particularly with methicillin and vancomycin, which is the case with VRE and MRSA bacteria, then there are other more aggressive antibiotics that will be chosen for this patient.<br />
Such brands and types of antibiotics for MRSA and VRE bacteria include Zyvox, which has both IV and oral dosage options.  There are also other antibiotics, such as Cubicin.  However these antibiotics for antibiotic resistant bacteria are given usually due to infections that have progressed to a more serious nature within a patient infected in such a way.<br />
Progressive medical conditions include sepsis, or blood infection, osteomyelitis, or bone infection, or Pneumonia, which is a serious lung infection.  A hospital stay is normally required with such patients, as the last antibiotics mentioned for MRSA and VRE bacterial infections are given by IV administration initially for several days, if not several weeks.<br />
There are numerous classes and types of antibiotics available, yet bacterial resistance to most of these antibiotics constantly remains serious concern for the health care provider, and the infected patient, with MRSA at the top of the list of concerns for the health care providers.<br />
Dan Abshear</p>
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		<title>By: catherine</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6461</link>
		<dc:creator>catherine</dc:creator>
		<pubDate>Sun, 25 Jan 2009 19:23:48 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6461</guid>
		<description>I&#039;m glad you posted about the sinus rinse.  This week sinus nastiness began for me, but I was able to say to myself, &quot;Ah, WhiteCoat just posted about this! I&#039;ll try out the nasal rinse that he mentioned!&quot;

Thank you!</description>
		<content:encoded><![CDATA[<p>I&#8217;m glad you posted about the sinus rinse.  This week sinus nastiness began for me, but I was able to say to myself, &#8220;Ah, WhiteCoat just posted about this! I&#8217;ll try out the nasal rinse that he mentioned!&#8221;</p>
<p>Thank you!</p>
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		<title>By: ToLazyToThinkOfOne</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6372</link>
		<dc:creator>ToLazyToThinkOfOne</dc:creator>
		<pubDate>Wed, 21 Jan 2009 23:32:29 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6372</guid>
		<description>Dr. Kranky says: 
January 21, 2009 at 11:38 am
Who in the world said that antibiotics don’t work on sinus infections??

Umm, about every study done on sinusitis in recent years has said antibiotics have little to no benefit over &#039;standard&#039; care and of course have some harm (abx-associated diarrhea, C-diff, nausea, and of course resistance)</description>
		<content:encoded><![CDATA[<p>Dr. Kranky says:<br />
January 21, 2009 at 11:38 am<br />
Who in the world said that antibiotics don’t work on sinus infections??</p>
<p>Umm, about every study done on sinusitis in recent years has said antibiotics have little to no benefit over &#8216;standard&#8217; care and of course have some harm (abx-associated diarrhea, C-diff, nausea, and of course resistance)</p>
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		<title>By: Dr. Kranky</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6357</link>
		<dc:creator>Dr. Kranky</dc:creator>
		<pubDate>Wed, 21 Jan 2009 17:38:43 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6357</guid>
		<description>Who in the world said that antibiotics don&#039;t work on sinus infections??</description>
		<content:encoded><![CDATA[<p>Who in the world said that antibiotics don&#8217;t work on sinus infections??</p>
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		<title>By: nicole</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6323</link>
		<dc:creator>nicole</dc:creator>
		<pubDate>Tue, 20 Jan 2009 20:03:34 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6323</guid>
		<description>I hate my sinus rinse. I had a FESS/septoplasty back in November and using the Neil Med rinse regularly for 2 months is part of my doctor&#039;s aftercare process. I absolutely cannot stand the feeling of water in my nose. But I gotta admit that it helps my sinuses stay clearer, so I use it anyway. But man, do I dread those twice daily rinsing sessions. Bleh!

Also, if most antibiotics don&#039;t work on sinus infections why would both my PCP and ENT prescribe multiple courses of Augmentin? I&#039;m not a drug seeker, but I did at one point ask if there was anything else I could take for my chronic infection because it felt like the Augmentin only caused minor improvement, if any. Hm.</description>
		<content:encoded><![CDATA[<p>I hate my sinus rinse. I had a FESS/septoplasty back in November and using the Neil Med rinse regularly for 2 months is part of my doctor&#8217;s aftercare process. I absolutely cannot stand the feeling of water in my nose. But I gotta admit that it helps my sinuses stay clearer, so I use it anyway. But man, do I dread those twice daily rinsing sessions. Bleh!</p>
<p>Also, if most antibiotics don&#8217;t work on sinus infections why would both my PCP and ENT prescribe multiple courses of Augmentin? I&#8217;m not a drug seeker, but I did at one point ask if there was anything else I could take for my chronic infection because it felt like the Augmentin only caused minor improvement, if any. Hm.</p>
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		<title>By: C</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6306</link>
		<dc:creator>C</dc:creator>
		<pubDate>Tue, 20 Jan 2009 02:02:04 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6306</guid>
		<description>What an idiot! If she read all the studies she should know that the nasal rinse is FAR better and works wonders for sinus infections. Not to mention she is risking a very annoying yeast infection for meds that arent going to work anyway. Love my neti pot!</description>
		<content:encoded><![CDATA[<p>What an idiot! If she read all the studies she should know that the nasal rinse is FAR better and works wonders for sinus infections. Not to mention she is risking a very annoying yeast infection for meds that arent going to work anyway. Love my neti pot!</p>
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		<title>By: HyperAl</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6303</link>
		<dc:creator>HyperAl</dc:creator>
		<pubDate>Mon, 19 Jan 2009 20:56:11 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6303</guid>
		<description>To answer my own question:

http://www.wpro.who.int/NR/rdonlyres/3EA2DBBF-28EB-4718-8893-E608738BD2F0/0/RC5309.pdf</description>
		<content:encoded><![CDATA[<p>To answer my own question:</p>
<p><a href="http://www.wpro.who.int/NR/rdonlyres/3EA2DBBF-28EB-4718-8893-E608738BD2F0/0/RC5309.pdf" rel="nofollow">http://www.wpro.who.int/NR/rdonlyres/3EA2DBBF-28EB-4718-8893-E608738BD2F0/0/RC5309.pdf</a></p>
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		<title>By: HyperAl</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6299</link>
		<dc:creator>HyperAl</dc:creator>
		<pubDate>Mon, 19 Jan 2009 19:10:07 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6299</guid>
		<description>Good point. However, if that is the case then the ED should be full of superbugs since it is the gateway to most of these patients and I don&#039;t think that is the case. I also have not heard of a WHO alert, that superbugs are a big problem in these countries. Be good to know.</description>
		<content:encoded><![CDATA[<p>Good point. However, if that is the case then the ED should be full of superbugs since it is the gateway to most of these patients and I don&#8217;t think that is the case. I also have not heard of a WHO alert, that superbugs are a big problem in these countries. Be good to know.</p>
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		<title>By: rogue medic</title>
		<link>http://www.epmonthly.com/whitecoat/2009/01/antibiotics-or-else/#comment-6285</link>
		<dc:creator>rogue medic</dc:creator>
		<pubDate>Mon, 19 Jan 2009 08:21:02 +0000</pubDate>
		<guid isPermaLink="false">http://whitecoatrants.wordpress.com/?p=1685#comment-6285</guid>
		<description>Why not make everything that is only harmful to the patient OTC - opioids, benzodiazepines, et cetera. Require a triplicate prescription for antibiotics (as New York does for controlled substances).  

ERPAC,

Why do you desribe antibiotic drug seekers as different from other drug seekers? They are there for drugs they do not need. They will manipulate to their heart&#039;s desire to get their fix. 

Shadowfax,

If only we could get the viruses to commit suicide.</description>
		<content:encoded><![CDATA[<p>Why not make everything that is only harmful to the patient OTC &#8211; opioids, benzodiazepines, et cetera. Require a triplicate prescription for antibiotics (as New York does for controlled substances).  </p>
<p>ERPAC,</p>
<p>Why do you desribe antibiotic drug seekers as different from other drug seekers? They are there for drugs they do not need. They will manipulate to their heart&#8217;s desire to get their fix. </p>
<p>Shadowfax,</p>
<p>If only we could get the viruses to commit suicide.</p>
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