Doctors in the USA have no feedback mechanisms to know whether treatments work or not. They’re probably falling back to hunches in marginal cases. Also, if you are discussing treatment options with parents or patients, advising against antibiotics is a losing battle: the parent/patient gets angry whether you are right or wrong. The question of whether antibiotics would be helpful or ineffective means there is asymmetric risk. Even long term risks are unknown on an individual case by case basis.
There is definitely a mix of issues. Some patients expect antibiotics because they paid for the visit.
However, every physician should be able to present patient with different options and risks. It simply is not happening. Some antibiotics carry smaller risks than flouroquinolones as this drug belongs to topoisomare II inhibitors along with chemo drugs. Some reactions we are seeing are much like damage from chemo. However, the action of damage is still very poorly understood. There is some research on mitochondrial dna damage and adducts.
There recently has been talk if flouroquinolone antibiotics could be a potential cancer treatment even.
If I knew I would never touch this antibiotic unless on my death bed.
I live in an Asian country where antibiotics are massively overused. Go to the local pharmacy and tell them you have cold symptoms and you're likely to get 3 different full spectrum antibiotics.
I've asked a few pharmacists about this and the usually say they know it is bad but it is what people expect -- the more pills they get, the more effective they think the treatment will be. If you don't hand out as many pills as the pharmacy down the road then you'll lose customers and go out of business. So it is a race to the bottom tragedy of the commons kind of market failure that can only really be fixed with effective government regulation. Which isn't easy in a developing country, to say the least.
Is this Japan, perchance? Every time we take my kid to a doctor here they seem to reach for antibiotics. Extremely frustrating and the source of some cross-cultural marriage tension.
