Antibiotics: less is more

Well, in the context of writing not one but TWO prescriptions for antibiotics in the last 24 hours (long-time readers will recall that I am a fanatic about the overuse of antibiotics and I write for them very rarely)

This time, I had a reason.

Our local version of the pertussis outbreak has become signifiant.  With 21 confirmed cases in a high school about 4 miles from our office, I treated a coughing student from that school this morning after consultation with the health department.   But last night's customer was a textbook case.  The PCR's will be back in a few days. We'll see.

In realted news …

This study in JAMA confirms that a shorter duration of antibiotics may be better in the ICU:

  • CONTEXT: The optimal duration of antimicrobial treatment for ventilator-associated pneumonia (VAP) is unknown.
  • Shortening the length of treatment may help to contain the emergence of multiresistant bacteria in the intensive care unit (ICU).
  • RESULTS: Compared with patients treated for 15 days, those treated for 8 days had neither excess mortality (18.8% vs 17.2%; difference, 1.6%; 90% confidence interval [CI], -3.7% to 6

Medicare Prescription Program

The Medicare prescription drug program stinks.  I don't quite understand why AARP supports it.  Many seniors will get LESS benefits under the program.    Here's a report (pdf) that explains some of the reasons that we shouldn't support it.  Our local newspaper published an editorial this week against it, and I am impressed with their insight.

From an article in the Kansas City Star:

Meanwhile, a dozen AARP members gathered outside the organization's Washington headquarters to protest the decision of the large seniors' group to support the Republican Medicare proposal. Some tore up their membership cards.

"I always felt like they were for us," said Queenita Gaskins, 67. "I cannot believe that they want us to go with something that isn't for seniors." Gaskins criticized what she said was the bill's skimpy coverage of drug costs; the package would offer no coverage, for example, for costs between $2,200 and $3,600.

"This bill is terrible, just terrible," added Evelyn James, 85, as she stood outside the AARP building in pouring rain. "This offers nothing for seniors and will diminish our health services."

.. and another look at the issue from UAW