I read a fascinating article from Emergency Physicians Weekly (a free circular that ER docs get) which describes how treating strep throat with antibiotics became the norm. And thus, leading to bigillions of viral infections (misdiagnosed as strep)being unnecessarily treated as well. Who can we blame? Some researchers in the 1940′ at a military base in Wyoming. This is a must-read.
The point of the article is that the data that was used to make the recommendations was from a small pool of patients during an unprecedented outbreak of rheumatic fever. Rheumatic fever (thought to come from strep infections) can cause severe heart disease later in life. It is now very rare at baseline, so to prevent one case of it, one has to treat hundreds of thousands of strep throats. Every study done since then has only shown minimal improvement with Abx treatment – 16 hour shorter duration. No case of Rheumatic fever has ever been reported in a trial of comparing antibiotics to placebo in the treatment of strep throat in 50 years!!!!! Now think of all the possible (and frequent) dangers of Abx – resistance, c. diff colitis, diarrhea, vomiting, allergic reactions, etc.
What are we treating? Patients’ expectations is what we are treating. They expect antibiotics because they have grown up expecting them – from millions of unnecessary treatments over the years by doctors going on outdated treatment concepts.
There should be a campaign like M.A.D. D.(Mothers Against Drunk Drivers) for this – I would call it “D. A. A. F. T.” or Doctors Against Antibiotics For Tonsillitis.