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Beware the Clostridiapocalypse!

C. difficile is an enormous clinical problem to which, unfortunately, we physicians can contribute, as ZDoggMD tells us in Dawn of the C. Diff:

You go to the doctor to talk ‘em in
To givin’ antibiotics for your coughin’ thing
They explain that the pain in your throat’s a virus
“Antibiotics are not desirous!”
But you ain’t hearing this, you get all in they face
“Why, this is malpractice, a total disgrace!
I’m not leaving this place without a script, my man!”
Frustrated and berated, doc throws up his hands

The result? Well, let this video tell the tale:

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

23 replies on “Beware the Clostridiapocalypse!”

This post reflects the medical skool “received wisdom” that, if one has a virus, antibiotics cannot help one’s condition. Leaving aside that this ignores the experience of the patient, whut about the research that shows that the people who take the most antibiotics live longer than those who don’t take them. Just askin’.

I have always responded to antibiotics in a way that is positive except for upset stomach for certain. I am going on gut reaction and have given some layman’s thought to the anti-antibiotic hair pulling and came to the conclusion it is a non event. The theater needs to show another feature.

Call me old fashioned if you will, but I don’t think I would use such a method to teach the youngsters.

It requires simultaneous dancing and rap “singing”

I was also working along the lines of “Antibiotics lose their allure. When coprophagia’s the only cure.”

I was also working along the lines of “Antibiotics lose their allure. When coprophagia’s the only cure.”

And for that awfully painful sinusitis/Could be abcess, see a dent-itist (sorry, had to make it rhyme)

Did I catch hints of “Another One Bites The Dust” in there?

Dum, dum, dum… Another butt goes bust.

Bil Pal,

First, I’d have to see what research you’re talking about before I could comment on whether or not it’s applicable. Second, how on Earth are antibiotics supposed to help a virus? That’s like changing a flat to fix your brakes.

Now, I *can* believe that people who take antibiotics live longer than those who don’t. After all, people who let nature take its course when they get bacterial pneumonia will probably have a poorer outcome. I’m not sure that’s a good justification for indiscriminate antibiotic use (although many farmers certainly do use that justification, using prophylactic antibiotics to avoid losses in their herds or flocks — they do have better survival rates if given antibiotics, but it’s a scattershot approach to the problem and does *create* other problems).

This post reflects the medical skool “received wisdom” that, if one has a virus, antibiotics cannot help one’s condition.

Under what dense theory would anyone expect antibiotics to treat a viral disease? That’s like expecting the Roomba on your carpet to straighten out the papers on your desk.

Leaving aside that this ignores the experience of the patient,

If the patient tries to claim that the anecdote of their personal “experience” demonstrates the truth of a particular far-fetched claim such as “this antibiotic alleviated my viral infection” or “this yoga exercise alleviated my viral infection,” ignoring it is probably the best response.

whut about the research that shows that the people who take the most antibiotics live longer than those who don’t take them.

1. What research? Citation needed. For all we know, you’re talking about a paper published in Medical Hypotheses, the scientific equivalent of a supermarket tabloid.
2. Even if that correlation were correct, correlation does not equal causation; “antibiotics treat viral infections and thus prolong life” is not the only or even the most plausible explanation for the observed phenomena. Where do the people who take the most antiobiotics get those antibiotics? Could it be, oh, I don’t know, the doctor’s?? The causal relation “People who make frequently use of medical resources live longest, and also use the most antibiotics” is far more plausible than “antibiotics treat viral infections.”

Just askin’.

JAQing off, in other words. Noted.

Well, this is a scary topic, and since there are doctors on board this thread, I’d like to ask a question that has been gnawing on my mind for many years: When does one know it is appropriate to take antibioitcs? Also, is there anything one can so (e. g. changes to diet) to make sure nothing screwy goes on in the intestine while one is on an antibiotic regimen? I never like to contibute to a problem, especially one as serious as this.

“how on Earth are antibiotics supposed to help a virus? That’s like changing a flat to fix your brakes.”

Not the virus itself, but maybe a secondary bacterial infection. I once had enough of an ear infection, after a bad cold, that it was worth ten days’ worth of amoxicillin to the medicreature at my campus clinic. If someone were particularly sensitive to that sort of thing, I could see why they might want the antibiotics as soon as they got the cold, but we aren’t all such that we might need it every time, or…well, we’d need it every time (or, feel the lack thereof, almost every time).

ebrillblaiddes:

Not the virus itself, but maybe a secondary bacterial infection.

Which often only happen with rather severe viral illness like measles and chicken pox. Not with your average “just feeling under the weather” cold.

thank you for making me smile while recovering from c.diff.

Though I feel the video did not quite accurately portray what it feels like to have your body try to turn itself inside out through the colon…be wary of broad-spectrum, friends!

many farmers certainly do use that justification, using prophylactic antibiotics to avoid losses in their herds or flocks

I can see that antibiotics allow for factory farming of chickens and pigs, with overcrowding to a level that would be lethal without the drugs, but in addition isn’t there a general appetite-stimulant side-effect?

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