Another antibiotic conundrum

[rumak]

I posted this about my hip surgery..........  i think it deserves to be seen as a seperate topic :

 

 

as some here know i am not a big fan of antibiotics.      yes, i have used them at times,  like once or twice when i had a throat infection.    I read a very good "baby book" by a doctor  long long ago that explained how antibiotics are for bacterial infections,   but when sick with a high fever it was almost always a virus ( he explained how to go about diagnosing) .........

I followed that advice and raised a very healthy daughter who also had a few occasions when antibiotics were needed.  BUT,  most of the time not....... even though the doctors ALWAYS  prescribed them anyway (the few times i went to one)

 

The comments i get telling me how much stupider i am than the professionals i always expect .

I was given  35 DAYS  worth of post operative antibiotics !!   after my hip surgery.  I took for 8 days until i thought "what the heck is this all about...."     Now i am not a great fan of WHO,  but most people agree they are the "experts" .    So,  ok ,   here is what i found on page one of my search :

 

https://www.google.com/search?q=who+says+antibiotics+not+needed+after+surgery&rlz=1C1GCEA_enTH872TH872&oq=&aqs=chrome.0.35i39i362l8...8.234436523j0j15&sou

 

there are a few other  google articles in agreement........... but the long held standard "that is the way it is done"  seems to be still in the forefront .      of course i am "scared" .    who do i believe?

We are "taught" that drugs and doctors are meant to be adhered to.    Why are the WHO's  recommendations being ignored,  if that is the case ?    

[ukrules]

7 minutes ago, rumak said:

Why are the WHO's  recommendations being ignored

Don't assume that something the 'WHO' tells you is for your own good.

 

They will make recommendations based on what they believe is good for 'mankind', that might differ from what's good only for you.

 

They're not thinking about your hip, they're thinking about MRSA and how it becomes prevalent.

 

[Sheryl]

https://journals.lww.com/clinorthop/fulltext/2004/02000/antibiotic_prophylaxis_in_hip_fracture_surgery__a.29.aspx

 

Thai doctors definitely overuse antibiotics

 

 

 

 

 

[Lacessit]

I was prescribed an antibiotic after a routine cystoscopy in October here. I've never been prescribed an antibiotic after the same procedure in Australia. So I just stuck with drinking plenty of water.

IMO if proper surgery protocols for antisepsis are observed, antibiotics should be unnecessary.

[dddave]

Four years ago, I had triple by-pass cardiac surgery.  While the surgery itself was successful, I came extremely close to loosing my left leg and darn near my life to an ancillary cellulitis infection.  

My surgical "team" was so focused on cardiac issues, they didn't take it seriously when symptoms of the infection in my leg appeared.  I was discharged without follow-up home care and only after calling a hotline was I rushed to an EW where I was put on a powerful IV antibiotic.  I was later told that 12 more hours and I'd probably have lost my leg.

 

All this to say that hospital acquired infections are a huge concern after major surgery and joint replacement surgeries are among the more susceptible to such infections.  

In the US alone, more than 100,000 people are known to die every year from such infections with many more reported instead as "complications from surgery"

I know this because I researched the issue intently after my close call.  I have arthritis in both my knees but have avoided double knee replacement just because of this; once burned, twice shy.

 

I would suggest to the OP that administration of antibiotics after hip surgery as a prophylactic, reducing the chances of post surgical infection is a pretty good call considering the risks.  

 

Edited December 13, 2020 by dddave

[rumak]

9 hours ago, dddave said:

I would suggest to the OP that administration of antibiotics after hip surgery as a prophylactic, reducing the chances of post surgical infection is a pretty good call considering the risks.  

 

[rumak]

thank you 3 for your replies.     from my post i think i was fair in NOT saying that antibiotics are never necessary.

The question here is threefold.    1.  when are they most effective/needed     2.  when are they NOT proven to be needed but " oh well,  give them anyway as if one in ten thousand get an infection we can say that the CAUSE was 

lack of antibiotics (and who can prove us wrong? )    3.  actually do an impartial analysis of when and how antibiotics should be administered !   None other than  WHO  did this as the overuse of antibiotics has been proven to actually be harmful in many cases ... read their conclusions 

 

dddave:   i am sorry for your experience,  but the cause of your infection could have been a number of factors,  and

from what i read (see WHO  and a few others).......  the use of post operative antibiotics was pretty much dismissed as having any useful purpose.   Most likely (but we don't know) ,  the infection was due to something

just before or during the operation .  

 

 

[rumak]

I would also add that  " give them to the patients, it can't hurt"   has been proven many times not to be a

factual statement.

 

i took my 8 days of the stuff.     27 days more will not be used

[rumak]

11 hours ago, ukrules said:

 

They're not thinking about your hip, they're thinking about MRSA and how it becomes prevalent.

I think if you read their report they did a little more research than what you assume.

 

However,  if at any time (which i have)  i make a remark on a forum questioning their (WHO)  relevance I am

usually beaten down like a sick dog.     

 

Obviously a case of can't win no matter what or from WHO  some facts are presented.     

[owl sees all]

When are people gonna realise that the human body is designed for attacks to its system.

 

The body's immune system has been developed to sort out attacks from nasties. Keep eating decent food, breathe clean air, drink contaminate free water and your body will look after you.

 

As a general rule; keep away from medical professionals as much as possible. They generally are highly compromised and care little for you. They are (generally) blinkered and brainwashed also. I spent three years studying Whitechapel Hospital in London and was amazed at what I saw going on. Actually I met my love, Fatima, there. But that's a story for another time.

 

Edited December 14, 2020 by owl sees all

[Fat is a type of crazy]

My approach would be to avoid antibiotics if I don't need them but if I had any sort of invasive surgery such as you are talking about then I would totally follow doctor's instructions.

Especially in a foreign country in a tropical climate. They aren't likely to be telling you to do so to sell a few extra cheap antibiotics. Just not worth the risk of infection.

If you are concerned maybe just visit a second doctor to see if the first doctor is overdoing it.

The potential upside way outweighs the downside. 

[rumak]

8 minutes ago, Fat is a type of crazy said:

My approach would be to avoid antibiotics if I don't need them but if I had any sort of invasive surgery such as you are talking about then I would totally follow doctor's instructions.

Especially in a foreign country in a tropical climate. They aren't likely to be telling you to do so to sell a few extra cheap antibiotics. Just not worth the risk of infection.

If you are concerned maybe just visit a second doctor to see if the first doctor is overdoing it.

The potential upside way outweighs the downside. 

I think you are this post is a great example of what people think in general.   Not based on facts,  just what we

have been programmed to believe.     WHO  is supposed to be the largest organization researching and presenting

what they see as the facts.    

I know we agree on many things....... but please have another think on this matter .

[rumak]

1 hour ago, owl sees all said:

When are people gonna realise that the human body is designed for attacks to its system.

 

The body's immune system has been developed to sort out attacks from nasties. Keep eating decent food, breathe clean air, drink contaminate free water and your body will look after you.

 

As a general rule; keep away from medical professionals as much as possible. They generally are highly compromised and care little for you. They are (generally) blinkered and brainwashed also. I spent three years studying Whitechapel Hospital in London and was amazed at what I saw going on. Actually I met my love, Fatima, there. But that's a story for another time.

 

Thanks so much for stating what mirrors my experience with "medical professionals"  and the "industry" in general.

Such a shame that the philosophy of  care and healing has basically disappeared in the business world which so caters to the masses.

I do want to give credit to Dr. Warun at Rajavet Hospital for his professional work and (under the circumstances of a heavy work load)  providing me with exceptional service .    

 

 

[Odysseus123]

1 hour ago, rumak said:

I think if you read their report they did a little more research than what you assume.

 

However,  if at any time (which i have)  i make a remark on a forum questioning their (WHO)  relevance I am

usually beaten down like a sick dog.     

 

Obviously a case of can't win no matter what or from WHO  some facts are presented.     

Gorn fishin'....

 

Best of luck with the post operative hip surgery recovery.

 

We all hope to see you bouncing around on the forum soon.

[Sheryl]

To be clear, no one is saying there is no role for antibiotic prophylaxis in surgery.  Joint surgery (hip, knee replacments) and repair of hip fractures in particular are recommended to give prophylactioc antibiotics IV but intra- or perioperatively. At most for the 1st 24 hours post op.  Prolonged course of oral antibiotics post operatively are not recemmended.

[sometimewoodworker]

2 hours ago, owl sees all said:

When are people gonna realise that the human body is designed for attacks to its system.

So it is designed to be cut open and drilled with no problems? Antibiotics have reduced death and disease enormously, but yes they are significantly overused, used incorrectly and patients who are under educated will take them for too short a time. I am not suggesting that the OP is in that group, a common use pattern is to just take the first 3 days of a 7 day low dose regimen.

Edited December 14, 2020 by sometimewoodworker

[rumak]

6 minutes ago, Sheryl said:

To be clear, no one is saying there is no role for antibiotic prophylaxis in surgery.  Joint surgery (hip, knee replacments) and repair of hip fractures in particular are recommended to give prophylactioc antibiotics IV but intra- or perioperatively. At most for the 1st 24 hours post op.  Prolonged course of oral antibiotics post operatively are not recemmended.

Yes,  (drum roll.......  I agree ) .   That is why it is neccessary to read the complete link from WHO  which states what you have .   I thought it quite unusual that they would say (quite definitively)  that there was absolutely no supporting evidence that given post op antibiotics were beneficial  (almost the opposite) .   

I am pretty sure that doctors here (and probably many countries)  are afraid that any complication later could easily be blamed on not giving antibiotics.     I  feel thankful that i just happenned to come across the story when googling.   My body feels much better already.