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Fact: It’s no different in other countries, so don’t
Most infections do not require antibiotics. demand an antibiotic. If you are prescribed
Viral infections should not be prescribed one and you don’t think you need one then
antibiotics. Most bacterial infections do not ask why? Patients are allowed to ask
require antibiotics. Infections get better on questions! Don’t buy antibiotics over the
their own in most cases. counter. Antibiotics are widely available in
pharmacies no questions asked. Almost half
Antibiotics can even make infections worse. my patients with coughs first went out and
They kill bacteria. If you have a viral respiratory bought antibiotics, then when it didn’t work
infection, your throat is red and sore with (why would it?) came in to see me. Many of
damaged cells and increased mucous. you know my favourite cough medicine.
Mucous is an excellent growth medium for Honey, a single malt and hot water. But for
some bacteria. The bacteria that live in your under 5’s go easy on the malt.
throat, the harmless commensals on the
surface that cannot replicate and invade any Lastly beware of Doctors who simply want to
further because you are immune to them, will impress by prescribing exotic, expensive and
grow in that mucous. A swab will detect them. unavailable drugs to make themselves look
They are probably resistant to most penicillin’s, important. When an antibiotic is prescribed
hence the adverts that claim to prove that the simplest, cheapest most available drug
most upper respiratory bacteria are resistant might be the most appropriate.
to common antibiotics: So you need z-pack. Example: penicillin is still the most appropriate
These commensal bacteria are not only drug for most bacterial sore throats, the
harmless they are beneficial. Many bacteria streptococcus is still sensitive to penicillin and
practice ethnic cleansing, they don’t let other is the most likely bacteria to cause severe
bacteria grow in their backyard. Some disease or complications. A report on urine
actually produce a substance that kills other cultures across Europe showed nitrofurantoin
bacteria, essentially an antibiotic. If you kill the top of the table for least likely that the
commensals something more virulent, infection was resistant. I remember a lady
invasive and immune resistant might grow in deciding to see a surgeon for a urine
its place. Vacuums are filled, there are no infection and getting a prescription for
microorganism deserts on our surfaces. If you intravenous gentamicin. I refused to dispense
have a viral infection, it’s best to keep your or provide it: suggested she go back to the
commensals. In the same way our intestines doctor who prescribed it. Surely if it was so
are teeming with bacteria: almost all of them important for her life that she got that drug
harmless or beneficial. And we all know about I’m sure he would open his office twice a day
lactobacillus keeping the vagina free from over the weekend to give it.
unpleasant infections. We are colonised or
infected with countless bacteria that we In summary Antibiotics are essential life
should not disturb or try and eradicate. An saving drugs and increasing bacterial
antibiotic is indiscriminate, rather like using a resistance is a genuine concern. Whereas it
flame thrower in a farm yard to get rid of ants. ought to be a problem only for medically
It works but kills the chickens so you get a qualified prescribers - actually the general
plague of cockroaches instead. Learn to live public can do a lot to help. The whole of
in peace with our microbes: don’t disturb society needs to be aware. In animal farm
them then they don’t disturb us. ignorance is bliss. In the bacterial farmyard
knowledge is power.
So how do you know if an antibiotic is
essential or unnecessary? Realistically only by 2 Naguru Drive, Naguru, Kampala
proper training, experience and a commit- Reception Numbers:
ment to a low antibiotic prescribing practice. +256 312 256001-3/ +256 772 756003
When essential, using narrow spectrum drugs reception@thesurgeryuganda.org /
that target specifically the harmful bacteria administration@thesurgeryuganda.org
you want to kill. Of course, it’s primarily a
problem for the medical profession, but Emergency Numbers:
society can help. Can you influence +256 256 312 256008 +256 752 756003
prescribing? Yes. See my first story. US doctors nurse@thesurgeryuganda.org
admitted to giving in to patients’ demands. www.thesurgeryuganda.org
@TheSurgeryUganda (f)

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