Matthew Cooper, Prof. Institute for Molecular Bioscience at The University of Queensland, introduces his article with some rather alarming Antibiotic myths and facts before looking at 'Getting it right'. His article is a general one and having CLL warrants some exceptions to the standard process outlined by Matthew, in particular when it comes to the use of prophylactic antibiotic cover where the degree of compromise of our immune system by CLL and treatment for CLL warrants it.
We'll be familiar with the following when we front up to our doctor with an infection:
"To prescribe, the doctor makes an educated guess as to what may be causing the infection. This is based on knowledge of what type of bacteria are normally found in these cases and, if available, the patient’s history. But she doesn’t know exactly what type of bug is causing the infection. In the absence of an accurate diagnosis, as well as to minimise potential risk to the patient, a broad-spectrum antibiotic is used to “cover as many bases” as possible.
Until we can develop point-of-care technology that can identify a bug on demand, such broad-spectrum drugs (the grenade approach to bacteria) are a better option for doctors than targeted specific drugs (a sniper against superbugs). But the latter is the better long-term option for the patient and the community, although it may not always work."
With our current medical capability, I think that ideally we should be provided with a broad spectrum antibiotic if our condition and health history warrants it, followed by a culture test to find what is causing our illness if we don't improve, so a more effective treatment can be prescribed.
Also of interest, Matthew mentions the recently published "Danish study that followed more than a million patients and found an association between frequency of antibiotic use and Type II diabetes.
The study showed an association between antibiotics and diabetes, not causality."
It will be interesting to follow future research into what's behind this association - is it caused by antibiotics adversely impacting our gut bacteria say, or because less healthy people that are heading toward Type II diabetes are ill more often and hence have more antibiotics prescribed?
Photo: Greater Crested Terns