"[She] treated her last flu with castoff amoxicillin."

An article in today's New York Times profiles the trials and tribulations of young twenty-somethings who lack health insurance. For some it's out of hubris, but for most it's because they fall through the cracks--paid enough that they don't qualify for public health care but still lacking the means to afford health insurance of their own. It's pretty sad, and it's a stupid result of America's wacky health care system (a system around which many high hopes have been pinned to President Obama to effect some real change).

As stupid as this situation is, though, it pales in comparison to the utter stupidity of this gem from the article:

Ms. Polec's roommate, Fara D'Aguiar, 26, treated her last flu with castoff amoxicillin--"probably expired," she said--given to her by a friend.

I'd like to think that this Times writer has a particularly subtle sense of irony, but just in case the face-palm-ness of this has escaped anyone's notice: ANTIBIOTICS ARE TOTALLY INEFFECTIVE AGAINST A VIRAL ILLNESS LIKE THE FLU!!!

Not only will taking unnecessary antibiotics not do anything beneficial in this case, doing so actively contributes to the growing scourge of antibiotic resistant bacteria. Also, it probably goes without saying that taking prescription medicines not prescribed to you is never a good idea. Not correctly following a course of antibiotics doesn't just affect you--it affects everyone. The fact that this person's friend had part of an unfinished course of antibiotics just sitting around hints at how widespread this problem is.

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Yeah, people don't seem to know that... nor do doctors. To make patients feel like they're being treated, and just "in case" it's not viral, they tend to overprescribe antibiotics as a cure-all. And then people wonder why we have these multi-antibiotic resistant bacterial illnesses running around...

Taking antibiotics for a viral illness doesn't just affect others, they affect the patient. They do have side effects. They will kill off the good flora we have. Patients might not care about others, but maybe if we stress this point they might use unnecessary antibiotics less.

You do realize that most people say "flu" when they mean "bacterial gastroenteritis," right?

You do realize that most people say "flu" when they mean "bacterial gastroenteritis," right?

Uh huh, and I'm sure the layperson will be able to identify the cause herself....

No, Lily, even the brunt of those gastroenteritides are viral (norovirus, etc). Antibiotics would be contraindicated in those cases, too. Hell, they're even contraindicated when the suspected etiology is E. coli O157:H7 because of the risk of hemolytic uremic syndrome.

What gets my goat is that these kids who reufse to buy themselves insurance also neglect to get free flu shots and other preventives.

Dunno about where y'all are, but out here, public health clinics are free of charge to all regional residents. I have insurance, but the PH clinic is next door, so I go there for free flu shots, HIV tests and whatever else I don't want to bother my PCP with.

By Rogue Epidemiologist (not verified) on 18 Feb 2009 #permalink

Maybe we should stop using the word "antibiotics". Call them "antibacterials", or some other term to make their action clearer.

In the mid 80's, one day i went to work. My co-workers thought i had a hangover. I went home. A couple days later, i cleaned myself up and went to the clinic. They gave me a form to fill out, two sides of one page. And it had hard questions, like, "what is your name?". At 45 minutes, i hadn't finished it. They seated me and stuck a thermometer in my mouth. Ten minutes later (and i still hadn't finished the two pages), a nurse took it out of my mouth, looked at it, took the clip board from my hands and said, "Perhaps you'd like to lie down." 105. "No, no, i'm fine."

A doctor came to see me. He said, "do you have any other symptoms?" I said "no". He said, "I can't do anything for you. Antibiotics aren't effective against virus infections." In total ignorance, i said, "but what can i eat?". He ask what I was trying to eat. I said, "Cereal with milk, orange juice..." He said, "It doesn't matter - whatever you can get down. Try junk food". So i did. He didn't mention how to break the fever.

And i needed to break the fever. I had a 140 bpm heart rate while resting. For five days. It's amazing i lived through it.

Some 20 years later, i learned that aspirin, etc., can be used to break a fever. This needs to be taught in high school.

The last time I was prescribed antibiotics by my dentist, I didn't take them--I saved them for an upcoming time when I thought I might need them more. This was before I was employed by Seed and had health insurance. I know enough that I wouldn't have taken them for the flu, but I think it would surprise you how many people would make the same mistake as this girl.

awesome. LOVE IT.

and as far as hemolytic uremic syndrome - that usually occurs in children, not so much in adults...

Yoo Hoo! Earth to Rogue Epidemiologist!

I hope you were being facetious when you wrote that you go to your friendly neighborhood public health clinic "for free flu shots, HIV tests and whatever else I don't want to bother my PCP with".

Your public health clinic survives on (very inadequate) tax money. Even though you see your clinic as "free of charge", and don't pay at the door or recieve a bill, the public Health clinic is NOT "free". I don't care which state you're in, it costs millions of dollars a year, and has extremely limited resources for testing, vaccinating, staff and other expenses. Having insured people using them can and often does deprive others of critical access to care.

You, with your insurance and sense of entitlement, are sucking up extremely limited resources that are desperately needed by those without a PCP or medical home.

I hope you don't lie about your income to get food stamps too.

- A public health nurse

By noroviral (not verified) on 25 Feb 2009 #permalink

My mom does this all the time. If my father doesn't take all a prescription for antibiotics, my mom hordes them and instead of going to the doctor for a sinus infection, she uses the left over antibiotics that my father was prescribed for his sinus infection, LAST YEAR!

It upsets me that she does this and I know they have very little money to go around but I have offered every time to pay the prescription and she refuses.