Here is a little foreword for those who are completely out of the loop…

 

There are viruses, and there are bacteria.

99.99% of all children’s colds or runny noses, coughs and fevers are viruses and they are called upper respiratory tract infections.

Antibiotics work on bacteria but don’t affect viruses, therefor upper respiratory tract infections shall not be treated with antibiotics.

Nevertheless, upper respiratory tract infections may cause complications precipitated by bacteria (for example otitis or pneumonia).

It is tempting, then, to prescribe antibiotics when your patient suffers from upper respiratory tract infections not to kill a virus, but for prophylactic purposes – in order to prevent complications. Medical science proved with tenth of thousands investigations that this doesn’t make any sense. Moreover – it makes the situation only worse.

  • First of all, because there always will be a bacterium which survives.
  • Secondly, because by killing one type of bacteria we create conditions for multiplication of other types, thus increasing rather than decreasing the probability for the same complications.
  • Thirdly, because by destroying safe and potentially pathogenic flora we, as a matter of fact, increase the probability for the respiratory passages’ occupation by microbes which are definitely pathogenic, harmful and undesired.

***

It is impossible to graduate from any medical university and not to be aware of the fact that antibiotics don’t work for treating upper respiratory tract infections. It means that any children’s doctor regardless of where they received their diplomas about higher education and where they practice, are fully aware that there is no need to prescribe antibiotics when you deal with upper respiratory tract infections.

Nevertheless, the antibiotics are prescribed – both to be used at home, and when you are referred to out-patient and in-patient clinics. They are prescribed by the doctors! For upper respiratory tract infections treatment! For prophylactic purposes!!!

It is impossible to comprehend and justify this fact.

However, it is possible to explain it.

The doctor’s possibilities to treat upper respiratory tract infections “as it should be” are extremely limited. Organization of due child care, involving proper regimen, clothes, food, drink and air conditions – this is what the treatment actually consist of. Are any complications possible? Indeed. They are possible and probable.

And what is the doctor’s role in these complications’ appearance, what are supposed to be the doctor’s actions in order to prevent them?

They are limited in fact - to be patient in fighting prejudices and persuade into not feeding, giving drink, ensuring proper humidity in the premises and fresh air…

But a doctor is expected to demonstrate a completely different approach! Not preaching and asking, not lecturing, but providing real help and real medications. So, where the doctor is supposed to get these medications from? What are you supposed to do if you are demanded to provide a prescription, but the majority of population doesn’t see any difference between viruses and bacteria, and moreover, doesn’t want to find out and comprehend why they have to think in this direction at all. ‘This is why you, doctors, are appointed for your positions, to treat and monitor, to assist and foresee, to not harm and prevent!’

What is the doctor supposed to do if the lectures and talks don’t help? If the room is furnished by three carpets and equipped with two heaters, if the floor was washed with chlorine, if instead of a drink the child gets a dish of chicken burgers and the child’s breast is covered with a centimeter-thick layer of badger’s fat, and the whole back is covered with awfully looking bruises from cupping-glasses put the day before by caring parents?

So when five days later all these wonderful measures result in pneumonia, this is going to be the doctor’s fault, who:

- doesn’t know how to help;

- visited for three days in a row and caused this to happen;

- didn’t prescribe any medications, and this is why it “came down”.

How do you explain than nothing comes down anywhere! Insufficient amount of drink, along with dry and warm air resulted into sputum accumulation in the lungs, this is why inflammation happened, and it should be prevented not with an antibiotic, but with warm compote and air humidifier … The most sorrowful thing is that nobody requests any explanations; moreover, nobody wants to listen to them at all. The public attitude is quite explicit, and everything was decided ages ago: if a doctor prescribed antibiotics and complications followed, this is not the doctor’s fault because they did “whatever they could”, and moreover, this is a fault of a child, who “despite timely help” couldn’t get well because he or she is a small and weak thing. But if complications occurred, and the doctor was beating about the bush and tried to be clever with their supposedly valuable advice, this is definitely the doctor’s fault, who “allowed it to happen”.

Let us assume that a child felt worse in the evening. The emergency vehicle was called. The doctor in the emergency department inspected the child and made a conclusion: pneumonia

— What do you mean pneumonia! Our doctor came this morning, didn’t diagnose anything, didn’t prescribe anything, and repeated as a parrot “it is very hot here, give him a lot of drink”, and here it is, this is what it resulted into…

We already mentioned before that looking for a guilty person (persons) is a specific mental game which has been successfully played within the territory of our Motherland for many decades. An iconic image of a doctor - saboteur is a great illustration of this game. What is essential in our example “got unwell in the evening”? First of all, the fact, that the doctor, who diagnosed pneumonia, is definitely completely innocent. Moreover he or she is acting in the role of qualified diagnostician and rescuer, and this actually corresponds to the truth. Especially when you have a definite contrast: ‘diagnose - treatment’ in the hospital and “ordinary upper respiratory infection – no medications” at home.

Who would consciously decrease their significance by saying the “your doctor was right to do what he did”?

Who would consciously sour relations with the patient’s parents by naming the same mistakes to them, especially when the guilty party has already been punished?

Who would tell you that it is not that difficult to diagnose and treat pneumonia, especially the pneumonia which wasn’t treated with antibiotics beforehand?

Nobody would! And this is the best scenario. And when we come to the worst you may well hear comments that the main thing when you treat pneumonia is to prescribe antibiotics and who knows how long all this outrage has been going on for, and we can give you no guarantees now, but we, of course, will do our best…

The situation which we tactically call the worst, happens, in fact, quite frequently (softly speaking), and the same applies to a variety of the “public service” sectors. Any assistance from an electrician, a plumber or an automobile mechanic will be accompanied in the end with some information about the fact that the previous guy “laid a wrong wire”, “put a layer of a wrong size” or “didn’t tighten the nut properly”.. The diploma about higher medical education doesn’t cancel the professional jungles’ laws – because the doctors-saboteurs were enthusiastically fought by their fellow doctors.

What is “prophylactic antibiotic therapy” in consideration of specific relationships of the child’s doctor with colleagues and patients’ relatives?

It is only a way of self-protection. They try to get themselves protected from attacks, from accusations in carelessness and incompetence, as well as from legal prosecution.

And a great idea that it is necessary to prescribe an antibiotic on time leads to the fact that a particular boy gets antibiotic on time indeed. But thousands of other boys and girls get them for no reason…

So what is there to do?

  • Find common ground with the doctor
  • Don’t look for somebody to blame
  • Be fare
  • Make friends with doctors
  • Write in capital letters at schools: Volga runs into the Caspian Sea, virus infections are not treated with antibiotics.

Once again, to remember, in capitals:

VIRUS INFECTIONS ARE NOT TO BE TREATED WITH ANTIBIOTICS.

(Перевод на английский язык адаптированного к формату статьи фрагмента из книги Е.О. Комаровского «ОРЗ: Руководство для здравомыслящих родителей» любезно осуществлен Юлией Хейлетт.)

автор Комаровский Е.О.
опубликовано 03/03/2015 17:48
обновлено 11/06/2015
Для специалистов, Медицина и общество, Болезни и лечение, Лекарства

Комментарии 2

Для того чтобы оставить комментарий, пожалуйста, войдите или зарегистрируйтесь.

Лучший комментарий
Яна
04/03/2015 07:57

Яна Украина

I never argue with our doctor, who always prescribes antibiotics, because she would be angry with us.I just do not follow her instructions. In fact, if it is just a running nose, cough and fever, I don't go with my son to the clinic, because I am afraid that we can catch there another disease.
2
Lua
24/03/2015 11:49 #

Lua Катар

Охх, как же необходимы статьи на английском!!! спасибо за эту. особенно хочется на тему температурных условий для малышей, иначе невозможно объяснить иностранным врачам (а также мужу и семейству), что ребенку только хуже от кутания и не пребывания на свежем воздухе.

Скачивайте наши приложения