(Off topic). Brad, several pointers:.
Obviously as James Baker pointed out to you, you are confusing 2 issues:
One is that PCN G is the drug of choice for organisms/ diseases that are known or documented to be HIGHLY sensitive to it .This is correct.
The second is that the NUMBER of serious organisms/ diseases and most importantly , patients that are sensitive to it is very high. This is wrong. In fact they are RAPIDLY DECLINING.
These are two totally different issues.
It is beyond the scope of this thread to get any further into the second point. If you would like to inquire further into the rapidly rising resistance to PCN and antibiotics in general you can write to an excellent source who has publishes in the AN of Int Med among others plus the pulmonary literat. :
Dr Joseph Lynch III
Division of Infectious Diseases &
Division of Pulmonary and Critical care Medicine
Univer of Mich Medical Center
3916 Taubman Center
Box 0360
Ann Arbor Mich, 48109
He'll be glad to send you the most recent reviews on this.
Next Brad I must say that I am VERY concerned by your paternalistic attitude:
Message 4728363
" Insinuating that someone should question their physician for
prescribing PCN is unethical ".
I can tell you Braddy, can I call you Braddy?, that if you were my physician, and I as an intelligent patient,
such as we could assume Baron Von Hyman might be [ albeit that this requires a certain leap of faith], and I felt that I needed some clarification of an issue or even Heaven forbid question your recommendations
( to err is human after all, and this is MY LIFE we are talking about ), and you Braddy called me unethical,
well Braddy I'd be out of your office yesterday and recommend by subsequent letter that you see a shrink
fast to achieve a complete cure of the God complex.
Next Brad, let me get this right:you are saying that you would give a patient with a severe staphylococcal sepsis PCN G , even though you are saying that 30% of isolates are resistant and thus you have a 30% chance of failure and the patient has a 30% chance of crippling/death? Am I reading this right?
Message 4730787
"Staphylococcus aureus has about a 30% overall resistant rate. More resistant strains are encountered in hospitals, some more than others. For initial therapy of severe staph aureus, PCN G, administered parenterally, is first choice ".
What if I instead gave the patient an antibiotic ( Vancomycin ) that I could guarantee a 100 % sensitivity rate by Staph Aureus a nd thus a 100% cure rate. Which doctor do you think the patient would choose and who would be least likely to get sued?
And syphilis Brad is significantly controlled compared to 30 years ago although not totally eradicated. It is seen by and large primarily in inner city hospitals in places with a high degree of promiscuity, lack of hygiene and prostitution.
This is as far as you and I are going to go Braddy.This has already taken an inordinate amount of my timetime but I thought it would be important to point them out to you for your education and the safety of your patients.
TA
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