Winter is a funny time of year for us all. Sure there’s snow and joy and whatnot, but it’s also the time of year mounds of us pent-up college students are most susceptible to illnesses like the cold or strep. And the Health Center has to deal with them.
Okay, so working at Health Center during this time of year isn’t the easiest thing in the world, and we all owe them a round of applause. But this does not make over-prescription of antibiotics all right. Last year, people could simply walk into the Health Center complaining of vague flu-like symptoms and walk out with penicillin. I wrote a pretty heated Wespeak about Health Center’s antibiotic prescription practices and I even spoke to a doctor at Health Center. He informed me that doctors do their best to identify bacterial infections, but there is a lot of chance associated with these diagnoses. He explained away his low correct diagnosis record that year on “regression to the mean,” he said he would try harder and it would go up. It sounded like bad logic to me, but hey, who’s got the M.D. here. Not me! So I let it drop.
However, despite the good doctor’s assurances, a year later antibiotics are still prescribed with little or no basis, often in the face of other evidence such as a negative throat culture. The Health Center treats these drugs like magic pills that make problems go away, but in reality, they are anything but. Antibiotics unequivocally are only effective against bacterial infections. That means it will not clear up your cold or the flu or any of the millions of unnamed and unidentified viral infections out there. And their overuse is not at all benign. Any antibiotic use carries the risk of creating drug resistant strains of bacteria. In a semi-isolated, semi-permanent community like a college campus (for example), we are at risk for developing these strains right here. One only need look at the frequency of highly-virulent, oft-lethal, drug-resistant, once-benign bacterial infections in the hospitals of Southeast Asia to see that this is only becoming a worse problem with time! Because penicillin just doesn’t work, people die every day from drug-resistant strep, which, yes, Virginia, is actually pretty dangerous if untreatable.
So, antibiotics should be used sparingly as a rule of thumb. They don’t always work, not even against bacterial infections. What they do, however, is placate sick kids who see a surefire pill to get well and do their work. It forces them to wait 10 days until their treatment is fully over. By that time, they probably would have been better anyway, so the Center often never sees the kids again and gives itself a pat on the back when it is anything but deserved.
Health Center’s treatment strategy comes in the face of mountains of good medical evidence. It is akin to sticking your fingers in your ears and denying that there is genocide in Darfur or driving a big ‘ole SUV in the face of global warming. Except this is happening here and now, and it’s not all that difficult to put a stop to. It’s just plain irresponsible and increasingly in violation of more and more stringent American Medical Association guidelines for prescription of antibiotics. Also, it’s professionally unethical and the sort of thing you lose your DEA or medical license over.
To you students receiving antibiotics, this isn’t your fault. If a doctor gives it to you, it isn’t for me to tell you not to take them, but please don’t go seeking out antibiotics. Maybe even ask your doctor if this is best when they suggest them.
But to the Health Center: I implore you, before we as a community or you as an institution get into some real trouble because of drug-resistant infection or suspension of medical licenses please reexamine your practices. If you don’t have enough capable staff to make responsible prescriptions based on good, sound diagnoses, then you need to stop making any until you do.
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