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From: dyer@spdcc.UUCP (Steve Dyer)
Newsgroups: net.med
Subject: Re: Where are drugs (antibiotics) legal?
Message-ID: <22@spdcc.UUCP>
Date: Fri, 28-Feb-86 23:20:50 EST
Article-I.D.: spdcc.22
Posted: Fri Feb 28 23:20:50 1986
Date-Received: Sun, 2-Mar-86 00:04:15 EST
References: <156@proper.UUCP> <12057@ucbvax.BERKELEY.EDU> <915@felix.UUCP>
Organization: S.P. Dyer Computer Consulting, Cambridge MA
Lines: 71
Keywords: penicillin, etc.
Summary: comment on ignorant comment

In article <915@felix.UUCP>, daver@felix.UUCP (Dave Richards) writes:
> This is getting off the track of the original posting, but one of my pet
> peeves is the fact that penicillin is not available over the counter (or
> any effective antibiotic, that I know of).  Is this due to pressure from
> the A.M.A., to force people to see their doctors, or what?  It seems rid-
> iculous to have to go to the doctor and pay a small fortune, when you
> already know what's wrong with you and what you need to fix it.
> I'm lucky, because if I ever decide I need some, I live close enough to
> Mexico to go down there and get it over the counter.  Of course, one
> must be careful of all the penicillin addicts laying around in the 
> alleys there. (heavy sarcasm)

Penicillin and other antibiotics are not made available for sale over the
counter because there is precisely NO medical benefit which would result
from it, and because there is a great potential for harm, both to the
individual who takes such drugs indiscriminately, and to the public health.
You've heard the canard "a doctor who treats himself has a fool for a 
patient", well, this guy isn't even a DOCTOR--(heavy sarcasm)--what does
that make HIS patient!?

A couple of points to back up these assertions:

	- Indiscriminate use of antibiotics when they aren't indicated
	  contributes to the development of strains of bacteria resistant
	  to antibiotics, which then may become a real clinical problem
	  in the population.  This is already a problem with current levels
	  of antibiotic use--imagine the magnitude if such drugs were
	  available over the counter.

	- Antibiotics are not harmless substances.  Simply through their
	  ability to disrupt the population of normal bacterial flora,
	  they can encourage the growth of harmful microorganisms which
	  were previously held in check.  Several vitamins and cofactors
	  needed in human metabolism are synthesized by microbes which
	  can be wiped out, at least temporarily, by antibiotic therapy.

	  Finally, you must realize that antibiotics are toxic by their
	  very nature, after all, that is how they work.  Only very rarely
	  is the mechanism of action of an antibiotic totally selective
	  for microorganisms and harmless to the patient.  The decision
	  to embark on antibiotic therapy comes from a consideration of
	  the condition of the patient, an identification of the organisms
	  involved and their susceptibility to the antibiotic, a clinical
	  judgement as to whether or not antibiotics would effect the course
	  of the condition, and an assessment of the possible side effects
	  relative to the seriousness of the patient's condition.

	  Here are just a few side-effects that can occur from therapeutic
	  doses of a number of antibiotics: anaphylactic shock, deafness,
	  kidney damage, liver damage, jaundice and aplastic anemia, just
	  to name a few.  What would you like to tell the mother in Tiujuana
	  when the antibiotic she bought for her children's colds has left
	  them permanently impaired, if not dead?  Don't you think that
	  the pharmaceutical companies make the most of exploiting such
	  uneducated people in such unregulated areas?

	  I doubt that Richards wonders about any of these things when he
	  swings down to Mexico after waking up with a scratchy throat.

	- Finally, antibiotics are not useful against viral infections,
	  which covers a large majority of the typical "I'm not feeling
	  well" visits that are payed to a doctor or clinic.  Were antibiotics
	  available over the counter, the misuse in cases like these would
	  be unbelievable.

If there's anything less flattering than flaming, it's flaming when the
flamer doesn't know a flaming thing.
-- 
Steve Dyer
dyer@harvard.HARVARD.EDU
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