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Treating Kids with Acute Appendicitis without Surgery?

Nonoperative treatment of acute appendicitis could be an option.

In a small group of kids (102,  ages ranging from 7-17) who presented with acute, uncomplicated appendicitis families chose whether the patient would immediately have laparoscopic surgery or begin antibiotic therapy. Of these cases 37 chose antibiotics, and 65 surgery. After one year, 76% of those taking antibiotics did not need surgery, experienced fewer disability days and lower medical costs than the surgery group

PositiveTip: Nonoperative management of acute appendicitis may be a good option in some cases, but more research is needed.

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Animal Antibiotics and Children's Health

Over 4 times as many antibiotics are sold for animal use compared to human use.

The American Academy of Pediatrics has taken a stand against the use of nontherapeutic antibiotics in animals. This report describes how the use of antibiotics as growth stimulants in livestock contributes to strains of resistant organism and potential infection through the food supply. Children are the most vulnerable to these infections. Physicians are urged to encourage families to purchase antibiotic-free meat and poultry.

PositiveTip: Choosing a plant-based diet will help avoid the potential exposure to antibiotic-resistant infections.

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Antibiotics Still Drastically Overprescribed

You may not need to see your physician for every sore throat.

Analysis of two large national databases reveals that physicians order antibiotics for about 60% of patients who present with a sore throat--yet only about one in ten is caused by a pathogen that responds to an antimicrobial agent. For bronchitis, 73% of cases result in an antibiotic prescription--but the problem never responds to the medications. Time, extra rest, and a healthful lifestyle may be the best remedies.

PositiveTip: Do your part to curb antibiotic overuse--ask your physician if you really need that prescription.

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Antibiotics No Help to Most Coughs

Comfort care best for the common cough.

Commonly used antibiotics are of little help in adults with coughs. More than 2000 adults who complained of a cough were randomly assigned to either get the antibiotic amoxicillin or a placebo for a week. Overall, the antibiotic group had no better relief than the placebo group, including those over 60 years of age. Indiscriminate use of antibiotics increases risk of side effects and the emergence of multi-resistant bacteria.

PositiveTip: Don't beg your doctor for an antibiotic! Pamper yourself with extra sleep and plenty of healthful fluids--and a humidifier at night.

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Antibiotics and IBD in Kids

Kids that take anti-anaerobic antibiotics are at greater risk of IBD

According to a retrospective study of more than one million children in the U.K., kids exposed to common antibiotics early in life experience an 84% higher risk of inflammatory bowel disease (IBD). Those exposed in the first year of life had more than fivefold the risk. The later the exposure, the lower the risk. The authors suggest this may be due to alterations in the gut microbiota.

PositiveTip: Ask your physician if antibiotics are absolutely necessary, especially for young children.

Doc, Do I Need an Antibiotic?


“Doc, don’t I need antibiotics?” is a frequent question heard by many physicians. Some of the most common problems – like colds, sinus infections, urinary tract infections, bronchitis – cause many patients to miss work and feel miserable. The patients assume that they should be taking an antibiotic. What they don’t know is that an antibiotic may be exactly the wrong thing to be taking – for several reasons.

Reason #1: Misuse – Most common infections, including those listed above, are caused by a virus and NOT by bacteria. Antibiotics will not kill viruses. Antibiotics will not make you feel better and will not get you back to work faster. Do not ask for antibiotics if the doctor says you have a virus. If you want to be sure, ask the doctor for a culture.

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Waiting It Out is the Best Policy for Colds

Antibiotics won’t chase away a cold any quicker than watchful waiting.

According to a randomized, controlled trial, antibiotic treatment does not improve the sniffles and stuffiness (called acute rhinosinusitis) that often accompany a cold. Disease-specific quality of life as measured by the Sinonasal Outcome Test (SNOT-16) did not vary between antibiotic or placebo groups over a 10-day study period. Remember, most colds are caused by viruses, which do not respond to antibiotics. In fact, excessive use of medications contributes to antibiotic resistance.

PositiveTip: Watchful waiting after the onset of cold symptoms should be the norm--try to reduce antibiotic use.


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Probiotics: A Possible Treatment for Mastitis

Lactobaccilli-based probiotics hold their own against antibiotics. The "how" is not understood.

Mastitis in lactating women is fairly common, often caused by drug-resistant staphylococci. Spanish researchers have tested treatment with Lactobaccilli-based probiotics and traditional antibiotics. This randomized, prospective study of 251 women with mastitis showed promising results. The probiotic group reported better resolution and less pain after 21 days, and did not discontinue breast-feeding as often as the antibiotic group. Much more research needs to be done, but these early results are most intriguing.

PositiveTip: If you are experiencing mastitis, ask you doctor about the possibility of trying probiotics.

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Antibiotic Resistance is Real

Avoid developing bacterial resistance by prescribing the fewest antibiotics, for the shortest period of time.

New results of several studies show that patients who received antibiotics for respiratory or urinary infections had more than twice the risk for developing bacterial resistance within the first couple of months compared to those who did not take antibiotics.

Their risk of becoming resistant to antibiotics declined over time, but was still elevated as long as a year after treatment. Multiple courses of antibiotics, and longer treatment times, also seems to raise risk.

PositiveTip: Discuss the benefits and risks of possible antibiotic prescriptions with your physician, and be sure to ask about alternatives such as rest, hydrotherapy, or just plain "tincture of time".

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Bad Antibiotic Information on Twitter

Double check tweets for misinformation about antibiotics.

Have you ever had a question about symptoms or medications? Do you go to the internet to find answers? 

Researchers from Columbia University analyzed more than 1000 tweets on Twitter in an effort to see what kind of information was being shared about antibiotics. Not surprisingly, some tweets offered to share medications with friends, asked what to do with leftover pills, and inquired how to stretch their antibiotics as long as possible!

PositiveTip: Carelessness with antibiotics can be serious. Confirm all medical information from social media with your healthcare provider.