On the Soapbox:

What’s So Special About Antibiotics?

by Lynda Lambert

With a simple chart and advice from a pharmacist, a sick person could skip the doctor’s visit and treat a bacterial infection before it gets out of hand.
I have recently gone back to teaching high school. After two weeks spent going back and forth from 100-degree classrooms— no air conditioning—to 65-degree meeting rooms, I came down with a flu. I went to school the day after Labor Day with a 101-degree fever.

Three weeks and three days later, I'm still coughing. I think, perhaps, I have a latent bacteria infection. But I have not had time to see a doctor; hence, I can get no anti-biotic. As I sit here, coughing up gunk, I ask myself, "Why should I have to see a doctor to get the antibiotic I'm pretty sure I need?"

No matter what doctors seem to think about "super bacteria" and "mutant strains", I think it is time that we begin to by-pass the doctor's prescription. My idea is a simple one. At the pharmacist's counter, there should be a list of antibiotics that are effective for certain kinds of infection. For instance: I know that with me, if I have a sinus infection, I should take Ceclor. If I have bronchitis, my body likes PenVK 500 mg. But for those who have no idea what antibiotic is for what type of infection, there is the list.

Then, to actually self-prescribe the antibiotic, there would be a symptom and diagnosis sheet. You would check off the appropriate symptoms and it would lead you to a diagnosis.

For instance: Fever might be the first symptom category. You note down a fever of 104. The arrow leads you to "You may have a bacterial infection, go to question #2." So, question #2 concerns your throat--what it looks like. Question #3 might have to do with pain or earache or the color of the muck you're coughing up.

The point is that symptoms of bacterial infections are finite. Once known, anyone, even a novice, can diagnose a bacterial infection. So, once you have answered all the questions, the sheet will point you toward a diagnosis, i.e., "You have a bacterial infection in your sinuses, choose an appropriate antibiotic from the sinus infection list." Or, "You do not have a bacterial infection."

If it’s indicated, you would get the medicine when you need it, instead of waiting days for doctors' appointments and spending $60 to $90 to see them, only to be turned away without a prescription because the infection hasn't progressed very far. Or, even if you get a prescription, by the time you do, the process has taken way too much time and money for too little return.

Personally, I'd like to stop having to spend $90 for a $5 prescription, and I would like to have it when the infection is new and hasn't yet threatened my life. If this idea were put into practice, I would bet that almost 50 percent of doctor's visits and 50 percent of emergency room visits would end. Think what that could do to reduce the cost of medical care in this country.


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This story was published on October 20, 2003.