ampicillin a placebo?

Tim Robbins

Hi,
Is Ampicillin prescribed when a Doctor wishes to prescribe a placebo? Does it have any effectiveness still?

tallaght01

Ampicillin: Given intravenously, I've used it to save many many lives, especially in neonatal meningitis.

Amoxicillin: The one given out like smarties, for mostly viral infections. It can be very useful for some bacterial infections. But mostly given out for infections for which it's useless, I reckon.

meditraitor

tallaght01 wrote: »

Amoxicillin: The one given out like smarties, for mostly viral infections. It can be very useful for some bacterial infections. But mostly given out for infections for which it's useless, I reckon.

I have only been prescibed this for an absis and its very effective.


Ampicillan is not the same but its penicillan based and differs only in an amino group.
Certainly not a placebo, am I right in thinking its used as part of the Gonorrea treatment:p

Dfens

Tim Robbins wrote: »

Hi,
Is Ampicillin prescribed when a Doctor wishes to prescribe a placebo? Does it have any effectiveness still?

I have difficultly understanding why a doctor would prescribe what effectively is still an active drug (even if there is widespread bacterial resistance to it) as a 'placebo'. It was/is practices such as this that contributed to the widespread development & spread of resistance to many antibiotics in the first place.

tallaght01

meditraitor wrote: »

I have only been prescibed this for an absis and its very effective.


Ampicillan is not the same but its penicillan based and differs only in an amino group.
Certainly not a placebo, am I right in thinking its used as part of the Gonorrea treatment:p

I had amoxicillin prescribed (read: Irresponsibly decided to treat myself and wote my own prescription) for an abscess.

Didn't work and had to be halued into hospital on a saturday night for an operation

Thugh it does have it's uses. It's just often prescribed in situations where it's not useful.

Tim Robbins

tallaght01 wrote: »

I had amoxicillin prescribed (read: Irresponsibly decided to treat myself and wote my own prescription) for an abscess.

Didn't work and had to be halued into hospital on a saturday night for an operation

Thugh it does have it's uses. It's just often prescribed in situations where it's not useful.

Interesting answers. Some Irish Pharmacists sell magic magnets which "heal" sports injuries. I think this is a disgrace. Some of them cost up to 50 Euro.

I think that behaviour is far worse than a Doctor prescribing any anti - biotic to treat an infection that may be viral in which case it is useless.

The reason for this is because the time and cost taken to be sure the infection is bacterial is far greater than the risk posed by giving someone an antibiotic when they didn't need it. So the Doctor is making a calculated decision based on an assesment of the patient whereas the Pharmacists knows the magic magnets do nothing and is just willing to rip their customer off.

Comments...

AtomicHorror

Tim Robbins wrote: »

Interesting answers. Some Irish Pharmacists sell magic magnets which "heal" sports injuries. I think this is a disgrace. Some of them cost up to 50 Euro.

I think that behaviour is far worse than a Doctor prescribing any anti - biotic to treat an infection that may be viral in which case it is useless.

The reason for this is because the time and cost taken to be sure the infection is bacterial is far greater than the risk posed by giving someone an antibiotic when they didn't need it. So the Doctor is making a calculated decision based on an assesment of the patient whereas the Pharmacists knows the magic magnets do nothing and is just willing to rip their customer off.

Comments...

If people can't take the time to think "where's the evidence that this really works" then they're letting themselves in for all manner of trouble. Pharmacies shouldn't be selling this stuff, but I don't doubt for a moment that if they withdrew them that some people will just go to a health food shop and buy the same thing from someone with a certificate in homeopathy.

anotherlostie

I bet someone with a penicillin allergy wouldn't agree with the idea that ampicillin was a placebo!!

eth0_

Tim Robbins wrote: »

Interesting answers. Some Irish Pharmacists sell magic magnets which "heal" sports injuries. I think this is a disgrace. Some of them cost up to 50 Euro.
.

And some Irish pharmacists offer ear piercing using guns which cannot be effectively steraliser and can therefore pass on blood borne pathogens.

What can ya do.

Thoie

anotherlostie wrote: »

I bet someone with a penicillin allergy wouldn't agree with the idea that ampicillin was a placebo!!

I was about to say that it might be considered a placebo by some, but as it tries to kill me when stupidly administered by stupid people who can't see the big red sticker, I would consider it a nocebo.

SomeDose

Originally Posted by Tim Robbins
Interesting answers. Some Irish Pharmacists sell magic magnets which "heal" sports injuries. I think this is a disgrace. Some of them cost up to 50 Euro.

eth0_ wrote: »

And some Irish pharmacists offer ear piercing using guns which cannot be effectively steraliser and can therefore pass on blood borne pathogens.

What can ya do.

This is getting off topic, but hey ho. Let's be clear about the difference between pharmacies (i.e. the commercial premises) and pharmacists (the professionally regulated, legally responsible person on the premises). Many pharmacy businesses, and certainly all large multinationals such as Boots, are not owned by pharmacists, and will sell many non-medicinal or therapeutically-ambiguous products for purely commercial reasons. Once a pharmacist leaves the premises, it ceases to operate as a pharmacy, no medicines may be sold and it is effectively just an ordinary shop. The owner of that business is still legally free to sell whatever else they please. So you can still buy your magnets, perfume etc. For pharmacy owners who are pharmacists themselves, there are ethical guidelines regarding this but that's for another day.

Next time you're in one, go and ask the pharmacist about the benefits of magic magnets or whatever they're called. At best they will give you a non-commital answer, but they will not or should not ever actively endorse an unproven product for therapeutic purposes. Funnily enough, they will never recommend prescription products either (which most definitely are therapeutically proven), but for very different reasons.

Oh yeah, ampicillin. Therapeutically, it's activity is fairly similar to amoxicillin so in theory the two may be interchanged. In practice, however, it's got pretty rubbish absorption when given orally, hence why amoxicillin usually prevails in community. But it's still useful as IV and where sensitivities are present. So no, not a placebo at all.

eth0_

I know of several pharmacists in Dublin city centre where the pharmacist themself does the piercings!

And they MUST know these guns cannot be properly steralised and are therefore a health risk.

Anyway...I guess this thread has gone waaaay off topic.

Fionnanc

Ampicillin is great because it is less frequently prescribed, there is less resistance to it. I Think t can cause an odd rash when treating streptococcal infection infection, and is a great option for penicillin allergic patients

Another great older antibiotic is clindamycin which can be given orally or IV. Great for soft tissue infections such as cellulitis especially in combinination, just make sure your are not dealing with an abscess or something nasty like necrotizing fasciatis or gas gangrene. I believe it may still be one of the antibiotics of choice after debridement for gas gangrene or nec fasc.

Amoxicillin or co-amoxiclav- great for a strep throat and in Iv form good for biliary sepsis.

Tazocin=domestos for medical septics

Thoie

Fionnanc wrote: »

Ampicillin is great because it is less frequently prescribed, there is less resistance to it. I Think t can cause an odd rash when treating streptococcal infection infection, and is a great option for penicillin allergic patients

What? Why? Is this some way of using natural selection to kill off patients with penicillin allergies?

Fionnanc

I stand corrected. Clindamycin is the better choice in the penicllin allergic patients. Thx. Medical student mistake. Ampicllin is in the penicillin family

Kurtosis

Tim Robbins wrote: »

Interesting answers. Some Irish Pharmacists sell magic magnets which "heal" sports injuries. I think this is a disgrace. Some of them cost up to 50 Euro.

I think that behaviour is far worse than a Doctor prescribing any anti - biotic to treat an infection that may be viral in which case it is useless.

I'd have to disagree with you. While obviously a ridiculous situation, the only damage these magic magnets are going to do is to the customer's wallet and the pharmacy's reputation. The overly casual prescribing of antibiotics for viral infections has the potential to do a lot more damage with regards to the development of resistant strains.

Thoie

I'm not a med student, just allergic to penicillin.

My general rule (now, after a few horrendous experiences) is that if it contains "cillin" anywhere in it, I'll question it again and again - with the doctor, with another doctor and with the pharmacist before taking it. I'm even wary of people called Cillian, just in case

Fionnanc

Thoie, you are completely right. I made the med student mistake.

tallaght01

Beware the clindamycin colitis!!!!!

SomeDose

tallaght01 wrote: »

Beware the clindamycin colitis!!!!!

Did I hear someone mention Clindamycin? I'll get the stool chart so. Mmmmm....C.diff-a-licious!!

Fionnanc

I'd take clindamycin anyday as a 2nd line agent for series subcutaneous sepsis, especially if the peniciliins don't work after dosage escalation

tallaght01

Sure, clindamycin is a useful antibiotic, but you have to learn to think about the costs/benefit toss up when you prescribe.

c. diff can be a total swine of an infection. It can kill you. You should always be thinking of the side effects of any antibiotic you prescribe.

Your patients won't thank you if they need a faecal transplant!!! (are they still using these in the world of adult medicine??).

DrIndy

clindamycin is a great drug - in addition to being a potent antibacterial - it is also a potent anti-toxin and inactivates many bacterial toxins which greatly helps to dampen down inflammation.

It is recommended for use in necrotising fascitis and second line for skin infection.

But the adverse reaction of colitis means it must be used with great caution -preferably in hospital only.

Amnesiac_ie

This is PURELY anecdotal but the two cases of C. difficile colitis I've seen post Clindamycin therapy were both extremely severe and difficult to control. Both patients survived, and neither received a faecal transplant though it was discussed in one case!

sam34

ok, i've got to ask- what the hell is a faecal transplant?? and how is it done?

anotherlostie

sam34 wrote: »

ok, i've got to ask- what the hell is a faecal transplant?? and how is it done?

You may be sorry you asked! I'm not surprised they wrinkle their noses.

http://www.telegraph.co.uk/news/uknews/1570515/Grandmother-saved-by-daughter%27s-poo.html

sam34

definitely sorry i asked!
am so glad i did psychiatry...