Comments on: Do the doctors even care?

By: sickofstupidpeople

sickofstupidpeople — Wed, 29 Oct 2008 05:22:36 +0000

If you have mono, and a simultaneous case of strep tonsilitis, amoxiciliin causes a rash – so, e-mycin is a better choice for the strep. I wasn’t suggesting emycin helps mono. sorry for the confusion.

By: Eric

Eric — Mon, 27 Oct 2008 19:27:06 +0000

My eyes were opened a few years after graduating. I had an ER doc who kept writing for Erythromycin 250mg bid. Finally I caught her in the hall (I work at a VA) and asked what was up with the funky prescribing. She said ‘If I could prescribe a placebo I would.’ Since we are at a time in health care where placebos are illegal I suppose this is the next best thing, although I’d prefer to pick something with no antibiotic qualities whatsoever.

By: sickofstupidpeople

sickofstupidpeople — Sun, 26 Oct 2008 18:18:54 +0000

Once daily e-mycin could be for acne… And, if you’re in a sunny area, a good alternative to doxy- or tetracycline. The ignoring the allergy thing? Plain stupid.
And, Meg – e-mycin is an excellent drug for strep throat if you can tolerate the GI effects. As a matter of fact, it’s a drug of choice if you have a penicillin allergy or have mononucleosis simultaneously (been there, done that). The second Dr you saw should have said that rather than just bashing the first Dr. He, in my opinion, was worse than the first one you saw – a little high & mighty…
And, for all you patients out there – ALWAYS ask the doc what they’re prescribing for you if you have allergies – BEFORE you leave the office.

Mono is a virus. Does E-mycin have antiviral activity that I’m not aware of? Or some how palliate those symptoms?

Also, if it was for acne, the doctor wouldn’t have shortened the days supply and removed the refill — acne vulgaris has to be treated for many months.

I also agree with you though — one doctor should never bash another or talk ill of their treatment options. If the doctor has a real issue, he can call the other. I’m sure that could easily straighten out the issues. Or, the doctor could simply say, “Okay, so Dr. 1 tried this. In my practice, I have had a lot of success with this (or I just read a study about how this worked well for people)…so let’s try it this way now.” Bashing is unprofessional — and it makes the other doctor look unqualified even though the bashed may actually be a better physician than the basher!

By: SKSutton

SKSutton — Fri, 24 Oct 2008 10:45:43 +0000

Simon makes a good point about erythromycin for gastroparesis except the usual dose is much lower and TID still. I haven’t got a clue what this was for. And the original 30 day thing AND 1 refill is still weird. I’d be waiting for the doc to call you back and yell at YOU for giving this Rx out when you should have known it wasn’t what he REALLY meant to give the patient.

Yeah, that was my thought against that idea. Going from 60 days to 14 days is not indicative of anything other than, “I don’t give a fuck.”

By: The Ole' Apothecary

The Ole' Apothecary — Fri, 24 Oct 2008 03:31:04 +0000

Sure turns all concepts of clinical practice into cow shit, doesn’t it? The only thing of importance is how the doctor treats a case of “gimme, gimme, gimme!”

On the flip side, however, my colleague told me yesterday about the time he intercepted a lethal dose on a pediatric chemotherapy order. The doctor said he was overworked when he wrote it. Pharmacists often do have the “key role” that academia and the pharmacy press talk about.

By: Meg

Meg — Fri, 24 Oct 2008 02:20:49 +0000

I just found your blog the other day. Your posts are awesome. So funny, and so true! I have a lot of respect for pharmacists and try to be as easy to deal with as possible. :)

I wanted to comment on this post because wow I hate erythromycin. About 5 years ago I had tonsillitis and I went to an emergency doctor office. They gave me erythromycin and I proceeded to throw up everything I ate. Not pleasant in any circumstance, but especially not with tonsillitis! So we went back to the office and another doctor gave me another antibiotic (and said “I don’t know WHY the original doctor even gave you erythromycin!”). Since then, every time I need an antibiotic I have to tell the nurse/doctor NOT to give me erythromycin, yet twice they’ve handed me a script for it anyway (which I hand right back of course). Sigh. Sorry, just had to rant a bit.

By: Simon

Simon — Fri, 24 Oct 2008 02:14:48 +0000

Erythromycin can be used for other reasons than killing bacteria. It can be used as a pro-motility agent, similar to Reglan (metoclopramide). It is quite effective as it is a very common side-effect of the drug.

Still, in my experience physicians dont really care much about allergies, or proper dosing or even breeding resistance which is what they do every time they use antibiotics for any sniffle or in this case probable constipation!

Keep up the good work!