American Doc towards Antibiotics (转载) - 未名空间MITBBS历史存档

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American Doc towards Antibiotics (转载)

American Doc towards Antibiotics (转载)# NextGeneration - 我爱宝宝

z*22013-01-14 08:01

1 楼

【以下文字转载自 Parenting 讨论区】
发信人: zeayin82 (zea), 信区: Parenting
标题: American Doc towards Antibiotics
发信站: BBS 未名空间站 (Mon Jan 14 10:01:36 2013, 美东)
Your opinion is welcomed.
Thursday night, my daughter (2-yr old) starts fever over 102F.
Friday morning, we went to see the doctor, since there is no symptoms found
(lung clear, ear good, no runny nose, etc); The doc did not do anything.
Saturday morning, the fever continues, on Ibuprofen/Acetaminophen, the temp
is still 102 F.
So we went to the doc again, this time, she heard some noise in her chest.
So Amoxicillin was precribed.
Now she is on Amox for the 3rd day, and the fever seems to be lowering
slowly (100F without NSAIDS).
I am thinking if the doc could give her antibiotics since the fever starts (
Friday morning)
maybe she can heal better. Without the anitibiotics for 1.5 days, the
bacterials just keep growing without any defeat...
NO MATTER it is what infection, yous only method is antibiotics anyway!
What's the benifit of preScribing one day later?!!!
What are the doctors precautious for!

L*N2013-01-14 08:01

2 楼

单纯的病毒感染如果使用抗生素，没有治疗作用，只会增加患者身体里和环境中细菌的
抗药性，抗药菌一旦出现，以后再用同样的药，甚至同类的药就不管用了。医生对患者
进行密切的观察，如果一直没有指征，证明是病毒感染，抗生素对此没有任何治疗效果
，有时候会起到反作用。如果出现指征，证明是细菌感染，可能一开始就是细菌感染，
先期症状没有出现，或者是病毒感染并发了细菌感染，这时给抗生素，及时治疗。要清
楚抗生素普通情况下不作为预防药物使用，为了防止耐药菌的出现。

found
★ 发自iPhone App: ChineseWeb 7.7

【在 z******2 的大作中提到】

: 【以下文字转载自 Parenting 讨论区】
: 发信人: zeayin82 (zea), 信区: Parenting
: 标题: American Doc towards Antibiotics
: 发信站: BBS 未名空间站 (Mon Jan 14 10:01:36 2013, 美东)
: Your opinion is welcomed.
: Thursday night, my daughter (2-yr old) starts fever over 102F.
: Friday morning, we went to see the doctor, since there is no symptoms found
: (lung clear, ear good, no runny nose, etc); The doc did not do anything.
: Saturday morning, the fever continues, on Ibuprofen/Acetaminophen, the temp
: is still 102 F.

z*22013-01-14 08:01

3 楼

I'm not saying antibiotics is for prevention.
How do you determine if the symtoms are caused by bac or virus?
chest noise, cough are cause only by bac, not virus?
I don't think so!
if there is no unique symptoms that help determine if it is bac or virus,
why wait until they come out to prescribe?

【在 L***N 的大作中提到】

: 单纯的病毒感染如果使用抗生素，没有治疗作用，只会增加患者身体里和环境中细菌的
: 抗药性，抗药菌一旦出现，以后再用同样的药，甚至同类的药就不管用了。医生对患者
: 进行密切的观察，如果一直没有指征，证明是病毒感染，抗生素对此没有任何治疗效果
: ，有时候会起到反作用。如果出现指征，证明是细菌感染，可能一开始就是细菌感染，
: 先期症状没有出现，或者是病毒感染并发了细菌感染，这时给抗生素，及时治疗。要清
: 楚抗生素普通情况下不作为预防药物使用，为了防止耐药菌的出现。
:
: found
: ★ 发自iPhone App: ChineseWeb 7.7

L*N2013-01-14 08:01

4 楼

理解你做父母的心情。病毒感染的肺部症状比较少见，一般止于气管炎。细菌感染更容
易出现更严重的肺部感染。所以如果没有肺部感染的症状，先按照病毒感染处理，事实
上多数患者是病毒感染而自动康复。如果出现可能的肺部感染症状那才应该使用抗生素
。患者是一个活人，不是机器，不能随便拆开看，也没有仪表显示。医学是科学，但不
是绝对的科学。诊断要靠症状和体征等，有病要治，没有的病不能乱治。医生的治疗原
则是千锤百炼总结出来的，起码以现有的知识水平下是最佳的。

★ 发自iPhone App: ChineseWeb 7.7

【在 z******2 的大作中提到】

: I'm not saying antibiotics is for prevention.
: How do you determine if the symtoms are caused by bac or virus?
: chest noise, cough are cause only by bac, not virus?
: I don't think so!
: if there is no unique symptoms that help determine if it is bac or virus,
: why wait until they come out to prescribe?

z*22013-01-14 08:01

5 楼

my ped did not tell me her lung is infected.
She did not do any further exams by just listening to her back and chest.
she just heard some noise in her chest.
it could be just 气管炎
then why she still gives her antibiotics?

【在 L***N 的大作中提到】

: 理解你做父母的心情。病毒感染的肺部症状比较少见，一般止于气管炎。细菌感染更容
: 易出现更严重的肺部感染。所以如果没有肺部感染的症状，先按照病毒感染处理，事实
: 上多数患者是病毒感染而自动康复。如果出现可能的肺部感染症状那才应该使用抗生素
: 。患者是一个活人，不是机器，不能随便拆开看，也没有仪表显示。医学是科学，但不
: 是绝对的科学。诊断要靠症状和体征等，有病要治，没有的病不能乱治。医生的治疗原
: 则是千锤百炼总结出来的，起码以现有的知识水平下是最佳的。
:
: ★ 发自iPhone App: ChineseWeb 7.7

L*N2013-01-14 08:01

6 楼

那你是现在又认为医生不应该给她抗生素了？你应该理解的是，医生如果听到了他认为
足够严重的指征就开始使用抗生素，不是要等到肺炎了再给。你的医生处理的没错，你
要么认，要么换人。

★ 发自iPhone App: ChineseWeb 7.7

【在 z******2 的大作中提到】

: my ped did not tell me her lung is infected.
: She did not do any further exams by just listening to her back and chest.
: she just heard some noise in her chest.
: it could be just 气管炎
: then why she still gives her antibiotics?

z*22013-01-14 08:01

7 楼

I'm saying she waited one more day (for things to turn worse) and then
without any confirmation
she still has to give antibiotics
then what is the meaning for those 1.5 more days of suffering?
what is the difference btw her practice and the Chinese docs?
I know, the Chinese doc can help the patient heal faster by giving them
antibiotics earlier.

【在 L***N 的大作中提到】

: 那你是现在又认为医生不应该给她抗生素了？你应该理解的是，医生如果听到了他认为
: 足够严重的指征就开始使用抗生素，不是要等到肺炎了再给。你的医生处理的没错，你
: 要么认，要么换人。
:
: ★ 发自iPhone App: ChineseWeb 7.7

L*N2013-01-14 08:01

8 楼

在这种情况下她的听诊足够作为使用抗生素的指征，不需要confirmation。她第一天听
到的和第三天听到的肯定是不一样的。第一天的不足以让他怀疑是细菌感染，而多数情
况下是病毒感染。第三天听到的以及其他症状，足以让她认为细菌感染的可能性很大。
这是一件多么好理解的事情啊，不明白你为啥这么纠结。

★ 发自iPhone App: ChineseWeb 7.7

【在 z******2 的大作中提到】

: I'm saying she waited one more day (for things to turn worse) and then
: without any confirmation
: she still has to give antibiotics
: then what is the meaning for those 1.5 more days of suffering?
: what is the difference btw her practice and the Chinese docs?
: I know, the Chinese doc can help the patient heal faster by giving them
: antibiotics earlier.

z*22013-01-14 08:01

9 楼

you know what I learned from American Doc?
wait until the 2nd or 3rd day of fever (of course not severe) to see the doc.
my 2 experiences taught me this:
#1 fever at night, wen to ER, nothing seen, attributed to "virus"
then after 3 days, fever continues, go to ped, then saw throat swollen, and
then antibiotics.
#2 this time. we went the ped the 2nd day before symptoms develop, so they
don't do anyting.

【在 L***N 的大作中提到】

: 在这种情况下她的听诊足够作为使用抗生素的指征，不需要confirmation。她第一天听
: 到的和第三天听到的肯定是不一样的。第一天的不足以让他怀疑是细菌感染，而多数情
: 况下是病毒感染。第三天听到的以及其他症状，足以让她认为细菌感染的可能性很大。
: 这是一件多么好理解的事情啊，不明白你为啥这么纠结。
:
: ★ 发自iPhone App: ChineseWeb 7.7

L*N2013-01-14 08:01

10 楼

你总结的很对呀，这不是挺明白的吗。医生不是神仙，他要知道是什么病也得看病程发
展，所以让等三天没错。当然如果情况危机也不要教条，实在不放心还是得去看，看了
他不给你用药那是有依据的，万一要是严重了他自然会给抗生素。总之医生的目的是把
患者用正确的方法治好，你不要纠结。实在有怀疑就换人.

doc.
★ 发自iPhone App: ChineseWeb 7.7
★ 发自iPhone App: ChineseWeb 7.7

【在 z******2 的大作中提到】

: you know what I learned from American Doc?
: wait until the 2nd or 3rd day of fever (of course not severe) to see the doc.
: my 2 experiences taught me this:
: #1 fever at night, wen to ER, nothing seen, attributed to "virus"
: then after 3 days, fever continues, go to ped, then saw throat swollen, and
: then antibiotics.
: #2 this time. we went the ped the 2nd day before symptoms develop, so they
: don't do anyting.

W*e2013-01-14 08:01

11 楼

不是啥病都能一开始就给抗生素的，也不是啥病都应该给抗生素的。比如说玫瑰疹，就
是发高烧，给啥都白搭，三天以后自己就好。楼主还是国内的思维，一发烧就立马上抗
生素，根本不管到底是啥原因引起来的。第一天发烧，很多病的特征都没出来，你让儿
医怎么给抗生素？况且抗生素对于病毒一点用都没有。你如果不相信这个儿医就换，不
过换了肯定也一样。除非你回国，能找到一发烧就给你宝宝吊水的大夫。