I've heard many monikers for the current young generation (generation Z, millenials). How about the ZPackers. Let me explain. The current generation is marked by a desire to push a button and get action. If you make them wait, they move on. Have a problem, then lets get a solution. Here's the problem, and now please fix it. It'd be nice if illness worked that way.
Now let's talk about the most common malady that we in primary care see in our offices-upper respiratory infections. Lets not call them "colds" (seems to unimpressive), so how about upper respiratory tract infections, or URI's for short. That is any combination of runny nose, nasal congestion, scratchy throat, loss of voice, cough, and malaise. Pick any two, and you likely have a URI. Those are nasty illnesses caused by viruses that take anywhere from 7-14 days to kick, regardless of what you do. Enter the Zpack generation. And alot of nifty marketing by Pfizer. ZPack-just roles right off the tongue, doesn't it?
What happens is about 3-4 days into one of these illnesses I see a patient who says they have a "sinus infection" (that puts the correct amount of emphasis and importance on their malady). You know, yellow snot, stuffy head, can't breath thru their nose, and perhaps now "coughing things up". Usually these folks know what they need ( a ZPack), and just dropped in to get one. Sure enough, once they start their Z pack, they are better in 3-4 more days (total illness 7-14 days). Now they are convinced that the ZPack cured them, and we have now created a huge public health problem. Not good for them personally, either.
Don'tjust take my word. Look at the science. The scientific literature is full of large studies that should lay any doubts to rest that URIs are not caused from bacteria, but from a variety of viruses (germs that are not killed by antibiotics, and must just run their course). That same literature also concludes that antibiotics have no effect on URI. In fact we are now seeing some pretty serious health consequences to overuse of antibiotics-the most dire is antibiotic resistance from certain commonly seen, and previously non life-threatening, bateria. The biggest and baddest maneater is called MRSA (MRSA= methacillin resistant Staph Aureus). I can't prove that overuse of antibiotics has caused this trend, but I and many doctors more expert than me believe it is at least one of the contributing factors. And not just a public health issue-on a personal level it takes up to year for your colon bacteria to fix itself once you have ingested an antibiotic. Nobody knows the consequences of that,either. But they likely aren't good.
Here's the probem. Go to most doctors tomorrow, tell them yellow snot. "sinus infection", you get them all the time, Zpacks always work, now coughing up phlegm, yada yada. Hey, we doctors want to please,so here you go, here's the ZPack. On to the next patient. Not me-I'll tell you truth if I'm not too exhausted from the previous patient (s) with the same request.
Commonly used tactics: " I go on vacation in two weeks and don't want to be sick". No. How about "I know when I get it in my head it will always go into my lungs". Nope again. Now desperate "My roomate says all I need is a ZPack". For goodness sake, stop it!
What's the right way to go about this? Doc, I fell bad, REAL bad. Cough, congested, blowing my nose all day. Can't sleep. So ask him, "do you think I need an antibiotic"? That's right, give him permission to tell you the truth. Perhaps he'll do the right thing and give you options. Yes, collaberate, bargain, lets try this or that, and if 14 days roll around and you are NO BETTER, then perhaps we'll give an antibiotic a try. Call me, or better yet email me. Won't cost you anything extra. And perhaps we won't use azithrmycin AKA ZPack. Just too strong, and we want it to really work well when we really need it like if you ever get pneumonia. Perhaps we'll try one of the other really good ones that won't kill your colon bacteria or let your Staph get drug resistant. Yep, that would be a better way to go. Your doctor will think you're smart!
So, wash you hands frequently, keep your fingers out of your nose and eyes during cold and flu season, get extra sleep that time of year. Stay away from sick people as best you can. That's the way to do it.
Now there is a second opinion!
Dr. Frederick
