Why are penicillin injections rarely given these days?

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Offline thedoc

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eliot  asked the Naked Scientists:
Hi Chris,

I hope you are well.
I always listen to your show on 702, the highlight of the week.
When I was younger, whenever I visited the Dr with Cold or Flu type symptoms. The Dr would give me a intramuscular injection of Penicillin mixed with Benadryl.  (Benadryl no longer available in South Africa) I would then go home, sleep it off until the next day, and then wake up 100%.

These days oral antibiotics are always given, and to my knowledge they are mostly comprised of synthetic components. They never seem to work fantastically, and usually requires several courses before the problem ceases.

My question is as follows:            

Why do Dr's no longer give Penicillin injections?

Thank you.

Eliot Hirschson

What do you think?
« Last Edit: 25/09/2012 04:30:01 by _system »


Offline CliffordK

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Re: Why are penicillin injections rarely given these days?
« Reply #1 on: 25/09/2012 04:52:14 »
Antibiotics kill bacteria. 

Many afflictions are not caused by bacteria, or are not improved with antibiotics.  There is also a risk of developing antibiotic resistance.  So, many physicians are reluctant to heavily prescribe antibiotics unless they are reasonably certain that the patient has a bacterial infection.  If the pathogen is known, then they might not need to choose a broad spectrum antibiotic.

In many cases, adults prefer not to have shots.  Amoxicillin is closely related to Penicillin, but can be effectively delivered as an oral medication.  Thus, several doses can be taken by a patient at home, and there is no need for injections, or repeated injections.  And, the patient can easily get a longer course of medication.

At home, we would occasionally give antibiotic injections to cattle and pigs because the dosing was easier than with oral medications, often a multi-drug cocktail called Combiotic.

Physicians have also learned more about antibiotic activities and dosing in the last few decades.  For example, one of the reasons that Trimethoprim-sulfamethoxazole is often chosen for the treatment of urinary tract infections is that the kidneys excrete it in its active form, thus effectively concentrating the drug in the urine where the infection is.  Other drugs that are metabolised in the liver such as penicillin would not be as effective of a choice.

Other drugs may be more active, or better targeted for specific bacteria.


Offline evan_au

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Re: Why are penicillin injections rarely given these days?
« Reply #2 on: 26/09/2012 11:44:10 »
Until the development of some of the recent anti-viral drugs (http://en.wikipedia.org/wiki/Flu_treatment#Antiviral_drugs), there was nothing the doctor could do except tell you to stay at home (so you minimise the number of exposed people), rest and take a painkiller for the symptoms; usually your immune system would take care of the virus over the next few days.

In fact, the presence of these symptoms shows that your immune system was starting to take action against these hostile invaders - studies of interferon therapy usually report side-effects similar to colds and flu. (http://en.wikipedia.org/wiki/Interferon#Diseases)

In common usage, "Colds" and "Flu" describe symptoms which are mostly caused by viruses, so they don't respond to antibiotics like penicillin.

It is now known that excessive use of antibiotics has a bad impact on your gut microbiome, and likely impacts on nasal, skin and other microflora that we all carry around with us, as well as potentially contributing to human obesity. http://en.wikipedia.org/wiki/Microbiome

With what we know now, saline solution would probably be better for you than penicillin. (...and maybe that's what it was?)