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Friday, January 30, 2015

Flu: Can we fight it?


Influenza, commonly known as flu, is a viral illness characterized by fever, runny nose, cough and muscle pains. Most often it is a self limiting ailment lasting for less than a week.

SHOULD ANTIBIOTICS EVER BE GIVEN FOR INFLUENZA?
Only 16% of patients with Influenza were prescribed Antivirals whereas as many as 30% were prescribed antibiotics. Unfortunately, we know that if you go to a Physician for a flu, you are more likely to leave with a prescription for antibiotics that you don't need than for an antiviral that might do you some good. 



If antivirals are started within 48 hrs of onset of symptoms, there will be an improvement of 30 hrs in time to getting better but if they are started after 48 hrs, there is not much benefit.

The problem might be a consequence of a lack of familiarity with antivirals and confusion over when to use and when not to use them. Also, there is a "deeply ingrained tendency" to prescribe antibiotics for sick patients because they need something or because of the perception that patients are going to be happier.
Inappropriate usage of antibiotics has thus led to a major crisis in antibacterial resistance.


Another very important reason is that clinicians 'don't want to risk missing anything'. Even if they know that out of 99 influenza cases, fewer than one will have a bacterial superinfection, physicians don't want to have not treated that one person who develops bacterial pneumonia as a complication of flu. It is true that flu predisposes to bacterial pneumonia, but it is not true that giving an antibiotic will prevent it, because the patient is likely to be infected with a different bacterium from the one targeted by the antibiotic. And if you treat 100 patients who don't need an antibiotic, you are probably going to send one to the hospital with a rash. If several develop diarrhea you will do far more harm than good.

SHOULD FLU SHOTS BE GIVEN TO ONE AND ALL?

Prevention is better than cure they say. A shot of the Influenza vaccine at the beginning of the cold season is recommended for everybody above the age of 6 months especially those at high risk - Immunocompromised, asthmatics, diabetics, etc. But the prevention rate is a measly 23%. The virus has a very high tendency to mutate and change its form. As a result, the antibody produced against the virus fails to destroy it. Also, the improper maintenance of the cold chain for preserving the vaccine has led to the high failure rate. Despite all this, the vaccine should be administered as advised since the benefits however small they seem, far outweigh the zero risk. The vaccine protects against certain strains of influenza, including the B viruses, which can cause severe disease and complications in infants, young children, and the elderly.

"Someone told me that they didn't want to take a flu shot because they didn't want to put a foreign substance in their body. What do they think they do at dinner every night?"

The flu is very unpredictable when it begins and in how it takes off.

Excerpts from Medscape