Wednesday, August 9, 2017
First, a bit of information that every nurse, EMT, or first-year Biology student is supposed to know by heart: antibiotics must be taken for their full course. Usually this is two weeks of three doses per day, sometimes it's weeks longer, and rarely it's only ten days. This is because bacteria have several defensive strategies, just as the antibiotics have several attack strategies, and it can take a long time to deal with them all. It's vitally important that the bacteria all be killed, because if even one survives, it will pass on the trick/immunity of its survival to its descendants. This is how bacteria become immune/resistant to antibiotics, and particular antibiotics become useless. The problem with giving antibiotics too much, too freely -- such as, to livestock -- is not that the livestock get too little, but that small amounts of the antibiotics get passed on to whoever consumes the milk or meat, and kill off only the weaker bacteria while leaving the stronger/resistant bacteria alive. Under-dosing, by any means, with antibiotics creates bacteria resistant to those antibiotics. That's what happened to the original form of penicillin. All healthcare professionals are supposed to know this. Keep that in mind.
Now my case was just the opposite; when I was a little kid I got a severe case of pneumonia, bad enough to put me in the hospital, and the doctors shot me up with massive doses of penicillin. The penicillin killed the pneumonia bacteria completely, but left me permanently allergic to penicillin. Ever afterward, I had to rely on tetracycline to clear up all my bacterial infections. That was all right; tetracycline worked well with my personal chemistry.
The problem was that, over the past ten years or more, it's grown harder and harder to find doctors willing to prescribe tetracycline. When I asked why, I got dozens of different excuses -- mostly revolving around a theme of "We have much better antibiotics these days". A few personal experiences showed that those "much better antibiotics" cost about ten times as much as tetracycline, or even classic old penicillin. Uhuh.
A little more research (gods bless the Internet!) revealed a few more interesting facts about both of those old standbys. First, both of them were developed so long ago that their patents have run out; this means that anybody can produce and sell them without paying royalties to the original -- or the last -- patent-holder, which makes them cheap. Second, both antibiotics are easily found in nature -- penicillin derives from blue bread mold (I wrote a song about that), and tetracycline from an African beer-yeast; it was only the refining process that could be patented. The basic breeding-stocks can be readily found, collected, bred and refined -- just about anywhere, by anybody with the knowledge, which is likewise commonly found. Third, both remain reliable killers of most kinds of bacteria, despite sloppy over-use by everyone from incompetent medics to corner-cutting factory-farm managers. So, they're cheap, easily made and reliable: everything that big pharmaceutical companies hate. No wonder doctors are discouraged from prescribing them.
However, I found that by insisting -- and maybe claiming "allergy" problems with the shiny-new expensive antibiotics -- I could still get prescriptions for tetracycline, which still worked just fine, thank you.
Then, about six years ago, I discovered at least one doctor at my local clinic using a new tactic.
I'd gone there with a pesky jaw infection, gave the usual explanation about my allergies, and asked for a "full course of tetracycline". The doctor frowned, but wrote up a prescription and handed it to me, and started to head out of the exam room. Fortunately I'm a very fast reader and have a habit of always reading my prescriptions as soon as I get them, so I caught the anomaly before the doctor could escape.
"Hey!" I snapped, "This is wrong. This is enough for only one week; a full course of tetracycline takes two weeks. You'll have to change it."
He didn't like that, and he used the Argument From Authority: "Who's the doctor here?"
"Who's the doctor's daughter?" I countered, "And who's been taking tetracycline all my adult life? It's never prescribed for less than two weeks."
He retreated to the second line of Argument From Authority: "I've could show you where it's ordered in the Official Publication."
I called his bluff: "Yes, please show me that exact page." I didn't mention that I intended to xerox it as soon as I got my hands on it.
He shifted to: "It's not convenient. If you don't like that prescription, give it back, and go see another doctor." And he grabbed for the paper.
I snatched it out of his reach and replied: "You know perfectly well that it'll take me a week to get another appointment, so I'll make do with this for that long." And I hurried out before he could come up with another excuse. I also didn't mention that I wanted to have his signature on that prescription, in case he tried to squirm out of the clear malpractice.
First thing I did on my way home was stop at a copy-shop and get several xeroxes of that prescription. Second thing I did was stop at a drug-store and get the original filled. Third thing I did was take the best xerox copy, touch it up a little to make it look like a genuine original, take it to another pharmacy and get that one filled too, just in case (no, I'm not afraid that the DEA or somebody like them will come after me, these long years later, for illegally purchasing antibiotics).
Fourth thing I did was look up the phone numbers of the city health department, the county health department, the state health department, and finally the CDC in Washington, DC. I spent the rest of the day phoning those various Expert Authorities, asking if anyone knew about this new -- and dangerous -- tetracycline policy, and who had ordered it. All I was able to reach were various secretaries, none of whom had a clue about any policy of under-prescribing tetracycline, and somehow none of them were able to reach anybody who did know anything about it. A few more days of phonecalling brought no different results, so eventually I phoned the biggest newspaper in town, told them my tale, and asked if they knew anybody who knew anything. The reporter I talked to had an eager note in his voice when he promised he'd "look into it", so I guessed that he actually would do a bit of investigating.
He must have raised enough questions with enough of the right people, because the next time I needed to get a prescription for tetracycline, the doctor (a different one) had no trouble writing me a scrip for a full two-week course. I thought that was the end of the problem. Silly me!
A couple years later, troubled with another bacterial infection, I went to my local clinic here in Arizona, and tried to get a prescription for tetracycline again. This time the doctor claimed that tetracycline had been "discontinued", supposedly because so many bacteria were now "resistant" to it, and nobody was even making it anymore.
Surprised by this, I made more phonecalls and Internet searches. I found that tetracycline was really still being manufactured -- but only for "veterinary" use, and not much (just one company in the US) of that. Nowadays, you can only find tetracycline -- and penicillin, for that matter -- sold for use in tropical fish tanks. Other pet owners have advised me on how to calculate the dosage for other animals, but you have to mix the powder in distilled or boiled water yourself. The interesting part is that these supposedly-useless old antibiotics still work on the majority of bacterial infections.
What I see happening here is a years-long deliberate campaign of sabotaging two old reliable -- and cheap -- antibiotics. Now, who would have the ability to pull off a campaign this widespread and this effective? And who would have motive? Think.