{"id":125,"date":"2008-10-27T05:58:51","date_gmt":"2008-10-27T10:58:51","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=125"},"modified":"2015-06-04T15:31:43","modified_gmt":"2015-06-04T19:31:43","slug":"antibiotics-as-placebos","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/antibiotics-as-placebos\/2008\/10\/27\/","title":{"rendered":"Antibiotics as Placebos?"},"content":{"rendered":"
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(Not an ad.)<\/p><\/div>\n

This article <\/a>in the BMJ is geting lots of news:\u00a0 Out of 679 practicing physicians in the United States, about half admitted to prescribing placebos on a regular basis.\u00a0 A “small but notable proportion (13%) of physicians reported using antibiotics.”<\/p>\n

My first instinct was surprise that the rate was this low,\u00a0but then I remembered that public perception of this practice might not be so favorable<\/a>.\u00a0 As a result, the appropriate MD response to this news is to be “shocked,\u00a0schocked …”<\/a> that placebos are being prescribed, and to express grave concern at the ethics of the practice.\u00a0 So undoubtedly some of the doctors surveyed in that study probably didn’t tell the truth.<\/p>\n

From an ID perspective, reading that antibiotics are sometimes used as a placebo is hardly news at all. \u00a0Since about half of the US population believes that antibiotics are helpful for the common cold<\/a>, all a clinician has to do is prescribe a Z-pack for a runny nose to a patient expecting antibiotics, have that patient get better (colds do, after all get better eventually<\/em>), and the practice is reinforced. \u00a0This exact exchange must transpire hundreds of thousands of times a day in doctors’ offices and emergency rooms.<\/p>\n

I’ve written here about one potential cure <\/a>for this problem (C. diff), but it’s not exactly something you’d want instituted as a preventive measure. \u00a0<\/p>\n

Is there a way to exploit the placebo’s powerful effect in clinical practice that doesn’t seem so sneaky? \u00a0And doesn’t expose patients to medication side effects? \u00a0Here’s one: \u00a0Our office has a terrific coffee\/tea maker, and I’ve found that handing a patient with a bad cold a cup of freshly made green tea in a nice mug works wonders. \u00a0I don’t believe we ever covered that in medical school.<\/p>\n","protected":false},"excerpt":{"rendered":"

This article in the BMJ is geting lots of news:\u00a0 Out of 679 practicing physicians in the United States, about half admitted to prescribing placebos on a regular basis.\u00a0 A “small but notable proportion (13%) of physicians reported using antibiotics.” My first instinct was surprise that the rate was this low,\u00a0but then I remembered that […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,7,8],"tags":[72,191,197,727,801],"class_list":["post-125","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-misc","category-patient-care","tag-antibiotics","tag-clinical-care","tag-clinical-trials","tag-placebo","tag-resistance"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/125","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=125"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/125\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=125"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=125"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=125"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}