Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Antibiotics

Episode Date: February 2, 2018

This week on Sawbones, it's the story of a miraculous cure and how we all have to work together to protect it. Join Dr. Sydnee and Justin for the story of antibiotics. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. I'm the the the

the the the the the the the the the the the the the the the the the the the

the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the the for the mouth. Wow. Hello, everybody, and welcome to Sal Bones, a marital tour of Miss Guy to Medicine.

I'm your co-host, Justin McAroy. And I'm Sydney McAroy. Well, Sydney, it's called in flu season. Yes, it is, Justin. Did you get your flu shot? You know I did. Good. Because no matter what, we're not going to talk about the flu

because we've talked about the flu before. I just want to briefly say no matter what you've heard on the news about how effective or ineffective the flu shot may be, you still should get your flu shot. We still recommend it. Even if there's a chance it's not going to protect you, there's a chance it will. And also, we have reason to believe that because of some cross-reactivity, even if it's the wrong strain, you may have a believe that because of some cross your activity, even if it's the wrong strain, you may have a less severe version of the flu.

If you get it. So as someone who has had their flu shot and then still got the flu, I will still strongly recommend you get your flu shot. Get your flu shot. But this time, it's not just cold. It's not just flu. There's a lot of bugs this time here. That's right.

This is the time of year where everybody gets, you know, the sniffles. And they come into your office and they say, Sydney, make me feel better. It's true. It's very frustrating to have upper respiratory infections, meaning like the stuff that makes you have a runny nose, and a sore throat, and cough, and congestion,

and that kind of stuff, even like sinus infections, that kind of,, even like sinus infections that kind of in this same arena because most of them are caused by viruses. And there's not much we can do to expedite your healing from a viral infection in this case. There are other viruses maybe, but for this case, it's usually just time and fluids and rest, and you'll

get better. No mention pill for that. But one thing that generally will not help unless you do happen to have a bacterial infection are antibiotics. And you get a lot of people asking you for those, I know. It's a common problem because sometimes you have an infection and your doctor tells you you need antibiotics and then other times your doctor might tell you you don't and so it can be hard to understand why sometimes it seems like we're withholding something,

right? Well this treatment has helped me before why won't you give it to me again. But the truth is if you have a viral, which you most likely do, antibiotics aren't going to help you at all. They do have side effects. And every time we misuse antibiotics, and we're going to talk about this a little more, we run the risk of building up more resistance to these antibiotics. All right, well.

So I think it's a good time of year to talk about antibiotics. Let's do it. So thank you to Samantha and Ian and Austin and Jesse and Sydney and Matthew and Cecilia and Allison and Sage and Megan and I think a lot more people have suggested this over time. It got overwhelming. I don't know why we haven't covered this yet. This is a big topic in medicine, right? Antibiotics.

The story doesn't really formally begin until the 1900s. That's like the origins of what we think of today as antibiotics. But we have been trying to treat infections even when we didn't know that's what they were for a really long time, which is a truth for everything, right? We don't know what this is, but we're gonna put some stuff on it

and see what happens. We see some honey, some frog legs. Well, honey, you use honey, but honey's not a bad idea. Nice. Crushed it. I didn't want to take that old time, doctor. And that was one of the mainstays of early,

what we have, what we now understand is an infection, meaning some sort of bacteria is growing on something somewhere that it shouldn't. Honey was one of the most common treatments and that probably was in some cases somewhat effective. It doesn't treat all infections, but it probably did help sometimes, especially with skin issues.

The ancient Egyptians would actually rub bread mold on wounds that looked like they were not healing properly. Now we would recognize his infection. That's weird. Yes. That's really,'s weird. Yes. That's really really weird. Because as we will get into that may have been, may it work?

Maybe. I don't know what bread mold it was, but... Maybe some bread molds. Maybe it, let me say this. I don't know if it works or not, but using mold to treat infections was practiced throughout history in Egypt, in Greece, in Rome, in China, and in Serbia. Wow.

So, now, we have said this on the show before, just because a lot of people did it, doesn't mean it worked. It is. But, counterintuitive enough, though, that it makes you wonder, like, did they see some effect? Or do they understand on some deeper level city? Do you believe that there are some Medicines that we know instinctively work Medicines that we know instinctively work that we've that we instinctively know what

Sometimes what could help us do you think the instinct could drive like? It's an interesting question. I'd we're so far removed from that now in modern society. It'd be hard for me to make it get. I mean, there are certainly things we're programmed to know are bad for us. Right. You know, there are things that we naturally avoid, instinctually avoid because they're toxic.

So it's an interesting question. But I mean, there's some, our whole Podcast would lead you to believe otherwise The ancient Egyptians also Accidentally ingested an antibiotic called tetracycline, which is still in use today regularly How well they would brew this this kind of beer. It was sort of a chunky bread beer thing. It was a mixture that they drank a lot, about 3% alcohol, and it was like this fermented bread, porridgey beer stuff. beer sound good because of naturally occurring bacteria in their soil and in the things they grew and

all this, the beer would contain high levels of tetracycline as kind of an extra product that was created in the process. And this was long before we actually isolated tetracycline and figured out that it was an antibiotic and used it to treat infections. So it was the thing is though, the beer was elevated to not it was not just a drink. It was not just something you would invite, but it was not just used for for fun times. It was not, you know, a lot of people drank beer and you would think, Oh, because they were all getting intoxicated and it was fun. No, beer was thought to be a healthy drink. This was, this beverage was thought to be some, I don't want to say magical, but somewhat

magical and spiritual and important to the body, important to the culture and their taste. And you still believe that to this day, yeah? I'm, no, I'm not saying that. No, that just I am a fan of beer and it's magical property. I'm not going to say beer as magical properties. I'm looking forward to a time when I could drink it again at the end of this pregnancy. It's I know it is not magical.

I I'm kind of jealous of you because like I've never denied myself something. I love that much. For ten months. So like, I'm jealous of you that you're getting this great experience, because it's gonna be so good afterwards. I won't understand that. You know?

This is the point where I urged everyone to drink responsibly. Do you feel bad for me? Because I want to experience that great taste of 10 months without being in here? No, I don't. I don't at all. I don't feel bad for you in any regards to this pregnancy. Fair. That's, I'll take it. Anyway, so beer was used medicinally for all kinds of different things. Stomach ailments, coughs, constipation. There's a prescription that you can find for a beer animal that people would take. And we have figured all this out. Please just do, Natti, light. If it's going up your butt anyway,

that are the bees. Don't waste something good. Yeah, don't, don't get a good beer. But we know this, by the way, because we've studied bones and found tetracycline deposits in the bones of ancient Egyptians. Yes, the beer wasn't that great because they died. Well, I mean, we'll cover mortality at some other point. Traditional Chinese medicine relied on a number of different herbal medications for what would have been, like again, things that we now know to be infectious, because people would look for certain signs,

like, well, that's hot and red and swollen and there's pus coming out so we treat it with these things now we would say oh that's infected and and some of these things have been found to have natural antimicrobial activity meaning that you put this herb in a petri dish with some bacteria and the bacteria won't grow there. That doesn't always mean it will work in the human body the same way, but we have observed that. In addition, it should be noted that traditional Chinese medicine brought us Arnamesanin, which is a plant-based medicine that has been used for thousands of years for all kinds of different ailments, but it's very effective against malaria.

Now, when it comes to the Middle Ages, typically on this show, you start making fun of people. Yeah, not the people, although I mean, holistically speaking, yes, but the Middle Ages is normally where, if we are building up a head of steam, treating something, we all take a collective dump.

I mean, I can't think of a nice way to say it's in that, but we usually take a collective dump. I mean, I can't think of a nice way to say it's in that, but we'll usually take a dump during the Middle Ages. Now, I have to tell you that there is something that came out of the Middle Ages when it comes to fighting infection that actually is useful. X-calper. That's not a good thing about the Middle Ages.

No, it was not a sword. It was not a magical sword, X-calper. It was not, no, it was not a sword. It was not a magical sword excalibur. It was not no It was not a sword So I want to tell you about and this was something I think we independently had a lot of listeners When this came out in the news tell us we should talk about and we haven't covered it before so here you go bald's eyes salve This this is a recipe for a medicine. Okay, I Salve to south for your eyes.

You know, something that's important. Is it a brand? Well, it's from a guy bald. Oh, okay. Who made it? It's weird to think of brand. Yeah, it's from his book, Bald's Leach Book, which is a medical text from the 10th century in England.

So, which was a collection of a lot of recipes from the day, you know, for different ailments. So this was used for styes, which were known at the time as winds. So a stye, you know what a stye is on your eye. It's a little infected area on your eyelid, you know, I'm talking about. Okay. So this is a salve you would put on your eye. It contained wine, garlic, some sort of, um, allium species like a le oligar an onion and oxcall. And so you mix all this together, you have to put them in a brass vessel for nine days,

one nine nights I should say. And then at the end of that you use it. So a team of researchers in 2015 took this recipe and reproduced it exactly, including the nine nights in a brass vessel and all that. And then used it in Petri dishes as well as in some tissue from chronic mouse wounds that had a staff bacteria, specifically MRSA staff bacteria, which is the kind that's very resistant, methamcyl and resistant staff orius. So that's what a lot of people get scared when they hear that. They think it's called the super bug, right? So very resistant bacteria.

So they tried it against all this stuff, and it seemed to work. Now this was not in a human body, or even in a live mouse body, I should say, it was in a tissue from. So what would this do in the human body? I don't know, I can't tell you, but at least in petri dishes and in tissue cultures, it worked to kill the bacteria. They

even kind of put it up head to head against vankemiasin and antibiotic that we commonly use for MRSA infections. And they said it worked just as well, if not better. Well, how why? It's interesting. The theory is that it has to do with the allium, the leak or the onion. There are compounds in there that we know are antimicrobial. But this doesn't work on its own. You have to follow the directions. You have to mix these ingredients and you have to leave them for nine nights. It doesn't.

They tried variations of it and it didn't work unless you followed that recipe exactly. That's so strange. It's very strange. There was also some theories that because there was copper in the pot, and copper is known to be antimicrobial, we've referenced this before, copper inhibits the growth of bacteria, that maybe it was something synergistic between the alium and the copper. Anyway, the point is it worked. And then it began to call into question all of these old recipes from, I mean, the Middle

Ages or any time in history. This is undermining the very premise of our show. This is infuriating. No, I will say this. How am I supposed to sit in judgment from my perch, my modern perch and judge my ancestors? To be fair They were not the first researchers to have tried this in 2005 a team of researchers did it and they Could not reproduce through they could not make this happen. Mm-hmm. I shouldn't say reproduce because they did it first

But they they could not get the same results so I'm not homeizers Well that and they also called that in a question actually in the 2015 study. I don't think they did it exactly right. So it's hard to say, I think it is definitely worth investigating and repeating because as we're going to get into towards the end of the show, antibiotics, if you don't use them right, don't work forever. So it's always good to look for alternative methods

that work to treat infections. So you have to add that code of that work. I don't want to just say alternatives because there are lots of alternatives. Right. You can put anything on a wound. I just shouldn't. So, all of these principles that we've kind of talked about, all these things that have been gleaned throughout history, People using bread molds and honey's

and these salves that seem to actually work. There were a lot of efforts, all these principles between that and then getting to like modern day antibiotics, like penicillin, you'd think there was a direct line. But of course, we take a detour into using things like heavy metals for a good bit of history at this point, mercury

and arsenic, or like how we mainly treat infections, especially things like syphilis, which we've talked about before, things that were very caustic and painful and not necessarily the most effective. And we really don't get back into the story of the stuff that actually worked well and didn't harm people so much until we discovered microbes. So we've talked about this before. We figured out that there were,

what we're first called, anomacules. That's a cooler name. It is kind of a cool name. With germs, bugs, bacteria, microbes, things that cause infection. We figured out the germ theory of disease that that's why people get sick, that's why infections happen.

And then we start trying to figure out, okay, now we know why infection is a, or now we know why this is happening. We have a name for it, we have a target for it. And the person who really spearheaded that was Paul Erlich. He was one of the first to use like a systematic approach to figuring out his idea was that there's a silver bullet. You need to target the bacteria, target the germ, and then we can treat the infection, kill the bug, treat the infection, save the person.

Hey, what's a germ? What? Like what's a germ? Like something that causes disease? Like, it could have, is a bacteria a germ? Is it virus in germ? Yeah. So germ is a blanket term?

Yeah, germ, we don't really use, like medically speaking, I don't often say germ in like an actual jargon context. I had to find this one why she was sick, and I told her, she came to the right place, and I told her it was a cold germ, and then she said, what's a germ? And I was like, watch your YouTube sweetie. No, I mean, when we talk about the germ theory of disease,

the idea is that there is an infectious agent that we can look at that is an actual thing that we can isolate that is causing disease, as opposed to the measum theory or an imbalance of humors or something else like that. Got it, okay, so very brief flow. So Urlik wanted to find an effective and not so toxic treatment for syphilis. That was his big goal.

He tried out lots of different substances on rabbits with syphilis and the sixth compound of the 600th series worked. It was compound 606, later known as Salversan, or Neo Salversan, which was a less toxic form. And it was the big syphilis treatment for a while until we get to the 1940s. And I know this sounds like an offshoot

because we're still not getting into the real antibiotics that we use, but the principles he used to develop this is what would lead to everything that is about to happen in antibiotic what would lead to everything that is about to happen in antibiotic history. So he deserves that credit. What's about to happen? Well, I'm going to tell you, but first let's head to the Billion Department.

Let's go. The medicines, the medicines that ask you make my God for the mouth. Well said, you're going to get into what doors were open in terms of antibiotic research. So with this concept that we now have something to target, researchers got busy trying to find a way to actually kill these bacterial invaders. We usually think of penicillin as the first antibiotic. Yeah. invaders. We usually think of penicillin as the first antibiotic. And I'm going to tell you about penicillin, but it is it's fair to mention that sulfa drugs, sulfa methoxes, all very commonly

used now in combination with tri-methyparam, which is something called backdram, which a lot of people have heard of, were actually the first to come along, not that one, but sulfa drugs in general. There was something that was the brand name was Prontocil, the generic name. along, not that one, but sulfa drugs in general. There was something that was, the brand name was Prenticell, the generic name. If you can do it, I believe anyone is interested. sulfonamidocrysodine. Sophonamonicrysodine. Of course.

Right. It was synthesized by bear chemists and marketed in the 30s, so I actually predates penicillin. But the problem was the active part of the drug, sulfonilamide, was a dye that had been in use for a while. It was interesting. A lot of people observed that dyes would cling to certain things in petri dishes, and so it was a way to, oh, well, it targets that because it only attaches to that.

And actually, we accidentally killed the cell with this die. Hey, we killed the cell with this die. A lot of people started to notice this. Good news guys, we don't have to finish the experiment. We did it. We did it. That was so easy. We can't see it anymore, but we did it.

But the problem was, since Solfinilamide was already widely in use for other things, they couldn't patent it. So a bunch of different companies started making these kind of things to cure infections, sort of maybe, with questionable means really quickly. This is also a good situation. Yeah, this is also why when we talk about resistance to certain medications and bacteria not being killed anymore

by that drug. Sulfur resistance was one of the first to spring up. It's because we were just kind of willy-nilly throwing these sulfur compounds at infections. The first antibiotic that was really formally made and we used and kind of changed the course of human history, I think you have to give to penicillin. And most people kind of know the story, right? Mold was involved. Yes.

Louis Pasteur. Nope. Nope. Okay, well let me tell you. Mm, I like it. You're so close. You got the mold. I got the mold I knew.

So Scottish scientists, Alexander Fleming, you know that Fleming, Penicillin. Baby, I love you. We've been over this, though. You know I don't know any of this stuff. It's not a gag. It's not a bit. What were you so angry about?

There was something else you were angry at me about yesterday. Because you didn't know why you couldn't eat before surgery. Yeah, you were mad. You were mad at me. Anyway, Fleming was like, okay, well, it's your field. What was Mario's original name? And you're like a jump man? I was like, okay, well, I guess we're done talking.

Okay. Anyway, Fleming worked at St. Mary's Hospital. And he went on vacation for two weeks in the fall of 1928 and he left his lab in pattington. Oh, if I had some bear. Hey, that you know that. He left it a complete mess. Patronized me, Smirl. And he, this was not uncommon for him. He was not known to keep his bench clean, his lab bench, his table, the big, the big experiment table. It's called the lab bench. Yeah. Just in case he wondered. Anyway, he was, he was, he was not a fastidious

scientist. So this was not unusual. And so he came back from his vacation, well rested in September to find that, uh, Petri dish that he had left out was staff full of caucus, orius, staff, orius, a bacteria that causes infections, growing on it had become out with staff full of caucus orius, staff orius of bacteria that causes infections. Growing on it had become contaminated with a mold known as penicillium no totem. And he also noticed that in the areas on the dish where the penicillium was growing,

the staff bacteria were not. They had actually been liced and kind of destroyed by the penicillium Whereas the areas on the Petri dish where there was no penicillium the staff was growing just fine There's a t-shirt in this story somewhere. It's just so wordy. It's like yeah, my room's messy But I'm trying to discover a new antibiotic. Maybe you didn't know that's how, and then like at this point, you're at the belly button. It's space. This is getting to be a little worried.

It's like a little worried. It's not like bumper sticker material, but there's something in there. Aren't we lucky no one told Fleming to clean his room? That, and then that would be a great conversation start. That's what brown people would say. I don't, who is that? You know, who else was messy flimming? Okay.

Again, that you haven't really gotten the neck into the right thing. So, this was not the first time that a Petri dish had become infected with a mold or, you know, that this had happened. He was just kind of the first one to stop and look at it and go, huh, maybe I should investigate this a little further. And we had suspected, as I mentioned, throughout history, that mold had something to do with treating infections for a long time, because we've been sticking moldy bread on infections for, you know, thousands of years. So this was not a wild idea. The problem was trying to figure out exactly what it is in the mold that's stopping the bacteria from growing.

I mean, you can't just grow mold on wounds willingly. That doesn't seem like a smart idea. So that is what took a long time was to take that mold and isolate what is the compound in here that will help us treat infections. And how can we do that? Just because something works in a petri dish doesn't always mean it will work in the human body. And even if it will, making that happen is a that's a big process. Lots of research goes into that. So it took a long time. It actually wasn't until 1940. So now we've jumped from 1928 to

1940 that he was doing this research and he was publishing and another scientist, Dr. Howard Flory, who was a professor of pathology at Oxford University, got really excited about it and said, you know, I think we can help with this. So him and and another biochemistry worked with Dr. Ernst Chain started working on this process. How can we make more of this mold and isolate what in it will treat, you know, will kill the staff? So the problem that and they were very successful in doing this except that what they ran into is that it took them 2,000 liters of mold culture. So they had to create 2,000 liters of this mold in the lab

to isolate enough penicillin, which was what they called the compound that they found that inhibited the growth of bacteria, to treat a single case of sepsis in a person. That's a lot of mold to treat one person. They were having trouble overcoming that because that what happened is they had this new thing. They were using it in their lab and it seemed to work really well. And then there was a local case of a guy, Albert Alexander, who was a police constable, who had been working in his Rose Garden when he nicked his face. Probably, I'm assuming that's the order or something. And he

developed a really horrible cellulitis from that infection of his skin, an abscess, meaning a big pocket of pus and infection under there. He became septic. He was dying. And they were giving him sulfa drugs, which were around at the time, and they weren't working. So these two scientists, Chene and Flourie, were like, hey, can we try our new penicillin? He's going to die anyway. Can we try this?

We think this will help. And they did. And it was helping. Wow. And then they ran out. And then, unfortunately, he passed away. Great story, Sid. Sorry.

Top 10 medical... So they knew it worked, but they didn't know how, but they had to make more because they didn't even have enough in their lab to treat one person. I think as we've all of the audience, when I said I didn't think that anecdote was going to shake out that way, I felt a swelling of hope that you quickly doused with your lack of mold.

I'm sorry, they ran out of mold. Okay. Dr. Norman Heatley joined their crew and he, sorry, I'm sorry. I'm sorry, can I just take a brief moment to's a lot of good names in this episode already. Norman, he'd be Howard, Florian, aren't you? Don't mind if I do. Just like a lot of Albert Alexander is even good. That's like a Agatha Christie name.

That's good stuff. Some good names in this app. And all of these people work together. We always give Fleming all the credit and he definitely deserves credit for Pitta Sillin. But there are a lot of people helped get us from molding a Petri dish to... That's always way too much.

That's fine, it's very rare to find. Yes, I feel like in history books, you always just associate that one name. Yeah, Lorenzo made that oil by himself. That's about it. I don't think that's how that story name. Yeah, I mean Lorenzo made that oil by himself. I don't think that's how that story goes. So, he'd be joined the crew and he was growing vats of this mold in like bedpans, like his lab was just covered with all the mold he could grow to get interns to try to overcome this, but obviously there had to be something else to fix this because

this was not going to be reproducible on a mass scale at this point. So a lab assistant Mary Hunt showed up one day with a cantaloupe that she had found, covered in a mold, penicillium, chrysogenium. And this strain yielded 200 times the amount of penicillin that the no-todum did. That's dead. That's way more. So this definitely helped. Now they also at some point started radiating it, which like amped it up to a thousand times more penicillin. So that was probably the even bigger breakthrough. And so they finally figured out how to make enough penicillin to actually be effective to actually have some clinical impact on people. They took it to American

pharmaceutical companies and they began pumping out what was known as penicillin just in time for World War II. And you really saw a difference in rates of death from infection if you look at like World War One compared to World War Two, because in World War Two we were able to use penicillin. In March 1942 and Miller was treated with penicillin, she was the first civilian. And she was in a hospital in Connecticut, in New Haven. She had had a miscarriage and had developed an infection afterwards in Sepsus and was quite, quite sick. And typically at the time, you would expect someone in that

position to not survive and penicillin saved her life. Yeah, right. Yeah, so there's the happy. She's a lot of name, but other than that, pretty good. There's the happy story you wanted. Thank you. Thank you. In 1945, all these people we talked about essentially

got a Nobel Prize for the Discovery, except for Healy. Do you know they left him out? Oh, why? It was just one of those, who knows? They just overlooked it, or his name wasn't on the right paper, or whatever. This was actually, I don't know if write it is the right word, but many decades later they recognized him

with like the first honorary doctorate they'd ever done to kind of make up for leaving him out of the crew out of this, out of this ocean's 11 crew that discovered penicillin. But they won the Nobel Prize. And in his speech, in his acceptance speech, Fleming stood up and said, listen, this is great. And I'm very happy about this. I didn't.

He said something in the effect of like, I didn't know that day in the lab that I had discovered something that was going to change the course of mankind or save lives. There's something very grandiose. But then he turned around and he said, you should also know this won't work forever. Bacteria gets smarter. They do develop resistance over time.

Just because it's killing bacteria now, if we use this too much, if we don't find other ways to treat infections, this won't work for us forever. He warned of this in 1945, just a few short years after we had discovered and started using penicillin. Like, could we kick him for a decade? You just did it. I can't help you guys work. It's good science. It's good. I get it, but like, can we just beat? Can we just be stoked about penicillin for a second?

You came for a second. And then resistance started building. And now let me say, all men is still a problem in 2018. You could have kicked it for a decade and then dropped that on everybody. Let us just like chill out. They were seen resistance by like the late 40s, early 50s. I mean, that's the problem. Like this stuff happens.

The bacteria learn quickly and they grow, they grow and evolve faster than we do. So, This is a fun episode. I'm really sorry. No, it's true. It's good. It's good.

So from there, all other kinds of antibiotics started hitting the market. If you look at the intervening years, you know, different classes. Are they using basically the same idea? I mean, I know biochemistry isn't really your field, but is it? Well, I mean, in terms of how they kill bacteria,

there are different, there are all kinds of different ways that they attack the bacteria. Because some are bacteria's side, all meaning they actually license and kill the bacterial cells. Some are bacteria, static, meaning they'll just stop them from growing. And they target different things within the bacteria, which is why they're used against different infections.

That's why a lot of times I'll have someone ask me, like, well, can't you give me something stronger? I want a stronger antibiotic. And you can't think about antibiotics as stronger and weaker. You have to think about the spectrum of bugs that they kill. There are there are reasons we use certain antibiotics for a pneumonia versus a skin infection versus a urinary tract infection. It's because we know what kind of bacteria are likely to grow there and certain antibiotics work better there. Or maybe that antibiotic gets into lung tissue better, or maybe that antibiotic will penetrate the urine better, that kind of thing.

So it's good not to think there's like a ladder of antibiotics with the strongest one way up at the top and the weakest one at the bottom, and your doctor's picking a weak one because they don't want you to get better or something. It's better to think of it as like a web of antibiotics to treat different things. And that's what we came up with through the intervening years between then and now are all these new antibiotics. But like I said, the problem is bacteria are smart,

they're wily, and they keep coming up with new ways to evade these antibiotics. And nowadays we see a lot of different infections. MRSA, MRSA, being one of the big ones that I see that one in the media the most often. They can cause pretty devastating infections and it's very difficult to treat because only a few antibiotics work against it. There are other ones, Klebsiella, Interibacter, Acinida Bacter, Sutomonas, VR. There are all these different kinds of infections that now are resistant

to lots of antibiotics. So in some cases, there are still a couple of left that will treat them. I have seen cases where there is literally no antibiotic that will treat this infection. Everyone we have, and we still do it the same way. We put little antibiotic, like, circle discs in a petri dish of the bacteria and then see where the growth won't happen.

It's the same kind of thing that, that Fleming accidentally did in his lab. And sometimes the bacteria grows no matter what disc you put on there. So the reason I say this is not to be a bummer. And you're looking at me like I'm a bummer. I'm not trying to be bummer. What I'm saying is over-prescribed mean antibiotics, meaning giving someone an antibiotic that would kill a bacteria when they really have a viral infection, doesn't know one any favors. It's not going to make you any better any faster. It might give you diarrhea. You might get a yeast infection. And also maybe next time that antibiotic won't work quite as well for you. Because what you're doing is you're selecting for those really strong resistant bugs that you that are living there. So over prescribing is a big issue

with this self-administration in the US. It's hard to like go by over the counter antibiotics, but there are a lot of countries where that's not true. You can go by antibiotics at the pharmacy just like you would buy Tylenol or something. And that's very dangerous because then you're relying on, you know, everybody that just kind of know when they have an infection that needs an antibiotic. And you can't

know that. I mean, sometimes even, you know, as a physician with all of the years of education and training I have, sometimes I'm having to make educated guesses and based on my experience and my knowledge and do the best I can with that information. There's no way you can do that on your own. just every time you have a runny nose, think, well, I know I need a Z pack and go buy one over the counter. So that's really dangerous. And then obviously there are antibiotics in our environment. There in our water, in our soil, in our food, in our toothpaste, in our milk.

The milk I bought today, I had to get the drug store, so I didn't have a lot of options. The milk I bought today said I was looking because I was like, what about antibiotics? I looked on there and it said, tested franabotics. It's like, hmm, well, okay. Okay, that's, I mean, it's a start.

We look for them. Yeah, we look for them. And then they just like stare at me blankly. Like, yeah, we, oh no, we don't know. We look for them. Yeah, we look for them. And then they just like stare at me blankly. Like, oh no, no, no, we tested it for antibiotics. They're looking at you going, do you want to know? Do you really want to know? Yeah.

But the important thing to know is that, there's still plenty of antibiotics that work. Obviously, they're still powerful against most infections. And we're still working to try to come up with new ones and new ways of treating infections, but we should all be better stewards of antibiotics. People in the medical profession, and then all of us as patients, because sometimes I'm the patient, to know that, you know what, sometimes you feel so lousy and you think, can't you just give me something to make me feel better. you feel so lousy and you think, can't you just give me something to make me feel better? And unfortunately, sometimes the answer is, no, I can't, there isn't anything

that's gonna make you feel better faster. You will get better, but you're just gonna have to wait it out. Go home and rest, don't go to work, don't go to school, get in bed, get some tissues, watch some Netflix, and eat some chicken soup. Folks, that's gonna do it for us this week. Thank you so much for listening.

Thanks to the taxpayers for letting us use their song Medicines is the intro and outro of our program. Thanks to Max Fennel, who are for having us as part of their extended podcasting family. And thank you to you at home for listening to our program. Hey, if you haven't checked out quarter pointed yet, that's the show that Sid does, or sorry, Sid's dad does with Sidney's uncle, Michael,

who is a real actual lawyer. A real actual lawyer, it's a show about law stuff and I'm gonna be on a new episode. There's probably out. Monday. Monday, about net neutrality. So if you're interested in that topic or want to hear me blow the eight on a different format, then go check that totally out. So until next week, my name is

Justin McRoy. I'm Cindy McRoy. And as always, don't drill a hole in your head. Alright! Maximumfund.org Comedy and Culture, Artistone Listener Supported Listener supported.