As I wrote last time,
doctors treat strep throat with an antibiotic. Does it work?
That seems a no-brainer because
antibiotics definitely kill strep bacteria. But the answer turns out to
be….maybe. In scientific studies, giving antibiotics to patients with strep
throat is not dramatically effective. Some doctors suspect they don’t work.
This contrasts vividly with treating strep infections in other areas such as
the skin where it’s often obviously lifesaving.
“Wait a minute!!” assert
experts including my professors in medical school. It’s true that strep throat
goes away in three to five days even if not treated, but doctors must treat in
order to prevent rheumatic fever, a disease that can produce devastating heart
disease. Scientists don’t understand why, but a small percentage of strep
victims go on to develop rheumatic fever. Antibiotics lower the risk.
Are they right? Again
science delivers the answer: maybe. Evidence for preventing rheumatic fever in
America comes from a study conducted sixty-five years ago when rheumatic fever
was common. It’s rare now. I’ve never seen a case. Everyone agrees it wasn’t a
terrific study.
Some doctors believe that
rheumatic fever is so rare in the US that giving an antibiotic is more likely
to cause harm (yes, antibiotics can cause harm) than benefit.
While it’s fun to make
controversial statements in this blog, with patients I stick to the standard of
practice. This means I sometimes give treatments whose scientific basis is
weak. If you prefer therapy that’s guaranteed, you must stop seeing scientific
practitioners like me and seek out alternative or complementary healers. Google
“alternative medicine.” You’ll notice
that their treatments always work.
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