Tincture of Time By: Sasha Klemawesh, MD
In the preceding article I mentioned how antibiotics became accepted as standard treatment for diverticulitis; doctors considered which pathogenic bacteria would typically invade the gut, and drew a logical conclusion that if the colon was infected, then Cipro/Flagyl would treat it. The practice had staying power because patients seemed to get better while on said treatment. However, like many other entities commonly “treated” with antibiotics, it is not the antibiotic that is making the patient better, it is so-called Tincture of Time; the issue either has an inherently discrete duration and/or the patient’s body heals itself. It just seems like the antibiotics are helping because those two things coincide. This same phenomenon is the reason that so many people swear they MUST be prescribed a Zpack for their mild URI, or some Amoxil for their sinusitis. Both of those illnesses are far more commonly due to a viral trigger than bacterial, but because lazy doctors write for Zpacks at the drop of a hat, patients come to expect it. This is not good medical practice and is the reason for so much of the antibiotic resistance we have accrued in the US. While just like in diverticulitis, there is a role for antibiotics in certain cases of sinusitis or bronchitis, withholding them should be the rule for 90% plus of the cases, not the exception. So next time a doctor “refuses” to give you your precious Zpack, please know that it is more work for them to not simply acquiesce to your request, and thank them for actually having your best interest in mind.