Adrienne
Well-known member
If there does not seem to be a difference whether people take them or don't take them, why are they still recommended for high-risk people?
Do you agree with the new prophylatic guidelines?
- Thread starter LUVMyBirman
- Start date
Help Support Valve Replacement Forums:
http://www.ccs.ca/download/position_statements/11187_embi.pdf
As a follow up to Bob H's post, the following commentary (see link) helped clarify for me the rationale for the new AHA guidelines.
As a follow up to Bob H's post, the following commentary (see link) helped clarify for me the rationale for the new AHA guidelines.
I know it's pretty irrational to take a medicine that doesn't show a clear benefit, but... I love the placebo effect. Ignorance is bliss my friends. I've been told since I can remember to take a pre-med or else something crazy might happen to my heart, so it'll be on the back of my mind if I don't.
Not to mention the entire dentist's office won't touch my teeth unless I've taken my premeds. One time when they asked I told them that I failed to take the meds because I didn't care and they rescheduled my appointment.
Not to mention the entire dentist's office won't touch my teeth unless I've taken my premeds. One time when they asked I told them that I failed to take the meds because I didn't care and they rescheduled my appointment.
B
Bridgette
I would have thought that in a society where medical litigation is rife, that most dentists would give you the antibiotics anyway because they'd be scared of being sued in the event of a mishap.
When I have dental work done my dentist just writes me the prescription beforehand.
When I have dental work done my dentist just writes me the prescription beforehand.
................One time when they asked I told them that I failed to take the meds because I didn't care and they rescheduled my appointment.
Your dentist was wiser than mine. One time I told my dentist I forgot to take medication, he gave pills from his office and worked on my teeth. Believe it or not, I felt terribly bad after that and never went back to where I was before the dental work...it was not in my head nor a co-incidence!!!
Braveheart
Well-known member
I recently had a tooth extracted, and a cleaning. I am going in for a colonoscopy in a couple of weeks. Both doctors, aware of the new guidelines, said that they would not premedicate me.
My husband has had serious sinus problems over the years, and had often been given antibiotics. Possibly, as a result, he has had a couple of nasty bouts of MRSA, one which nearly did him in. He had to take 20 rounds of IV cubicin, when even vancomycin did not control the MRSA.
I am comfortable with taking my chances with not pre-medicating.
My husband has had serious sinus problems over the years, and had often been given antibiotics. Possibly, as a result, he has had a couple of nasty bouts of MRSA, one which nearly did him in. He had to take 20 rounds of IV cubicin, when even vancomycin did not control the MRSA.
I am comfortable with taking my chances with not pre-medicating.
acr
Well-known member
I had a dental procedure yesterday, and for peace of mind I took the meds. Appreciate that they're potentially useless but I'd rather take 'em than not, not wishing to take extra risks.
Found this really interesting piece of reading, its a response to the UK NICE regulations. Apparently 91% of surveyed members of the Society for Cardiothoracic Surgery of Great Britain and Ireland disagree with the new no-meds rule.
http://www.anticoagulationeurope.org/disagreeNICE.html
Found this really interesting piece of reading, its a response to the UK NICE regulations. Apparently 91% of surveyed members of the Society for Cardiothoracic Surgery of Great Britain and Ireland disagree with the new no-meds rule.
http://www.anticoagulationeurope.org/disagreeNICE.html
Not "new"
Not "new"
These guidelines are from 2007, aren't they?
They're not exactly new, then -- unless you haven't been to a dentist or had any kind of "invasive" procedure since prior to these guidelines being adopted.
In 2007, our dentist, cardiologist and family doctor all said that the AHA had changed its guidelines on premedicating before procedures. All said they wanted both John and me to continue premedicating.
It's easier to diagnose endocarditis than it is to determine if you would have gotten it without premedication. I choose to continue premedicating, since it's cheaper than treating endo and possibly having another MVR.
Not "new"
These guidelines are from 2007, aren't they?
They're not exactly new, then -- unless you haven't been to a dentist or had any kind of "invasive" procedure since prior to these guidelines being adopted.
In 2007, our dentist, cardiologist and family doctor all said that the AHA had changed its guidelines on premedicating before procedures. All said they wanted both John and me to continue premedicating.
It's easier to diagnose endocarditis than it is to determine if you would have gotten it without premedication. I choose to continue premedicating, since it's cheaper than treating endo and possibly having another MVR.
I premedicate before all dental procedures and will continue to do so.
Hey, it's worked for almost 18 years.
Oral medication is so simple, sure beats the IV I used for a few years after AVR.
My dentist always asked if I'm premedicated, it's his prescription.
Hey, it's worked for almost 18 years.
Oral medication is so simple, sure beats the IV I used for a few years after AVR.
My dentist always asked if I'm premedicated, it's his prescription.
Adrienne
Well-known member
There is another thing I was thinking of. The change in the guidelines are aiming at cutting down antibiotic use so that the whole population is protected from resistent bacteria. I do agree that doctors give out far too many antibiotics to people begging for them because they have the sniffles or something (in which case it does no good anyway). In any case, what I am trying to say is that the people who wrote up these guidelines are trying to get the best solution for the whole population, but not necessarily the best solution for an individual patient at risk. This is my opinion in any case.
LUVMyBirman
Well-known member
Your correct Marsha, they are not new. But....newer. If this is something you have been dealing with for life.
Yes, could you imagine having another valve replacement or a family member of going through that? I just don't believe in the new guidelines. Afterall, if there was no benefit in taking the pre-meds.....that would be status quo for all, not just heart valve recipients.
Yes, could you imagine having another valve replacement or a family member of going through that? I just don't believe in the new guidelines. Afterall, if there was no benefit in taking the pre-meds.....that would be status quo for all, not just heart valve recipients.
Hey Gina:
Love your photo. Was that from the St. Louis reunion last month???
Love your photo. Was that from the St. Louis reunion last month???
Philip
Well-known member
I have not read the new guidlines but I have had endocarditis; it was a much more challenging than valve replacement and the chance of death was much higher. I will accept the risk of antibotics even if there is only minimal proof that they work. Endocarditis is nasty stuff!
Philip
Philip
My guess is that over the next decade, you'll see the rest of the recommendations disappear or almost disappear.
I believe they have kept the ones they have now because it is too difficult to argue with people who are convinced it works (including some of their own), they do not want to deal with lawsuits that they pay to defend (even if they win) - which ratchet up their malpractice insurance costs, and because they don't want to look like complete idiots, as they have been espousing this method for decades without any proof of effectiveness at all.
For a parlor game, have some friends list out things that the health and medical establishments have said were good - or bad - for you that turned out to be untrue. It can keep you occupied for quite a while, especially if you have some folks there who were old enough to remember the health ads and warnings of the 1950s and '60s, the time when the use of "prophylactic antibiotics" was dreamed up.
MRSA is only one of the unpleasant and dangerous side effects that can occur because of frequent antibiotic use. Older and chronically ill people have the effectiveness of antibiotics in their bodies impaired, allowing them to get opportunistic infections that their bodies can no longer fight even with the help of newer antibiotics. Unfortunately, the notion that there will always be a new antibiotic to counteract the superbugs created by wanton antibiotic abuse is badly faulty. Several drugs that have only been out a couple of years have already proven ineffective against yet newer versions of the bugs they were developed to stop. And there's not much new in the pipelines. We're at risk, and worse: our children and grandchildren are at risk.
Best wishes,
I believe they have kept the ones they have now because it is too difficult to argue with people who are convinced it works (including some of their own), they do not want to deal with lawsuits that they pay to defend (even if they win) - which ratchet up their malpractice insurance costs, and because they don't want to look like complete idiots, as they have been espousing this method for decades without any proof of effectiveness at all.
For a parlor game, have some friends list out things that the health and medical establishments have said were good - or bad - for you that turned out to be untrue. It can keep you occupied for quite a while, especially if you have some folks there who were old enough to remember the health ads and warnings of the 1950s and '60s, the time when the use of "prophylactic antibiotics" was dreamed up.
MRSA is only one of the unpleasant and dangerous side effects that can occur because of frequent antibiotic use. Older and chronically ill people have the effectiveness of antibiotics in their bodies impaired, allowing them to get opportunistic infections that their bodies can no longer fight even with the help of newer antibiotics. Unfortunately, the notion that there will always be a new antibiotic to counteract the superbugs created by wanton antibiotic abuse is badly faulty. Several drugs that have only been out a couple of years have already proven ineffective against yet newer versions of the bugs they were developed to stop. And there's not much new in the pipelines. We're at risk, and worse: our children and grandchildren are at risk.
Best wishes,
LUVMyBirman
Well-known member
Hi Marsha,
Yes, thank you. That was STL down by the river boat. Spur of the moment snap shot.
Pleasant day taking my family member to the dentist. They would not touch it without the pre-meds. Stated, if it were their very own family.. they would do the same. Now that we are estabilshed. No worry about the prescription. I did not even make a fuss. Went with the flow. It was almost like they read my thread
An example was used of folks on maintenance antibiotics for acne. Nothing close to taking pre-meds twice a year for a dental cleaning. I guess we could talk about this until the cows come home. As myself and others have noted, think about kids with the sniffles and parents demanding antibiotics. They pass them out like candy. My young niece had a minor "start" of an ear infection today. What did the DR. prescribe? Amox ASAP. Imagine the millions of rxs written daily for just that. Something that can be cured with a homeopathic drop. Been there, done that. There was a guideline I read somewhere about haulting antiboitics for such. Oh, and BTW...this was the same Dr. that refused the pre-meds for an obvious risky cardiac condition! What a shame.
Yes, thank you. That was STL down by the river boat. Spur of the moment snap shot.
Pleasant day taking my family member to the dentist. They would not touch it without the pre-meds. Stated, if it were their very own family.. they would do the same. Now that we are estabilshed. No worry about the prescription. I did not even make a fuss. Went with the flow. It was almost like they read my thread
An example was used of folks on maintenance antibiotics for acne. Nothing close to taking pre-meds twice a year for a dental cleaning. I guess we could talk about this until the cows come home. As myself and others have noted, think about kids with the sniffles and parents demanding antibiotics. They pass them out like candy. My young niece had a minor "start" of an ear infection today. What did the DR. prescribe? Amox ASAP. Imagine the millions of rxs written daily for just that. Something that can be cured with a homeopathic drop. Been there, done that. There was a guideline I read somewhere about haulting antiboitics for such. Oh, and BTW...this was the same Dr. that refused the pre-meds for an obvious risky cardiac condition! What a shame.
CThrock
Well-known member
I rather be safe then sorry! So I take my premeds, I have even before OHS because had other issues too.
B
Bridgette
Yeah, taking antibiotics once or twice a year for dental treatments hardly constitutes "antibiotic overuse".
Bob and a few others don't believe in taking them, so they don't, but others on here wish to take them so they do. It's up to the individual - and their choice should be respected, not criticised, with a whole heap of articles and studies posted. A bit like valve selection threads, LOL.
Bob and a few others don't believe in taking them, so they don't, but others on here wish to take them so they do. It's up to the individual - and their choice should be respected, not criticised, with a whole heap of articles and studies posted. A bit like valve selection threads, LOL.
It is up to the individual and their doctor at this point. That's fine with me.
Just to unhook some things, though, the point is not how bad IE is. It's very, very bad. No one disagrees with that. No one.
It's just that there's no data that says that taking the premeds prevents it. No data out of 50 years of data.
This is like saying that meningitis is very bad, so you must drink a bottle of Yoo-Hoo chocolate every time you go to the park. Why? Because meningitis is bad...
Best wishes,
Just to unhook some things, though, the point is not how bad IE is. It's very, very bad. No one disagrees with that. No one.
It's just that there's no data that says that taking the premeds prevents it. No data out of 50 years of data.
This is like saying that meningitis is very bad, so you must drink a bottle of Yoo-Hoo chocolate every time you go to the park. Why? Because meningitis is bad...
Best wishes,
pamela
Well-known member
Patients who've had valve replacement are in one of the top groups recommended for antibiotic prophylaxis.
