Wednesday, April 16, 2008

Fevers, Delhi Doctors and WWW

Has the internet robbed doctors of their credibility?

A few days ago our daughter started complaining about painful ulcers in her mouth, which soon aggravated into a high fever and a runny nose.

Dr. Y examined her mouth, hands and feet and pronounced that these were the signs of a Cocsackievirus infection, which she probably got from her pre-school - a consequence of putting unclean hands into the mouth. He suggested some medicines -
  1. Zorivax - Aciclovir IP 400mg (5ml*four-hourly*5days)
  2. Nutrolin-B: (5ml*twice daily)
  3. Alerid - Cetirizine Hydrochloride(3ml*twice daily)
  4. Ibugesic (3.5ml, in case of high fever)

At a review two days later we informed him that the fever had abated but the ulcers had worsened. She could not open mouth now; the pain prevented her from sleeping and from eating or drinking anything except water.

The doc now said the problem is Aphthous Ulcers. He removed Alerid from the list and added two syrups:
  1. Enhancin - BD Amoxillin+Clavulanate Pottasium USP (5ml* twice daily * 5 days)
  2. Metrogyl -Metronidazole Benzoate Oral Susp. IP (2.5ml *twice* 5 days)
After spending a few sleepless nights tending to a distraught child, and while spending loads of money on consultation fees and medicines, you just wonder - was the medical consultation really worthwhile?

Skepticism gets compounded by the information available on the internet. Online pages like KidsHealth tell you that this infection is hardly preventable; there is no vaccine; drugs can only give marginal relief and that, in any case, the infection will blow over in a few days.

Why , then, did the doctor prescribe an anti-histamine (Cetirizine hydrochloride) ? Why give two separate moderate-spectrum antibiotics - Amoxicillin and Metronidazole Benzoate on top of an anti-viral (Aciclovir)?

We can only conclude that pediatrician was playing safe with his antibiotic shotgun - the medical equivalent of "spray and pray". It may not help sick children but it certainly helps keeps the pharmaceutical companies in the pink of health...
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