the frontier of medicine - antibiotics

Recently whilst on a placement in ICU, I was faced with the overwhelming sight of the frontier of medicine, where medical knowledge ends and the unknown begins! It is a scary feeling sitting in a meeting watching doctors put their hands in the air as to the decision for a patients diagnosis and therefore treatment plan. Asking questions yourself that no one can answer. It leads you to reflect on the evolution of medicine, seeing patients transferred to the ward, conscious and breathing that if they had presented to hospital a year earlier than they did, may not have lived. Another scare I got whilst on this placement, is the theory and practice behind antibiotics. So many people I know take antibiotics at the drop of a hat, without thinking about what they are actually doing. Antibiotics provide the body with the tools to fight bacteria. If the bacteria is known the antibiotic can be specific. If not a broad spectrum antibiotic is used. I recently attended an information session about antibiotics and their use. They are very relevant to the acute respiratory treatment of patients. You don't find the right antibiotic then the chest can deteriorate and our work becomes harder. The greater the use of antibiotics, the more exposure the bugs have to our fighting weapons, the more chance they have at developing resistance. We only have one more known type of antibiotics left, this is all we have up our sleeve at the moment should bacteria develop, as they have begun to, resistance to all other types. Bacteria are mutating, resisting and killing people in ICU everyday, and all we have left is one type. A back plan of one type. Whoever is given the job to decide when it is appropriate to crack open the last vile of this antibiotic has a challenge at hand. The world of tiny bacteria is huge and scary. I believe antibiotic therapy in the community should be more conservative. We are showing off our weapons too readily to the bugs and may eventually loose the war!