Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
Some thoughts I'd like to pass on to you. Due to scheduling
problems, this week I'll be working 16 straight hours, then
return the next morning for 8 more. Still, it's not as bad as
residents who work 36 straight hours without a rest.
Also, often we doctors are forced to internalize very
difficult situations. I personally can deal with body fluids
and doing procedures to people, but seeing a young soldier
with a family, who was killed in Shechem, or a 16-year-old
girl who died on the operating table after a fierce motor
vehicle accident, still seems to affect me for a long time
afterward. Somehow, we kiss our children in the morning and
go off to get involved in people's lives that we don't know,
and try our best to make better what is often a losing
battle. I am for sure not complaining, but I just wanted you
to see the other side.
A correspondent from Jerusalem who did not identify himself
as a physician objected to my saying Augmentin is a wise
choice for pneumonia and strep. He felt that this is
misleading, as they are not the drugs of choice for these
maladies. I'd like to speak on this subject.
First, finances as my readers know, are and always have been
a problem in Israel. I feel a medical column with accurate
information geared to the layman is very important, but it
would not be possible without the sponsorship our sponsor
provides. Glaxo, the world's largest pharmaceutical firm, was
a pioneer to realize that this column is an excellent way to
reach a large sector of the Israeli population that they
could otherwise not reach. As such, I am grateful for their
support for this column over the last two years and they will
continue this year as well.
However, they do want you to know about their medications.
Some of their medications are the drugs of choice for their
indications -- such as Ventolin for asthma. Some are not the
first line but are drugs that I really believe in, such as
Zyban for smoking. Others are the only ones for their
indications, such as Zeffix for liver disease. And of course
there are some that I am less enthusiastic about but
nevertheless I must mention them. Still I really believe I do
not mislead or falsely advertise.
So the facts on Augmentin. Augmentin is a strong antibiotic
that is not the drug of choice for most indications. The
reason is because it is more broad spectrum and more
expensive than a lot of alternatives. On the other hand, it
rarely fails that Augmentin is a wise choice, meaning it
performs well while not being the first choice in pneumonia
and strep throat.
Augmentin is the first choice in dog bites, cat bites, and
complicated infections, especially in diabetics. Many
physicians also feel it should be used the in elderly, where
ability to fight infection is diminished. For strep that does
not respond to penicillin, Augmentin succeeds, although other
choices are available and there is some controversy about
what penicillin-resistant strep is.
I hope this clarifies the situation. I do not like being an
ad man, but there is no choice at the moment and we should
all appreciate what Glaxo has done for us. No other
frum English periodical has a physician column like
ours. Write me in care of the Yated.
