Bacteriostatic doesn’t mean “ineffective”

I hear some wacky stuff come out of the mouths of pharmacists sometimes, and it makes me sad, because they should know better. One recent gem, said to a technician was “Well Zithromax doesn’t actually kill the infection. It’s a bacteriostatic drug, so it doesn’t really do anything. Why waste your money? Amoxicillin’s the same way.”

My blood pressure went up a few points — at least they didn’t say it to a patient.

Bacteriostatic doesn’t mean that it doesn’t work. It also doesn’t mean that you’d be just as well off taking sugar pills. In fact, there are relatively few bactericidal drugs out there, and most of them are the nuclear bombs of the antibacterials: fluouroquinolones, vanco, rifampin, linezolid, and so on. The majority of oral antibiotics that are filled on a daily basis are, in fact, bacteriostatic.

And guess what? It doesn’t matter. Bacteriostatic drugs hold the infection in check while the immune system clears it out. I thought this was common knowledge; I guess I was wrong. Of course there are instances when this isn’t good enough. Those are the minority of circumstances, however. Infections don’t usually need to be killed. That’s why we have an immune system.

9 thoughts on “Bacteriostatic doesn’t mean “ineffective”

  1. Sounds like some stupid shit a first year resident would say.

    Cause really… are you at risk for sepsis? Are you septic? If not, then go all other avenues first. PLEASE.

    I work pedi intensive are, usually we go 3rd or 4th generation cephalosporin, or amp, before we head anywhere near the drugs you mention at the end of your post. They are much more toxic, and scary if not used properly.

    And you can bet there are pharmacists, nurses, doctors, and others tellings people that with all the scary completely untreatable killer bacteria out there, that we need to treat everyone with our strong more broad spectrum antibiotics that bacteria have as yet little resistance to.

  2. Well gee, coumadin doesn’t dissolve clots when you have DVT or LV thrombus, so guess it shouldn’t be used either.

  3. Hi,

    Why don’t you move to scienceblogs.com. You will have more readers there.

    I’m not smrt enough. No, but seriously, scienceblogs.com is owned by Seed magazine which is a real honest-to-goodness print publication. I have written professionally in the past, and I’m really not interested in doing that anymore. Not for a lay audience, anyway.

    Besides, I don’t think I have enough letters after my name to qualify… :p

    Sounds like some stupid shit a first year resident would say.

    Some of these folks have been out of school for… quite a while. And they work in a really busy store with folks full of entitlement issues. They spend most of their time just trying to keep their heads above water in terms of script output. They really are just dispensers.

    I think I could shoehorn Maslow’s heirarchy of needs in here quite nicely if I tried…

    Cause really… are you at risk for sepsis? Are you septic? If not, then go all other avenues first. PLEASE.

    Let’s blow that otitis media out of the water with some moxifloxacin. Rawr!

    Well gee, coumadin doesn’t dissolve clots when you have DVT or LV thrombus, so guess it shouldn’t be used either.

    Haha.

    Btw, when are you going to start blogging?

  4. Bacteriostatic is a good thing when you want to just stop the growth of the bacteria and not actually lyse the cell wall, as in the case of alot of gram negative bacteria. Doing so will release toxins from inside the cell wall and you’ll have alot more problems than you started with. Letting the immune system take down the bacteria.

  5. That image you linked to doesn’t just make baby Buddha cry, it gives puppies and kittens (and everyone else, maybe) horrific nightmares. If you like the corset look, then wear a corset. Gah, the horror.

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