Tag Archives: antibiotics

Chronic Lying Disease part 2

ByjnKcqCcAABtXL[1]In Treatment wars: Chronic Lying Disease we noted a regrettable tendency of quacks to promote the fictional “chronic Lyme disease”.

Note that there is nothing fictional about the symptoms, but as you’ll see in a moment they are generally either (a) hopelessly generic – “symptoms of life” if you will or (b) caused by something else.

Nor is there anything fictional about Lyme disease. It is real, a tick-borne infection caused by the borrelia burgdorferiW bacterium (in the US) or a close relative (in th Europe). The symptoms are characteristic – erythema migrans, a bull’s-eye rash – and the infection can be confirmed pathologically by blood test.

And indeed there is a real thing called post-Lyme syndrome, or post-borrelia syndrome, or “Lyme arthritis”, which is characterised by fatigue and muscular pains, especially, in patients who have had Lyme disease.

No, the fictional disease is chronic Lyme disease, which is a disease diagnosed by quacks and treated using quack treatments, especially long-term antibiotics (ironically WDDTY also fulminates against antibiotics, but promoting mutually contradictory ideas in the same story has never been a problem for the editors).

Continue reading Chronic Lying Disease part 2

100 ways to live to 100: 10 situations that don’t usually require a doctor

Part of a series on WDDTY’s “free” advertorial report “100 ways to live to 100

10 situations that don’t usually require a doctor

If there’s one thing you can rely on doctors telling you, it’s when you don’t need a doctor. They are about as keen to see people with the common cold as WDDTY is to see evidence that vaccines are safe and effective. And in both cases, that doesn’t stop it happening, all the time.

61 Backache

Some 80 per cent of us suffer from back pain, but medicine doesn’t offer much besides potentially dangerous surgery (which leaves only a quarter of patients free of pain) and drugs. In most cases, an osteopath, chiropractor or Alexander Technique practitioner can sort you, as can exercise.

Let’s unpick that. If medicine cures back pain by surgery, that’s evil. If medicine gives drugs to manage the pain, that’s evil. If medicine recommends exercise and physiotherapy, that’s ignored because it would undermine WDDTY’s pretence that these are “alternative” and thus the sole preserve of quacks like their advertisers.

Why don’t doctors tell you that Alexander Technique works for low back pain? They do. They also recommend osteopathy and chiropractic, but there are severe problems with both these fields, due to the prevalence of crank ideas. Osteopaths need to discipline and exclude charlatans who practice “cranial osteopathy”, and chiropractors need to recognise that there is no evidence that chiropractic works better than evidence-based manipulation therapy, and substantial evidence of actively dangerous practices such as cervical spinal manipulation, potentially leading to stroke, bullshit claims to treat ear infections, asthma and other things unrelated to the musculoskeletal system, anti-vaccination propaganda, and of course the big scam: never discharging a cured patient, but instead trying to sell them an indefinite course of worthless “maintenance”.

If you have back pain, see your doctor, they will recommend the most appropriate treatment. Which might be surgery, drugs, exercise or some form of physiotherapy. Unlike WDDTY’s advice, this won’t be based on dogma or pleasing the advertisers, it’ll be based on the best currently available evidence.

62 Earache

Shout it loud: antibiotics just don’t work for earache. Nor does removing adenoids fix glue ear.39 Instead, try time, mullein oil, a woolly hat, a hot-water bottle, homeopathic Pulsatilla,40 osteopathy or auricular therapy (acupuncture of the ear). Before having grommets inserted in your child’s ear, cut down his fat and sugar, and investigate food or airborne allergies as the potential cause.

Reference 39a: JAMA, 2006; 296: 1235–41 Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled trial. Spiro DM, Tay KY, Arnold DH, Dziura JD, Baker MD, Shapiro ED.

Reference 39b: BMJ, 2004; 328: 487 Adenoidectomy versus chemoprophylaxis and placebo for recurrent acute otitis media in children aged under 2 years: randomised controlled trial. Koivunen P, Uhari M, Luotonen J, Kristo A, Raski R, Pokka T, Alho OP.

Reference 40: Ullman D. Discovering Homeopathy: Medicine for the 21st Century. Berkeley, CA: North Atlantic Books, 1991; AHZ, 1985; 230: 89–94

If you follow this advice, a repeat of a recent and particularly dreadful article,  you’ll have to “shout it loud” because your child may be deaf.

The standard of care is watchful waiting, but adenoidectomy may be indicated in the presence of both glue ear and persistent nasal symptoms. Antibiotics work as a primary treatment for bacterial ear infections. Most children will grow out of them in time, but leaving the infection untreated when treatment is indicated, on ideological grounds as WDDTY propose, is perverse.

HomeopathyW has three problems: first, there’s no reason to think it should work; second, there’s no way it can work; and third, there’s no proof it does work. Of all alternatives to medicine, it is the most thoroughly debunked. Its doctrines were refuted over a century ago and its only real value now is as a litmus test for lack of critical thinking. A test WDDTY fails on a truly epic scale.

Dana Ullman, the cited source, is a high priest of the cult of homeopathy, he is a proven liar who claims Darwin and Nightingale for homeopathy despite their well documented contempt for it, and is responsible for propagating the lies that Montagnier’s work proves homeopathy and that the Swiss Government found it safe and effective. His propagandising for homeopathy knows no bounds. Each new publication by a True Believer is presented as the final clinching proof of homeopathy, and when it’s shown to be flawed or fraudulent he merely moves on to the next, occasionally repeating the old ones if he thinks nobody will notice. His self-promotion and steadfast denial of reality got him banned from Wikipedia.  There’s even an eponymous law: the Dull-Man Law. In any discussion of homoeopathy, being Dana Ullman loses you the argument – and gets you laughed out of the room.

AcupunctureW is also nonsense, though it is only recently proven to be completely useless. Auricular acupuncture has absolutely no basis in fact and lacks even the marginal credibility of acupuncture. The ear looks a bit like a baby, therefore the bits of the ear correspond to the organs that would be there if it was a baby. No, not even vaguely sensible.

63 Infection

For common and non-serious infections, try Echinacea, essential oils like clove, lavender, lemon, marjoram, mint, niaouli (Melaleuca), pine, rosemary and thyme oils, and goldenseal, manuka honey, tea tree oil, good old garlic and cranberry, all of which are powerful alternatives to antibiotics.

Alternatives they may be. Effective? Not so much. There’s some evidence of manuka honey as a topical antibiotic but why on earth would you not use antibiotics? They work very well, are generally well tolerated, and they have saved countless millions of lives.

This references a May 2013 article, we’ve added it to the work list.

64 Just-in-case checkups, particularly if you’re aged over 50

If you have nothing particularly wrong with you, going to the doctor won’t necessarily protect but is likely to unleash the entire arsenal testing apparatus have you leaving prescription (or three) in your hands.

So let’s get this straight: it’s wrong to see your doctor in case he finds something wrong with you.

Er, right.

65 Menopause In most cases, holistic measures

In most cases holistic measures (diet, homeopathy, herbs) will help you through the change in a safer way than using hormone replacement therapy (HRT), which continues to be discredited, despite protestations by doctors, because of a link with breast cancer.41 Our medical detective Dr Harald Gaier has had greater success with Phytoestrol N (which contains rhubarb root) than most of the popular herbals for menopause.

Reference 41:  Am J Public Health, 2010; 100 [Suppl 1]: S132–9 Decline in US Breast Cancer Rates After the Women’s Health Initiative: Socioeconomic and Racial/Ethnic Differentials Nancy Krieger, PhD,corresponding author Jarvis T. Chen, ScD, and Pamela D. Waterman, MPH.

HRT was discredited years ago, when it was shown not to protect against coronary heart disease but instead to promote it. Well-informed doctors don’t push it unless the symptoms of menopause are extremely bad, or for very early menopause or occasionally hysterectomy.

Homeopathy doesn’t work. Herbs may or may not (remember that a herbal remedy is basically an unknown dose of a potentially pharmacologically active compound with unknown impurities). The source for Harald Gaier’s success stories is Harald Gaier – WDDTY seem to think that blatant conflict of interest is fine as long as the message is ideologically acceptable.

66 Chronic but non-life-threatening conditions

Eczema, psoriasis, non-life-threatening asthma, arthritis and the like generally respond better to alternative measures than drugs, which only suppress symptoms. Check out the alternatives before resorting to lifelong drug use.

Few things are more infuriating than the claim that medicine “only suppresses symptoms” so alternatives are better.

Alternatives do one of two things: suppress the symptoms less effectively and less predictably, or nothing.

There are no alternatives which cure chronic conditions. If there were, they would no longer be alternative (Minchin’s Law).

The easiest way to demonstrate how wrong this advice is, is with a simple case study of one of the “non-life-threatening conditions” listed: eczema.

A couple whose baby daughter died after they treated her with homeopathic remedies instead of conventional medicine have been found guilty of manslaughter.

Gloria Thomas died aged nine months after spending more than half her life with eczema.

The skin condition wore down her natural defences and left her completely vulnerable when she developed an eye infection that killed her within days of developing.

And it’s not the only case. It’s extremely clear that the very last thing you should do when faced with a chronic condition is to consult an “alternative” practitioner, who will follow an ideologically-determined path with no provable value to you, for profit.

67 Slimming

All doctors usually have to offer are drugs and calorie counting, which aren’t long term solutions, and numerous slimming drugs have potentially fatal side-effects. Look first for potential food intolerances, get your thyroid checked out, clean up your diet, and opt for low-GI foods and lots of fruit and veg.

The GI diet was developed by doctors. It’s recommended by doctors, who also recommend exercise and weight management clinics. Oh, and they can also refer you for lap band or other surgical interventions which have a reasonable success rate in the chronically obese who are not compliant with diet regimes. Doctors are also pretty good at spotting thyroid problems.

In the end, though, there is only one diet that is proven to work 100% of the time: the ELEM diet. Eat less, exercise more. Every reputable doctor in the UK, and probably the world, will tell you the same. WDDTY seem to prefer nutritionists who generally have no recognised qualifications whatsoever but nevertheless often sell miracle or fad diets.

68 Colds and flu

Unless you’re elderly and your immune system is compromised in some way, there’s nothing your doctor can give you (or your children) to end a cold or flu, which is usually caused by a viral infection (against which antibiotics mostly don’t work). Bed rest and plenty of fluids, plus zinc, Echinacea, Pelargonium sidoides, Andrographis paniculata, vitamin C and probiotics can all shorten the life of a cold (see WDDTY December 2013).

We’ve critiqued these claims recently. No reputable doctor prescribes antibiotics for uncomplicated viral illness. WDDTY’s view of current medical advice seems to be 20 years out of date and from another continent.

69 Fever

Heat is the body’s extremely clever method of killing foreign invaders of all varieties, and taking anti-inflammatories and other drugs to lower your temperature just hampers that process. Allow your body to self-help by not interfering with a fever unless it’s so high that it may cause permanent damage. Fevers for ordinary viral and bacterial infections won’t exceed 105 degrees F (40.5 degrees C), which generally isn’t dangerous. But see a doctor immediately if you suspect a serious problem like meningitis.

WDDTY don’t seem to know the difference between anti-inflammatories and antipyretic|antipyreticsW. As it happens, Clay Jones at Science Based Medicine recently wrote a much more nuanced piece on fever, in the context of acute cases in hospital, which seems to be the situation WDDTY are considering.

As it happens, Clare Gerada, chair of the Royal College of General Practitioners, recently tweeted a much more pragmatic piece by an actual doctor. Why would you allow your child to suffer the symptoms of fever, if a cheap and safe drug can bring them relief and let them at least get to sleep?

70 Acne

All your doctor can offer are drugs with horrendous side-effects; isotretinoin, marketed as Accutane and Roaccutane, can cause permanent damage to the cornea, impaired hearing, fatal pancreatitis, depression and even suicide.42 Try changing your diet, balancing your blood sugar and identifying any food intolerances first, then look to acupuncture, shown to help in 80 per cent of cases, or herbs like the Ayurvedic herb guggul (Commiphora wightii).43

Reference 42a: Arch Dermatol, 2012; 148: 803–8 Ocular Adverse Effects of Systemic Treatment With Isotretinoin Meira Neudorfer, MD; Inbal Goldshtein, MSc; Orna Shamai-Lubovitz, MD; Gabriel Chodick, PhD; Yuval Dadon; Varda Shalev, MD

Reference 42b: Am J Ther, 2004; 11: 507–16 Polar hysteria: an expression of hypervitaminosis A. O’Donnell J.

Reference 43a: J Tradit Chin Med, 1993; 13: 187–8 Treatment of 86 cases of local neurodermatitis by electro-acupuncture (with needles inserted around diseased areas). Liu JX.

Reference 43b: J Dermatol, 1994; 21: 729–31 Nodulocystic acne: oral gugulipid versus tetracycline. Thappa DM, Dogra J.

The first source says that “Isotretinoin use may be associated with short-term ocular events, especially conjunctivitis, underscoring the importance of educating patients and caregivers about these potentially important AEs of the therapy.” In other words: always read the label and be mindful of the balance of risks and benefits. To spin “may be associated with short-term ocular events” as “can cause permanent damage to the cornea” is typical of WDDTY.

The second source discusses accutane’s similarity to vitamin A, and thus the possibility that it may lead to hypervitaminosis A (but of course no actual vitamin is bad, as because natural). It’s an interesting paper that specifically note that accutane is indicated only for severe recalcitrant nodular acne but is being prescribed for less serious cases. However, this applies almost exclusively in the US, where drug manufacturers can advertise direct to consumers. In the UK, doctors are much closer to following the actual indications, because parents and patients are much less likely to pester the doctor for the drug they just saw advertised on TV. The increase in suicide with accutane should also be weighed against the fact that acne itself may induce suicidal thoughts. Bottom line: ask your doctor. This is the kind of thing GPs are trained for.

The third source is in a journal dedicated to promoting “traditional” Chinese medicine – in fact largely an invention of Mao. Such journals have serious issues with publication bias. The combined weight of evidence is pretty clear: needling results in only placebo effects. Electroacupuncture may have similar effects to TENS, but traditional it is not. Chinese acupuncture uses bamboo needles – bamboo is a notoriously poor conductor of electricity,

The fourth source, from 1994, promotes gugulipid (guggul). There’s decent evidence this works, but (as with every effective treatment) it has side-effects, which WDDTY either haven’t seen or don’t care about because natural.

It can cause side effects such as stomach upset, headaches, nausea, vomiting, loose stools, diarrhea, belching, and hiccups. Guggul can also cause allergic reactions such as rash and itching. Guggul can also cause skin rash and itching that is not related to allergy […].

Hormone-sensitive condition such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Guggul might act like estrogen in the body. If you have any condition that might be made worse by exposure to estrogen, don’t use guggul.

Underactive or overactive thyroid (hypothyroidism or hyperthyroidism): Guggul might interfere with treatment for these conditions. If you have a thyroid condition, don’t use guggul without your healthcare provider’s supervision.

So, quite a lot of problems there. And guess what? Thanks to assiduous lobbying by the supplement industry, you might well never find out about these.

Acne is a bugger. See your doctor for good evidence-based advice, and see a counsellor if you find the bullying of your peers to be distressing.

WDDTY on UTIs and antibiotics

Women with UTIs get better in a week without drugs
Sometimes WDDTY so grossly misrepresents its sources that a rebuttal takes very much longer than the original content. This is one of those times.

A subset (70%) of a subset (55%) of a subset (37%) of a subset (137) of  a subset (176) of a small (205) eligible pool of people asked to consider delaying antibiotics, got better anyway. In other words, the uncomplicated UTIs that doctors told them might get better on their own, sometimes did.

This is spun by WDDTY as brave maverick women who refused antibiotics generally getting better anyway. But they didn’t refuse, they were asked to defer treatment to see if the condition resolved spontaneously, as it sometimes does.

WDDTY’s agenda-driven style is expertly dissected below by Nurture My Baby.

“What Doctors Don’t Tell You” magazine on UTIs and antibiotics

Reblogged with permission from nurturemybaby (@nurturemybaby)

UITsIf you want some background about this magazine that promotes quack nonsense and potentially puts lives at risk, I’ll just refer you here and also to Josephine Jones’s master list which contains all manner of relevant blog posts including ones that debunk the articles in this magazine.

I did write a letter to the supermarkets stocking it too, so that might be of interest if you want to further understand some of the issues, or if you want to write your own letter you can find the relevant email addresses there.

Anyway, I’d like to talk about a specific article from the magazine in this blog post.

Here’s a headline from the December 2013 edition:

WOMEN WITH UTIS GET BETTER IN A WEEK WITHOUT DRUGS

This got my attention, having suffered from this particular affliction myself repeatedly over the years.

Actually, 7 days after giving birth to my son I was admitted to hospital for three days and nights and put on several IV antibiotics for what started as a UTI. Only later did I realise I had “Sus Seps” scrawled over my notes. That means suspected sepsis. Sepsis. That’s quite serious.

Anyway I digress.

Let’s see what happens next.

What follows is FOUR sentences which try to report on this this paper.

The research was clearly so trivial and straightforward and easy to summarise that it required a mere four sentences to explain:

Women with urinary tract infections (UTIs) such as cystitis who refused antibiotics have found that the problem cleared up on its own within seven days.

Up to 70 per cent of women with uncomplicated UTIs found themselves clear of the problem without taking the drugs, a new study from the University of Amsterdam has found. In the study, women with the problem were asked if they would postpone taking antibiotics. One-third of the participants agreed, and nearly three-quarters of those women were better or had improved symptoms within a week, the researchers reported.

I don’t really think research is ever so clear-cut that you can say anything useful about it with so few words. You need context.

Even the last sentence which tries to explain some of this context and show a bit more clearly where the figure of “nearly three-quarters” comes from is wrong, but we’ll get to that later.

I think we need to start with why this research was carried out in the first place. WDDTY don’t think this is important, but I do.

You might think from WDDTY’s article that the research was done to find out what proportion of women with UTIs that don’t take antibiotics are likely to get better. (I think that’s what WDDTY want you to believe.)

From the details of the study given in the piece it seems an odd way to go about trying to figure out this number. (Which I think WDDTY want us to believe is 70 or 75%)

That’s because this is not the purpose of the research at all. The purpose was to find out how many women would delay antibiotic treatment if asked by their GP. (Yes they did also look at how many women who agreed to not take antibiotics managed stay off them and get better – but the context is important. I think the study design means that whatever numbers they got for this are not applicable to a wider population) Why would the researchers be interested in numbers of women willing to delay antibiotics? Well it seems to me that they are basing this interest on the fact that antibiotic resistance is a bad thing and as previous research (from placebo arms of randomised trials) has shown that 25 – 50% of women would spontaneously get better without treatment, it seems it might be worth looking at.

Yes that’s right, the figure that WDDTY wants us to believe is 70% (based on a study designed to give information about something different) is actually, according to previous research quoted in the very same paper, 25 – 50%.

So now we better understand the purpose of the research lets take a more thorough look at the article.

Clearly the headline is massively sensationalist and misleading. It’s even misleading when you just compare it to WDDTY’s fabulous four sentences without looking at the research paper.

It’s rather a generalisation, and I don’t find it terribly….honest, or helpful, or meaningful. Look, it’s just stupid, OK?

It would appear from this headline that this “finding” would apply universally. Silly me then for letting those daft doctors prod me with those nasty sharp things and shove antibiotics into my blood stream!

Of course, from reading the paper, apart from bit where it is not the intention of the study to give any indication of how many women generally would get better without antibiotics, it’s obvious that someone in my situation would not have participated in this study. Perhaps it’s a given that this research would not apply to someone who looked like they had a serious infection, I don’t know, perhaps I should forgive WDDTY for failing to provide this particular bit of context terribly well in their headline, or in their next sentence, which continues the generalisation. Here’s that sentence again:

Women with urinary tract infections (UTIs) such as cystitis who refused antibiotics have found that the problem cleared up on its own within seven days.

Interesting use of the word “refused”.

This is not really what happened.

To reiterate some details about how the study was carried out:

Eligible participants (ie. over 12 and visiting GP with painful and/or frequent micturition and who did not meet any of the following exclusion criteria: pregnancy, lactation, signs of pyelonephritis, having used antibiotics or having undergone a urological procedure in the past two weeks, known anatomical or functional abnormalities of the urogenital tract, and being immunocompromised (with the exception of diabetes mellitus).) were ASKED BY THEIR GP if they would consider DELAYING ANTIBIOTICS FOR AS LONG AS POSSIBLE.

This is not the same as refused. Come on WDDTY, if you’ve only got four sentences you should use them wisely. At least try to accurately provide information on how the study was carried out. A bit much to ask when you ignore the purpose of the study in the first place, I suppose.

I guess “refused” just sounds cooler or something. After all it does fit in with the agenda of this rag, doesn’t it? Quick! Run away from your doctor and find some vitamin C/magic water pills/quack remedy pick of the day! You might say that putting it in this way fits in with a certain message that WDDTY want to give out. You might. Certainly I think you would say it’s not very accurate.

All this context is important, (ie. who took part, how the study was performed, the purpose of the study(!)) I think, when you are trying to interpret research, trying to help the reader “make better health choices” as they splash on the front of their glossy cover. WDDTY consistently defend themselves by saying that they just report the research that allows their readers to make an informed decision. It’s arguable that this is not possible to do in four sentences in the first place, but nothing that we have read here so far has indicated that they are capable of, or even genuinely interested in doing this.

Next up (I repeat):

Up to 70 per cent of women with uncomplicated UTIs found themselves clear of the problem without taking the drugs, a new study from the University of Amsterdam has found. In the study, women with the problem were asked if they would postpone taking antibiotics. One-third of the participants agreed, and nearly three-quarters of those women were better or had improved symptoms within a week, the researchers reported.

Oh right, so here we do find out that refused was a stupid word to use. Are they deliberately trying to make their writings confusing and hard to understand? I don’t know.

And they’ve also let us in somewhat (only somewhat, mind, as we’ll see when we look at the figures – and we’ve still not been told the purpose of the study) on how misleading their own headline and opening sentence is by clarifying that it’s uncomplicated UTIs we are talking about, and by giving us some numbers rather than suggesting this applies to everyone (even if the numbers are questionable). A whole magazine dedicated to helping people make health decisions and they go down the route of sensationalist, meaningless headlines and almost contradict themselves within the space of two sentences. (And did I mention they don’t even tell us the purpose of the research ;) )

Bah.

Anyway.

Let’s look at the numbers

This 70 per cent lark. Bearing in mind that this figure is what was observed as part of a study that aimed to look at something else and they are presenting it as the main finding and purpose of the research I think this figure is misleading. What I’m trying to say is that is was never the intention of the researchers, I don’t think, to take this 70%, and apply it to the general population. The paper already quotes a figure of 25-50% as being something that might be applicable in a more general sense.

I think it all makes more sense if we look at just how this figure is reached, so let’s go through some of the numbers from the study, as I see them, and then we can compare them to what WDDTY have told us:

Across 20 GP practices 205 women were eligible to take part.

Interestingly, 1 surgery thought that it was a wholly bad idea to ask patients presenting with a UTI if they would consider forgoing antibiotics (Obviously WDDTY aren’t going to tell you that though!). So 25 patients from that practice ended up not taking part. A further 4 were not included because their records were missing.

This leaves us with 176 women.

Of these 176, the actual number of patients who ended up being asked by the GP to consider delaying treatment was 137.

Of all the 137 patients asked to delay treatment, 51 (37%) agreed to it.

(At least WDDTY got something right. Well 37% is not quite the same as one-third, but I’ll let them off.)

So what happened to the 51 people who agreed to delay treatment (out of the 137 that were asked)?

Well, it was made clear to the participants that if they wanted to start on antibiotics at any point then they should and so at the 7 day follow-up it was observed that 15 of the 51 decided that yes, antibiotics were a jolly good idea after all. 8 did not report on antibiotic use.

So out of the 51 patients that agreed to delay treatment we know that 28 of them (55%) had stayed off antibiotics at the 7 day follow-up.

And so what happened to those 28?

Well 20 of them reported that they felt better or were cured. There we go. This is where the 70% (or 71.4%) comes from.

So when WDDTY say:

“Up to 70 per cent of women with uncomplicated UTIs found themselves clear of the problem without taking the drugs”

I put it to you that they are once again misrepresenting the research they cite.

I think the context that they have failed to provide is a huge problem.

It is 70% of 55% of 37% of 137 people asked to consider not taking antibiotics (out of 176 included participants out of 205 of eligible participants).

I do think all of this is quite relevant. Also, I don’t know why they say “up to 70%” but never mind.

Looking at how we got to these 28 women who did not take antibiotics, I think it’s fair to say that this 70% figure is in no way going to apply in a wider more general sense, to all women suffering from uncomplicated UTIs (Of course! Because this is not the purpose of the study!) It’s up to you whether you think WDDTY are trying to infer this from their article, but I think they do, as I’ve said.

Of course there is lots of other stuff in the paper that you are never going to capture if you condense it into four sentences. Data from the women was collected pertaining to the severity of their symptoms, whether they’d had a UTI before, whether they thought they were currently suffering from a UTI etc. and a urine sample was checked for blood, nitrites and leukocytes (all of which indicate infection) and was sent of to a lab to see if any bacteria were present. It is interesting to look at this data and look at the differences between those the GP asked to delay and those that the GP didn’t; those who agreed to forgo antibiotics and those that didn’t; and those that managed the 7 days without antibiotics and those that decided to take them even after agreeing to delay as long as possible.

I don’t really want to go into all these details right here, as I think the main point is that none of this has been mentioned at all, (nor have the limitations of the study) but I do find it interesting for example, that women who had haematuria and leukocyturia on urinalyis were less likely to be willing to delay antibiotic treatment when asked. Also of note, is that when the results of the culture came back it turned out to be positive for 51% (26/51) of the delaying women and for 67% (58/86) of the non-delaying women. This is especially interesting in light of the fact WDDTY is trying to make out these 28 women (not that they tell you there’s only 28 of them) who ended up delaying treatment are somehow representative of the wider population.

Whether you agree with me or not that WDDTY are trying to take this study and infer that 70% of women in the general population can get better from a UTI without antibiotics, it’s definitely fair to say that there is no mention of any of the above. There’s definitely a lot of context missing.

But what can you do when all you’ve got is four sentences.

Well you could at least try to get the last one right. I repeat:

One-third of the participants agreed [to forgo antibiotics], and nearly three-quarters of those women were better or had improved symptoms within a week, the researchers reported.

Do you see what they did there? In trying to give at least some context to this figure of “up to 70%” (or as they now call it “nearly three-quarters”) they have chosen to completely ignore the fact that not all participants who said that they would delay treatment did in fact stay off antibiotics. The 70% figure comes from looking at how many of the remaining 55% of participants, that did actually stay off antibiotics, (ie. 28) got better. Not by looking at how many of the one-third of participants that agreed to not take antibiotics (ie. 51), got better, which is what WDDTY would have you believe.

If you want to look at the amount of people who got better expressed as a percentage of the participants that agreed to forgo antibiotics then it would be 20 out of 51, by my reckoning. Which is 39%. Which is not nearly 75%. So I think that sentence is plain wrong. Never mind lacking in context and likely inferring things that shouldn’t be inferred, just wrong.

Overall not a great 4 sentences. At best the article is meaningless, out of context nonsense. At worst it’s misleading and inaccurate.

Have I been unfair? Please let me know if I have, or if there are any inaccuracies, or if there is anything that I could write more clearly. I’m not an expert at this. I haven’t quite got through my Big Pharma Shill training yet.

What Doctors Don't Tell You
Why don’t doctors tell you that UTIs sometimes get better on their own without antibiotics?
They do.