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Comment by Ozzie_osman | Hacker News Reader

The antibiotic link is really alarming. Growing up in a country where antibiotics are basically prescribed for any illness, my mom refused to administer it to us unless there was an emergency. Clearly she had some foresight.

I find it a tough choice for my own kids. For example, if they have an ear infection, you could try waiting it out, and sometimes they can get better on their own, but it's riskier and might be longer and cause more discomfort. Or you can give the antibiotic, but then you get the unknown side effects.

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I'm having a hard time believing in the antibiotic link.

I've spent quite a bit of time in various parts of South America where antibiotics are available without prescription and from what I've seen, used for every fever and sniffle for 40 years+ now. I'm not seeing generations of Autistic and ADHD people there. If the antibiotic link was true, wouldn't it be worse there?

My guess is food isn't so sterile (lack of probiotic and other micro-life) food in South America, Asia, etc [yet]. Same for water, environment in general. Plus more human to human contact. So effects of antibiotics are constantly being reversed. Plus lactobacillus tablets are literally taken with the antibiotics (tho probably it should be taken a week after a round of antibiotics?).

Whereas some Western countries might have a sterile-ness + formula + meds + other environmental factors that form the perfect storm. Edit: I'm not saying it causes x or y. Just that it is not ideal for a young kid.

I dont have any proof either way, but you're assuming it's the only factor. It could be a mix of antibiotic and diet, or antibiotic and lack of exposure to other germs.

Could also be that all bacteria evolved to resist the OTC antibiotics in that environment.

Thanks, really great anecdote for US centric folks.

You should also keep in mind that the "diagnosis" of an ear infection is often half assed / made up, mostly because it's much easier to prescribe an antibiotic (which satisfies most frustrated parents) than stop your busy clinic / urgent care / ED to explain why antibiotics aren't indicated (and then deal with the fallout of a complaint or negative review).

In contrast, it's pretty difficult to prove that an ear infection was not present at the time of evaluation. The assessment is highly subjective, can be really difficult to thoroughly assess in young kids, and generally doesn't leave any hard evidence to review or critique.

Nearly all of the bad incentives align to pressure providers to just diagnose an ear infection and prescribe the antibiotic and move on with their busy shift.

There's no such thing as reviews in the place I've been growing up, where you'd get antibiotics for basically a sneeze, and can even buy them yourself in the pharmacy (weekends, because your doctor won't be around). But reactions or not, bugs will definitely build a resistance over time, which won't be a problem if you stay lucky.

I've found this difficult as well, my mother always jumped right to antibiotics and it had some pretty clear long term consequences.

My approach with my kids has been to use antibiotics only if there's no progression (better or worse). I figure as long as it appears the immune system is doing its job, that's enough for most cases.

So far, we've given our 3-year antibiotics on two occasions. Once for an ear infection that wouldn't clear and for when he had pneumonia.

> I've found this difficult as well, my mother always jumped right to antibiotics and it had some pretty clear long term consequences.

How could this possibly be true that there were clear long term consequences? How could you reasonably know if there were long term consequences from antibiotic use?

Which antibiotics cause what and how do you know they are the cause?

How do you know it wasn't the antibiotics?

You can find many people online whose health (gut most often) got destroyed after a round of antibiotics.

You obviously won't see this in studies, look for individuals: many such cases.

Why wouldn't we see this in studies if it was common?

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