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Comment by gaius | Hacker News Reader

But they don't tho', that's why there's a problem. GPs hand out antibiotics like candy.

Sure, they hand out the antibiotics where resistance has already developed, but trust me, the "last ditch effort" antibiotics (like vancomycin) don't get used broadly at all.

Vancomycin is used routinely (at least in the three hospitals I work in) and it is far from a last ditch drug. That has shifted to Linezolid and Daptomcyin. In the three hospitals I work at, medicine doctors must consult Infectious Disease doctors for approval to place patients on those therapies.

"Last ditch" is a poor choice of words. The point I was trying to make is that if you come to you doc with the sniffles, it's unlikely you're going to get an Rx for vancomycin.

The parent post was referring to GPs, which at least in the U.S. aren't often operating in hospitals, and certainly don't get ID consults.

Vancomycin is the drug of choice for several major infections that are of a concern to hospitals (MRSA, C. difficile) because there's already pretty established resistance mechanisms. There are definitely some "more last ditch" drugs, but Vancomycin is kind of the first of the "Now we bring out the big guns" antibiotics.

Partially because it's a PITA to give to patients, and has some toxicity problems.

Depends on the antibiotic. GPs don't hand out vancomycin like candy, for example. Of course, that's also because vancomycin is a pretty brutal drug all things considered.

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