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HEALTH

You Docs: Testing for strep the now the recommended approach

It reduces prescribing antibiotics unnecessarily

Monday, November 19, 2012 - 12:01 am

Q: I took my 6-year-old to the doctor because she had a sore throat with white patches — strep, I assumed. So I figured the doctor would take one look at her and prescribe an antibiotic. But he took two throat swabs, did an office strep test on one — which he said was negative — and sent the other sample to a lab. When those results came back, it turned out it was strep after all. Then the doc gave her amoxicillin. But I wonder, is this doctor incompetent? — Murphy A., New City, N.Y.

A: Actually, quite the opposite. Your doctor was following the latest guidelines recommended by the American Academy of Pediatrics and the Infectious Diseases Society of America. The last thing your daughter needed was an antibiotic to treat tonsillitis caused by a virus. (Antibiotics are designed to knock out bacteria, but are 100 percent useless against viral infections.)

The Rapid Antigen Detection Test (or RADT, which he did in his office) is usually pretty good, but it’s not 100 percent accurate. So your doctor was smart to go with the gold standard and have a lab determine if your daughter had a bacterial infection or not.

Because of the increase of antibiotic-resistant bacteria, it’s getting more and more important for doctors to prescribe antibiotics only when they’re called for. Doctors who follow the same guidelines as your doctor cut their erroneous antibiotic prescription rate in half — from 28 percent to 14 percent.

Antibiotic-resistant bacteria are becoming a bigger health problem every day, and your doctor was doing a very good job of dispensing the proper antibiotic at the right time. Penicillin has saved a lot of lives (amoxicillin is a synthetic form of penicillin), and, if it’s overused, it could someday lose its effectiveness. Stay with your doctor.

Q: When we first moved into our apartment building on a big intersection, the noise didn’t bother me. But lately, every honk or passing truck makes me nuts. What can I do? — Min-shu L., Queens, N.Y.

A: Maria Sharapova delivered grunts with her volleys at the U.S. Open stadium (in your neighborhood) that topped out around 101 decibels (dB), far above the average sound level of most urban street traffic (60-80 dB).

But you’re talking about a negative reaction to more everyday sounds. It’s not unusual to become more sensitive to constant levels of urban sound over time; it’s kind of like becoming allergic to a food or a plant after repeated exposure.

You’re right to want to tone down your environment. Research shows that traffic and airplane sounds increase adults’ risk for heart attack, high blood pressure, emotional problems, make it harder for kids to learn to read and interfere with memorization and problem solving.

Environmental noise causes sleep disturbances, and that leads to health problems like diabetes, heart disease, high blood pressure and a lousy love life. It also reduces productivity and ups emotional distress. So-called phonophobia, or fear of sound, can trigger anxiety in anticipation of noise. So here’s what you can do to find some peace:

*Quiet your bedroom. Hang heavy-duty, sound-dampening curtains over windows, or replace standard windows with sound-proofing glass. Use a white-noise machine to drown out the sounds — in the winter, a humidifier with a fan (always a good move anyway) may do double-duty. Use earplugs, if you can find ones that are comfortable and effective.

*Reduce your stress level and lower your blood pressure by taking up meditation. It won’t make the sound go away, but it can change your response to it and reduce circulating stress hormones such as cortisol; when they’re chronically elevated, it’s bad for the heart and the emotions.

*Use noise-dampening headphones during the day.

*Get a loudness discomfort test (we didn’t make that up) from a hearing specialist. It can help identify specific sound sources that trigger your distress. You also might consider sound exposure therapies to desensitize you to noise.

Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Dr. Mike Roizen is Chief Medical Officer at the Cleveland Clinic Wellness Institute. Submit your health questions at www.doctoroz.com.