NAMRIP member identifies condition for which antimicrobial prescription would be inappropriate

How many conditions are prescribed antibiotics or other antimicrobial agents when they have no chance of being effective? One more possible condition was added to the list this week when Prof Tim Leighton published a paper commissioned by the Royal Society to celebrate its 350th anniversary of publishing.

 

The paper casts light on one possible route by which ear pain (and other symptoms), caused by a non-microbial sources, could be incorrectly diagnosed and the patient prescribed antimicrobial agents. Prof Leighton went to a number of public sites (libraries, schools, railway stations, swimming pools) and measured intense ultrasound projected into public places without the knowledge of the public, and without appropriate guidelines to protect them. These sites had been targeted by Prof Leighton because of complaints from members of the public at those sites of ear pain, headache, migraine, nausea and dizziness. Some of these people reported that they had been prescribed antibiotics for these symptoms, but the condition had not been alleviated by this medication.

 Prof. Leighton noted that, in the 1960s and 1970s, tests on the hearing of workers who used ultrasound in industry (e.g. in cleaning baths, milling etc.) often noted as an aside that those workers complained of the same set of symptoms reported today by some members of the public in the spaces in which he and his team measured ultrasound in air: ear pain, headache, migraine, nausea and dizziness.

 This unfunded study lacked the resources to conduct randomized double blind human experimentation to see whether the individuals who might be sensitive to ultrasound in air in public spaces do indeed respond to exposure with such symptoms. Conducting such tests is a long-term goal of the team.

 In his paper, Prof Leighton noted that ‘the lack of evidence means that adverse effects from airborne ultrasound are not included in any of the relevant NICE publications that support differential diagnoses’. He adds: ‘The possibility that antibiotics are prescribed for ear pain caused by this non-microbial agent is an interesting, but as yet unproven, possibility. It is no bad thing to wonder for a moment at the extent of the list of conditions for which antimicrobial agents are inappropriately used.’