AOPA Pilot Magazine - December 2017 - 30

FLY WELL

A tale of two Flemings

BY DR. JONATHAN M. SACKIER

Alexander's overused invention
IN LONDON, BLUE PLAQUES ADORN numerous buildings, identifying where luminaries lived or worked.
Two capture my imagination. One, adorning St.
Mary's Hospital, proudly proclaims that in 1928, two
floors above, Alexander Fleming discovered penicillin.
Another embellishes 22 Ebury Street, Belgravia, where
Ian Fleming-James Bond's creator-spent many years.
Two Flemings: One wrote of saving lives, another, of
ending them. Little did Alexander know his discovery
could end in villainous Bondian fashion. Antibiotics are
failing because of overuse, inspiring antimicrobial resistance. Bacterial baddies are winning the fight.
Antibiotics are either naturally occurring or synthesized medications that destroy certain disease-causing

A sore throat is frequently a viral illness for
which antibiotics are useless-or worse than
useless.

DR. JONATHAN SACKIER

answers members'
medical questions
through the AOPA
Pilot Protection
Services program
(www.aopa.org/
pps).

organisms, with names that would grace any 007 movie-
sulphonamides, aminoglycosides, cephalosporins, and,
of course, penicillins. Pharmaceutical companies have
endeavored to develop new ones to knock off bugs that
are trying to knock us off, but ideas are drying up.
Antibiotics only kill bacteria-specific drugs for
specific bugs-with zero activity against viruses or
fungi. Deploying antibiotics to kill a bug that is not susceptible may kill "good bacteria" in your gut, allowing
maleficent microbes to wreak havoc. This can lead to
pseudomembranous colitis, a potentially fatal condition demanding urgent treatment.
It's a nasty enough condition if it arose because the
causative antibiotic was required, but imagine discovering that the drug causing the colitis should not have
been administered at all-for instance, for a sore throat.
Yes, that can be caused by streptococcus and is often
easily treated with Alexander Fleming's wonderful revelation, but a sore throat is frequently a viral illness for
which antibiotics are useless. Or worse than useless. So,
instead of demanding antibiotics from your doctor, or
gulping down something left over in your home medicine cabinet (never a good idea), ask your physician if
he or she can do a simple office strep test first and, if
negative, treat yourself with chicken soup and bed rest.
The other problem is that when bacteria are
exposed to small, nonfatal doses of antibiotics, they

30 | AOPA PILOT December 2017

evolve and become resistant, passing that capacity to
their offspring, and then another drug heads for the
scrap heap. This is happening faster than new medications can be discovered.
More than 80 percent of all antibiotics are used in
farm animals, a matter of concern and contention. While
some are utilized to treat animal disease, 90 percent are
dispensed to support and encourage growth for intensive food production. The small amounts passing into
humans, some believe, contribute to the growing problem of resistance.
More than half of all antibiotic prescriptions are
inappropriate and, as such, doctors and veterinarians need to be part of the solution. The Global Chief
Medical Officers Network has agreed to publicize this
issue before it becomes a cataclysm. But we are few;
we need others to lead the charge. And that is where
you come in. Pilots-leaders by nature-can help themselves and society at large by becoming informed.
As in the sore throat example, determine if antibiotics are medically necessary, and then consider that
while the FAA may allow you to fly while taking antibiotics such as zithromycin, the underlying condition
may make flying inadvisable. For instance, if you have
a sinus infection, you should not be flying. If you have
a chest infection, you should not be flying. Get the picture? Additionally, antibiotics can cause delayed side
effects, most commonly nausea, vomiting, and diarrhea-not things you want to deal with while in the left
seat. If taking an allowable antibiotic, and the underlying condition is not a barrier to flight, wait at least
24 hours from the first dose before flight.
Antibiotics may be one of several medications
you're taking, so ensure that every drug you are taking
is allowable and appropriate for the cockpit.
Additionally, socializing while infected puts co-workers at risk, which is inconsiderate and could put further
strain on antibiotic use.
Be involved in health care decisions affecting you;
if an antibiotic is not absolutely necessary, avoid it.
Support the production of antibiotic-free foods and
read the labels; at the very least, this practice can't hurt.
Do all you can do win your own blue plaque and
ensure that there is never one to tell us where antibiotics finally died.
AOPA
EMAIL DrJonathanSackier@gmail.com


http://www.aopa.org/pps http://www.aopa.org/pps

AOPA Pilot Magazine - December 2017

Table of Contents for the Digital Edition of AOPA Pilot Magazine - December 2017

Contents
AOPA Pilot Magazine - December 2017 - Intro
AOPA Pilot Magazine - December 2017 - Cover1
AOPA Pilot Magazine - December 2017 - Cover2
AOPA Pilot Magazine - December 2017 - Contents
AOPA Pilot Magazine - December 2017 - 2
AOPA Pilot Magazine - December 2017 - 3
AOPA Pilot Magazine - December 2017 - 4
AOPA Pilot Magazine - December 2017 - 5
AOPA Pilot Magazine - December 2017 - 6
AOPA Pilot Magazine - December 2017 - 7
AOPA Pilot Magazine - December 2017 - 8
AOPA Pilot Magazine - December 2017 - 9
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AOPA Pilot Magazine - December 2017 - 16
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AOPA Pilot Magazine - December 2017 - Cover3
AOPA Pilot Magazine - December 2017 - Cover4
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