What is it with the Polish love of antibiotics? And Why do Poles get ill more?

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Aug 24, 09, 15:27 #1

In Poland it seems as if the doctors prescribe antibiotics willy nilly - pretty much for anything because they are cheap and, in the short term, effective.

But in the long term this is irresponsible because it prevents the body from developing its own immunity and also selectively encourages the emergence of super bugs.

What is the cultural reason for this? Does it stem from the communist times when the only thing that mattered was a day's work? Is there another reason?

I've noticed that Poles will try to "work through" any illness instead of taking time off to get properly better (and not spread the bugs around to work colleagues).

It's a clear cultural difference between Poland and UK. Can anyone throw any light on the reasons behind it?

I also noticed when living in Poland that people get ill much more often - particularly children. In winter, I put this down to the dirty air (lots of coal smoke) and cold climate.

Your thoughts anyone?

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Aug 24, 09, 16:02 #2

Myszolow:

Poles will try to "work through" any illness instead of taking time off to get properly better (and not spread the bugs around to work colleagues).

... the reasons behind it?

I think many Poles are afraid of being perceived as hypochondriacs (especially men). The reasoning is I suppose the following- why lie in bed if I actually can walk / it must mean I'm not seriously ill if I can still get up etc. ;-)

Some people think staying at home with minor infection is just a waste of time. Indeed, they are rarely aware they might pass on their bugs to others (which others will pass on them again and so on;D)

Myszolow:

people get ill much more often - particularly children. In winter, I put this down to the dirty air (lots of coal smoke) and cold climate.

This might be because of peoples's obsession with overheating their houses plus clothing too warmly.

MyszolowThreads: 4 Posts: 171 Joined: Jul 28, 09 ♂	Aug 24, 09, 16:36 #3
gosiaczek: This might be because of peoples's obsession with overheating their houses plus clothing too warmly. Oh, don't get me started on that one, bo zmarznię. LOL.

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Mar 4, 10, 01:29 #4

Myszolow:

What is the cultural reason for this? Does it stem from the communist times when the only thing that mattered was a day's work? Is there another reason?

Somebody can call it a fashion. But I was instructed in this subject by one of doctors. It's just quicker. They want to save some time, because they allot only few minutes to diagnose a patient.
But you're right, old Poles (age of 60+) like to go to a doctor. Newer generations has no time to do it. However it is always a matter of personal attitude. In my family we do not use antibiotics for colds and flues and trying to be healthy with some success.
I was struck how different are Britons' and Poles' behaviours in dressing. Britons just toughen their children up from small, Poles are always well-packed as onion with all these shirts, sweaters, caps and scarfs.

SeanusThreads: 22 Posts: 30,158 Joined: Dec 25, 07 ♂	Mar 4, 10, 09:37 #5
Self pity often weakens your resolve. It's just a case of keeping a PMA and not allowing negative wallowing to sink in. Rid yourself of negative emotions.

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Mar 4, 10, 11:41 #6

marqoz:

Britons just toughen their children up from small, Poles are always well-packed as onion with all these shirts, sweaters, caps and scarfs.

Don't you think that the minor difference in winter temperatures between PL and UK might be a reason for this? Also, I have noticed that (at least in London) people have no clue how to dress appropriately to the weather. In the hottest summer some women could be walking around in knee-high furry boots (and not much else), while slipping and sliding through a snowy winter's day in sandals and bare feet! And no coat on! If it's cold, you should dress warm and button up, as it helps keep your energy levels up. Otherwise, you spend most of your energy on just trying to keep warm enough to survive. Also, I have never seen so many ill, coughing, wheezing, snot-nosed (and very flimsily dressed) children around as in wintry London. These children should all be recuperating in bed, while teachers claim there is nothing wrong with them and they should be attending school.

marqozThreads: - Posts: 218 Joined: Feb 4, 10 ♂	Mar 4, 10, 12:01 #7
Seanus: It's just a case of keeping a PMA What the hell you mean Progressive Muscular Atrophy or Premarket Approval?

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Mar 4, 10, 12:09 #8

Magdalena:

Don't you think that the minor difference in winter temperatures between PL and UK might be a reason for this? Also, I have noticed that (at least in London) people have no clue how to dress appropriately to the weather.

Speaking as an irish man who has lived here for 4 years, i totally agree with you on this. I have noticed this since i came. People in ireland and UK will only put on the necessary clothes when they are about to fall over with the cold. I would be a bit like that...only buy gloves or wearing a scarf i absolutely necessary....I think in poland, kids are thought from early age to wrap up warm.

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Mar 4, 10, 16:57 #9

As an Englishman who has lived in Poland for five years i have to say i have never taken any antibiotics here..i have not needed to... In five years of living in this cold draughty farm house i have never been ill , apart from catching a slight sniffle from a friends kids...

I guess my old farm is too cold for any virus to survive , and the fact i won,t take any antibiotics means i have not ever developed a resistance to them...

Many viruses are becoming resistant to drugs because people take them at the first sign of a cold , its not such a great idea...

I shall be very happy to one day have a nice warm home , but i am sure this cold existance here has made me less prone to the usual ailments...

Why not try it folks...move out of your warm house , and go live in your garden shed...it will make you so much healthier..!

SeanusThreads: 22 Posts: 30,158 Joined: Dec 25, 07 ♂	Edited by: Seanus Mar 4, 10, 16:59 #10
Hehehe, I meant a positive mental attitude :) Stay loose and light and always remember to take plenty of deep breaths. It always gives me a laugh to see how seriously some old hags take themselves.

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Edited by: Myszolow Mar 4, 10, 18:15 #11

Magdalena,

I agree that Brits often don't dress well for the temperature. But you may have noticed most houses don't have thermometers on the outside either (ours does though). And people don't obsess about the weather forecast either. There's no need, it's always raining. ;)

Seriously though, I do believe part of it is climate related and there is a lot of coal smoke in the air in Poland in winter. When I was heating our house with coal and wood, I found exposure to the smoke and dust gave me a rough throat most of the winter.

It's true that the weather can sometimes kill you in Poland, and that's rarely true in the UK. But why, when Poles often overheat their houses to 25 degrees +, do they wear more clothes inside in winter?

I think the attitude to healthcare is just different. In the UK, parents are encouraged to keep children home if they are ill (and they do), to prevent things passing through the whole class. When my son went to pre-school in Poland, the Polish parents were advised the same thing, but they ignore it (perhaps they don't have an alternative? I'm not judging, just observing).

I read an article in the Łódź newspaper (in Polish, the one owned by the Times. Is it Wyborcza?) a couple of years ago which said that the Polish health system was massively over-prescribing antibiotics. Poles even slagging off English doctors who won't give them antibiotics and tell them to go to bed and rest for a few days. Instead they hop on the next ryanair flight, passing all their germs to everyone else on the plane (nice closed system virus incubation unit) go see their own irresponsible GP who gives them a supply, back to UK (infect more people on plane) and back to work to earn dużo funtów.

The thing is when you don't let your body fight these infections you don't build up natural resistance and you will get ill more often. (A chicken and egg situation).

That, is why Poles get ill more often because they do not take the responsible action of rest and recuperation when they are ill. They look for the quick fix instead so they can be more productive. (I blame the commies for instilling this mentality).

There you go.

Thanks for reviving this thread. I thought it had died without any proper debate. ;)

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Mar 4, 10, 20:47 #12

Myszolow:

In the UK, parents are encouraged to keep children home if they are ill

How about the standard set by educational authorities (at least in London) which states that normal school attendance should be 95% or over? Parents are outright asked by teachers and attendance officers to send their ill children to school no matter what, "if Johnny looks really poorly we'll send him back home". This is all done to make school attendance records look better. In PL, a sick child stays at home, no questions asked.

Myszolow:

They look for the quick fix instead so they can be more productive. (I blame the commies for instilling this mentality).

You couldn't be more wrong. In the "good old days" job security was 100% and you wouldn't need to fret about taking sick leave. If you can blame any mentality here, it would be the "go-getter" capitalist attitude of the early post-communist era, when everyone wanted to prove themselves valuable to the employers and for the first time in living memory (almost) unemployment loomed large on the horizon.

Myszolow:

The thing is when you don't let your body fight these infections you don't build up natural resistance and you will get ill more often.

For almost ten years, I suffered from recurrent strep throat or whatever it was. A high fever, loss of voice for days at a time, horrible pain while swallowing etc. I never took antibiotics for it because I figured it would go away on its own. Finally, a doctor friend of mine bullied me into taking a course of antibiotics. I did, and have never had the problem again. The thing is, I had been carrying a thriving colony of bacteria with me all this time, and whenever my immunity was down, they would attack me. Once I killed them off with the antibiotics, I regained my freedom ;-)
Taking antibiotics now and then - when needed - is all good IMHO. Problems arise when people start a course and don't finish it, or take antibiotics when they hadn't been prescribed any (eg "leftovers" from a previous treatment).

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Mar 4, 10, 21:30 #13

Clearly there are exceptions in both countries. :)

Decent schools (in whichever country) are concerned with educating children and their welfare, not ticking boxes on pieces of paper.

For something like strep throat a decent doctor would prescribe antibiotics. Did you even go to a doctor? I'm not against antibiotics at all, but they should be used within their intended guidelines, not for colds and minor flu bugs which will go away by themselves.

You may not be a typical Pole. I am certainly not a typical Brit (I wear a thick coat and hat when it's cold). But that doesn't change the fact that even the Polish health service acknowledges that antibiotics are being overprescribed. That's a fact. I may have the reasons wrong because I've only seen how it works in one area of Poland.

As to the commie thing, I was under the impression that the day of lost production was worth more than the person's health and the commies used any chemical means available to keep people productive. Total and utter short-termism. I'm sure we were taught in science class that the communist countries were abusing antibiotics in this way. (maybe it wasn't truw, but maybe it was?) How else do you account for the different prescribing habits of doctors?

You've obviously been in the UK quite a while, your English is impeccable. I salute you. :)

MyszolowThreads: 4 Posts: 171 Joined: Jul 28, 09 ♂	Mar 4, 10, 21:50 #14
http://fampra.oxfordjournals.org/cgi/reprint/13/5/445.pdf Interesting link here to a research paper on prescribing habits. (I note it also talks about recommendations for bed rest for tonsilitis - so it doesn't fully support all my points. But it is 14 years old).

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Mar 5, 10, 00:16 #15

Myszolow:

, I was under the impression that the day of lost production was worth more than the person's health and the commies used any chemical means available to keep people productive. Total and utter short-termism. I'm sure we were taught in science class that the communist countries were abusing antibiotics in this way.

Sounds really "science-fiction" to me - like something out of a dystopian novel ;-) Whatever unpleasant, nasty, or downright terrifying aspects living under the commies might have had, this would not be one of them. Employment was usually for life unless you really tried hard to make things difficult for yourself. Nobody was in a hurry to get anything done, and there were always ways and means to "sort out issues" (wink, wink, nudge, nudge) if necessary.

Myszolow:

How else do you account for the different prescribing habits of doctors?

I dunno. I was not prescribed antibiotics unnecessarily when in PL, and my opinion of British GPs is that they couldn't properly diagnose their way out of a paper bag. It's "go home and rest, and take a painkiller if necessary" for the widest variety of ailments from PMS to arthritis. I am rather healthy myself, but as community interpreter I have visited doctors literally hundreds of times in the last few years, so I think I have almost seen it all.
Polish docs might be big on antibiotics, but British ones hand out strong, codeine-based painkillers (Co-codamol anyone?) to almost anybody who complains of any sort of pain - without trying to find out what actually causes it.

SeanusThreads: 22 Posts: 30,158 Joined: Dec 25, 07 ♂	Mar 5, 10, 09:08 #16
There's sth in the mindset of a fair few here and I see it all too often. There's always sth that aches but the body of a Pole is no different from any other European. It's largely psychosomatic. Give that person a hoof up the arse and that'll sort them out. It grows thin to hear all the grunts and groans. I just ignore them now.

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Edited by: Myszolow Mar 5, 10, 09:29 #17

Magdalena:

I dunno. I was not prescribed antibiotics unnecessarily when in PL, and my opinion of British GPs is that they couldn't properly diagnose their way out of a paper bag.

LOL. Well you know plastic bags are not as biodegradable as paper ones. So they will eventually get out when the bag rots down. :)

So OK you poo poo my ideas about why Polish doctors overprescribe antibiotics. In fact you seem to deny it when there are clearly research papers out there that show this to be the case and also the newspapers within Poland are publishing articles about it.

In fact you are going so far as to start slagging the UK doctors (perhaps with some justification - some of them are a bit crap - mind you all Polish GPs do is refer people to specialists - they don't seem to treat anything apart from coughs and colds or flu and they prescribe antibiotics willy-nilly for those ;) )

But what you are not doing is answering the question posed in the original post, which is why are they overprescribing antibiotics?

I'd still like to know why. By the way it happens in China and many other countries with Eastern Bloc influence as well. Still think it's not commie culture?

I'm fully aware that your experience may not match up with what I'm saying. Not everyone has a typical experience. I lived in Poland from 2006 to 2008 and during that time my son was prescribed antibiotics three times. I'm not just making this up. I have been there and done that. How long have you been living in the UK? Quite a while I think.

Seanus:

There's sth in the mindset of a fair few here and I see it all too often. There's always sth that aches but the body of a Pole is no different from any other European. It's largely psychosomatic. Give that person a hoof up the arse and that'll sort them out. It grows thin to hear all the grunts and groans. I just ignore them now.

A hoof up the arse and a bottle of amoxycillin - the cure to all ailments. ;)

SeanusThreads: 22 Posts: 30,158 Joined: Dec 25, 07 ♂	Mar 5, 10, 10:49 #18
Flop like a doll and give yourself a shake. These 2 simple things really help. You are not really ill so quit the histrionic BS and make hypochondriac only a word in the dictionary. The tendency towards self pity is all too high, especially amongst women.

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Mar 5, 10, 11:04 #19

I have to comment on this topic..
Being British living in Poland I'm currently off work with a one week sick note and antibiotics from the doctor for tonsillitis. Ive never had tonsillitis before so i kinda expected antibiotics.
Just last night i argued with my polish husband about being sick. I asked him a simple question " When will the blister go in my throat?" His reply. Well you need to stay in bed !
Explain to me what the difference is between staying in bed for one or sitting on the sofa is?
He went on to explain that i should be in bed warm, He told me that the doctor thinks i should be wearing a hat in the house! ARE YOU CRAZY? A hat in the house??

As for getting sick in the first place i will have to say its the buildings. There just too WARM! Germ infested places.

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Edited by: Myszolow Mar 5, 10, 11:28 #20

Sarah:

He told me that the doctor thinks i should be wearing a hat in the house! ARE YOU CRAZY? A hat in the house??

Give me a doctor who can't diagnose his way out of a paper bag in preference to a cretin like that. ;)

Yes I believe there are more issues associated with keeping houses and flats overly warm. Eskimos don't have colds.

Many Poles think you can catch a cold by eating an ice cream in the sun or drinking a cold beer on a hot day. Oh dear. Pass the antibiotics.

Get well soon Sarah. BTW the link in post #14 was a study on the prescribing habits of Polish doctors for tonsilitis. You might find it interesting. I don't know whether antibiotics are indicated for what you have or not.

Certainly the attitude towards tonsilitis "angina" (which is a linguistic false friend because angina is a coronary artery disease in English, treatable with sub-lingual nitro glycerin) is very different in the UK and Poland. It's regarded as a big deal in PL.

TrevekThreads: 33 Posts: 2,155 Joined: May 21, 08 ♂	Mar 5, 10, 11:37 #21
Magdalena: In the hottest summer some women could be walking around in knee-high furry boots (and not much else), while slipping and sliding through a snowy winter's day in sandals and bare feet! And no coat on! Funny thing, in UK as the temeperature drops the skirts get higher. In Poland, the waist band of the jeans gets lower.

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Mar 5, 10, 11:49 #22

Myszolow:

In fact you seem to deny it when there are clearly research papers out there that show this to be the case and also the newspapers within Poland are publishing articles about it.

About the commies forcing people to swallow antibiotics and come to work? Even - even! - if Poles during communist times used antibiotics a lot, they would still stay home for the duration of the illness. Ever heard of the infamous L4 certificate? ;-)

Myszolow:

I'd still like to know why. By the way it happens in China and many other countries with Eastern Bloc influence as well. Still think it's not commie culture?

If there's anything of the sort going on now, it would be a relatively new phenomenon (as I said before). I would say big pharma are pushing antibiotics and other fancy meds for GPs to prescribe. I am sure you know how it goes - the GP is wined and dined by a "medical representative" and eventually signs a contract, being first promised participation in "medical seminars" abroad with like-minded colleagues etc. I have two friends in the medical representative profession, so I guess I would know. But even so, I am not aware of Polish GPs practically forcing antibiotics down their patients' throats. If this does happen, it's a totally new development which must have taken place in the last 5 years, after I left Poland. And even if it's totally true, I bet quite a lot of the patients never actually use the medicine they'd been prescribed. People tend to know when a doctor develops a pattern in prescribing antibiotics - esp. of a specific type or make. ;-)

Myszolow:

I lived in Poland from 2006 to 2008 and during that time my son was prescribed antibiotics three times.

Is that a lot? Children tend to catch quite nasty bacterial infections like tonsilitis and bronchitis. (Which, from my experience, often go untreated in the UK).

Seanus:

You are not really ill so quit the histrionic BS

Exactly what a good British GP might say :-)

Myszolow:

mind you all Polish GPs do is refer people to specialists - they don't seem to treat anything apart from coughs and colds or flu

Well, that's what they're for. They're called lekarz pierwszego kontaktu - first point of contact physicians. They're supposed to treat what they can and refer you to a specialist for the rest. Their British counterparts seem to think they can treat gynaecological conditions, cancer, rheumatoid arthritis, and pretty much every other illness in the book (and they do look up a sort of medical google facility on the computer to make their diagnosis - right in front of the patient). Which, as you can imagine, is not a good way to make that patient trust you.

Sarah:

Explain to me what the difference is between staying in bed for one or sitting on the sofa is?

For some reason, it's good to rest and sleep a lot when you're really sick. Also, there are many illnesses in which it is beneficial to sweat as much as possible (and ofc change your pyjamas and the bedclothes during the process) ;-) The elevated body temperature helps fight off the infection.

Sarah:

There just too WARM! Germ infested places.

Hey, they are usually warm and DRY. Warm and humid would be what you are thinking of :-)
Personally, I prefer warm and dry to cold and draughty, esp. in the winter when I am feverish and ill.

MyszolowThreads: 4 Posts: 171 Joined: Jul 28, 09 ♂	Mar 5, 10, 11:59 #23
All that typing and still no closer to an answer. ;) I think three times in two yeaars is a lot. The fact that you don't shows a cultural difference. Perhaps that's all it is? But the facts speak for themselves. Polish GPs are much more free with antibiotics. I'd like to know what started it.

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Mar 5, 10, 12:05 #24

Myszolow:

I'd like to know what started it.

Polish doctors (the corrupt evil big pharma puppets aside) usually want to treat patients and make them feel better. Therefore, they tend to prescribe medicine which they think will be fast and effective. If you have a nasty bacterial infection, antibiotics are usually relevant, though sometimes not absolutely necessary. BTW, have you ever had tonsilitis, with (excuse my French) pus running down your throat? I resent how the medical bigwigs in the British medical study you quoted call it a "minor upper respiratory tract infection." :-/

British GPs, on the other hand, seem to be happy to shunt the hapless patient back and forth between their (the patient's) bed and the surgery - for ages.

I still prefer the "Polish way."

TrevekThreads: 33 Posts: 2,155 Joined: May 21, 08 ♂	Mar 5, 10, 12:06 #25
My GP once managed to diagnose an ankle complaint, and refer me to a specialist, without me even needing to remove my high-leg boots. Funny, the specialist was an obnoxious git who screamed that I should tell my GP to go back to school.

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Edited by: Myszolow Mar 5, 10, 15:44 #26

Magdalena:

I still prefer the "Polish way."

Background. Concern about the increasing numbers of multiple resistant strains resulting from over and misuse of antibiotics is growing world-wide.

---SNIP---

Conclusions.
In conclusion, the results of this small pilot study indicate that Polish first-contact doctors
have an inadequate prescription behaviour in cases with upper respiratory tract infections. Our results underline the need for courses in pharmacotherapy within the postgraduate education course in family medicine recently introduced in Poland.

By the way the date of that paper is 1996. So it's not a sudden new thing that happened since you came over to the UK.

I appreciate that docs want to help patients. It's kind of the reason for their existence innit? ;)

Did you notice the authors' names for authors #1 & #2?
A Windak, T Tomasik, HM Jacobs* and RA de Melker*

Sounds like Pole, Pole, Brit, Dutch.

This is in line with the European study of management in acute tonsillitis, in which Poland showed the longest duration of the illness: mean duration 8.23 versus 4.79
days in The Netherlands and 2.56 days in Turkey.

This illustrates the importance of transcultural differences and underlines the fact that physicians can promote the medicalization of 'normal' common diseases such as upper respiratory tract infections by doing too much (tests, referrals, prescriptions) and explaining too little.

Ordering relatively high numbers of tests, making unnecessary referrals and advising bed-rest can lead to the somarization of relatively minor ailments. Moreover,
such management is inefficient and costly.

They did say relatively minor, not just minor. Apparently 30% of cases are appropriate for antibiotics. I have had some pretty bad sore throats in my life, but don't remember a pus dripping experience. However I believe those are the ones for which antibiotics ARE indicated.

Like Seanus said. Potrzebna kopa w dupę i już. :)

The problem with giving unnecessary antibiotics is that they will breed resistant strains of bacteria.

wildroverThreads: 180 Posts: 8,188 Joined: Jun 7, 07 ♂	Mar 5, 10, 16:27 #27
Myszolow: The problem with giving unnecessary antibiotics is that they will breed resistant strains of bacteria. I won,t take any antibiotics for this reason....unless i am really really ill..... mind you...i have no idea how many antibiotics get into my system from the food i eat that has been pumped full of them...???

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Edited by: Myszolow Mar 5, 10, 16:44 #28

This from 2009 TYGODNIK "POLITYKA", 06/06/2009 http://ec.europa.eu/health-eu/doc/jp_pl_art_en.pdf

For the time being the situation is far from satisfactory − among the countries of the European Union Poland occupies the 9th place with respect to the use of antibiotics.
And applying them automatically in case of viral infections (where they are completely inefficient) or when a surgical intervention would be sufficient (e.g. removal of an abscess or sinus surgery) contributes to increasing the resistance of germs. This, in turn, means that we fall ill more often and are ill for a longer period of time, risking medical complications and higher expenses.

I believe that paper I found has partly answered the question why Poles get ill more.

Part of it is due to inappropriate prescription of antibiotics and part of it may well be climate or culture related.

I'm slightly disturbed by a couple of translation errors in it though (without a look at the source text - but I am an experienced reviser of Pinglish). Angina has been translated as angina, which it isn't - it's tonsilitis. Efficiency of drugs is probably a translation of skuteczność, which in a pharmaceutical context should be efficacy - meaning - it works. Tut tut EU for using a non-native.

So all this begs the question. When did this irresponsible prescribing of antibiotics start to occur? Was it during communist times or was it later. I rather think it was during.

I don't really care if I'm right or wrong, I just want to know. I didn't think antibiotics were very profitable so I'm not sure if the evil big pharma argument is applicable. But it may be. Evidence please people. :)

From the same article...

Many doctors, even those holding a professorship, base their convictions only on their own experience or on the content of textbooks they last opened during their studies.

Which textbooks? When did they study? Who was in charge of the curriculum? Who instilled these irresponsible ideas and when? That's the next stop on this exciting adventure. ;)

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Mar 5, 10, 18:05 #29

Magdalena:

If there's anything of the sort going on now, it would be a relatively new phenomenon (as I said before). I would say big pharma are pushing antibiotics and other fancy meds for GPs to prescribe.

It definitely is nothing new. I grew up in the 80s and I had antibiotics rammed down my throat by the irresponsible doctor at every possibility. The end result: I was more often ill then not and my immunity went down to hell.
Then my mum took me to the more rational doctor, he gave me something to boost my immunity and I've been fine ever since.
On the other hand, a GP in the UK tried to give me nose drops for the terrible cough I had.

And you're right in one respect, Magdalena: Brits tend to dress without any thought of the weather. Maybe they don't look out of the windows? I too have seen girls in furry boots (fashion alarm!) in June and girls with bare legs in the winter (they seem to present a strange aversion to tights).

SeanusThreads: 22 Posts: 30,158 Joined: Dec 25, 07 ♂	Mar 5, 10, 18:24 #30
Good point, Mysz. Angina pectoralis is not the same as angina in Polish.

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