A New Look at an Old Problem: Inappropriate Antibiotics for Acute Respiratory Infections

Sirs, in my opinion, this intriguing article is not updated, since the author unfortunately ignores Biophysical Semeiotics (www.semeioticabiofisica.it). In fact, nowadays, it is very difficult to know the real nature of an infectious disorder at both the bed-side and ER,as well as to recognize a lot of cases such as those described in the article, not to speak of disorders recognizable by means of academic, orthodox, physical semeiotics. In fact, I am filled with wonder at reading that there are doctors who are sharing the uncertainty of the value of antibiotics for acute tonsillitis, pharyngitis, bronchitis in the form of written and verbal advice, although I do not know if these physicians are skilled at performing advancements in the field of physical examination (1). For space reasons, I underscore here merely the possibility of recognizing easily and quickly the “chronic” antibodies synthesis in the spleen during flu, as well as the spleen “small” antibody production, in the case of gram-negative bacteria (Esch.coli, HP, a.s.o.), which play a pivotal role in bed-side diagnosis of virus or gram-negative infections (1). Moreover, interestingly, a doctor can now-a-days observe clinically, and in a “quantitative”way, the so- called Reticulo- Endothelial-System-Hyperfunction Syndrome (RESH), which parallels with ESR and Protein Electrophoresis, but it is “more” sensitive and specific than both (2-3). Certainly, most adults, and children with acute bronchitis who consult their general practitioner (as well as University Professors...) will receive antibiotics, although in many cases antibiotics do not modify the natural course of the disorder at all. In my mind, the real problem is to recognize “clinically” both the nature of infectious disorder and the actual patient's defense , including antibody and PCR synthesis (in above- cited website): first, the “ethiological” , complete diagnose, starting from the bedside recognizing all constitutions (ibidem; 4) and, then, the proper therapy. Nowadays, we can solve such a problem, and a lot of others…if we are determined to be “open-minded” physicians. May I doubt it? 1) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Ed. Travel Factory SRL., Roma, 2004. www.travelfactory.it 2) Stagnaro-Neri M., Stagnaro S., Appendicite. Min. Med. 87, 183, 1996[MEDLINE] 3) Stagnaro S., Sindrome percusso-ascoltatoria di Iperfunzione del Sistema Reticolo-Istiocitario Min. Med. 74, 479, 1983 [MEDLINE]. 4) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. 5) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Ed. Travel Factory, Roma, 2005.

Competing interests:   None declared