A little help from our friends?

It was the evening of Christmas Day a few years back. The big feast was over, we had cleared up and were settling down for whichever blockbuster movie was on offer that year. The phone rang: it was our our younger daughter who had gone to her boyfriend's home only to find him suffering a raging fever, sore throat with rigors, vomiting, the works. She asked if we had any penicillin in the house. I had, but was not prepared for her to simply come and collect it: I had to see the patient. Half an hour later I had confirmed a rather unhappy, unwell-looking suitor suffering a temperature of 39degC and markedly enlarged, inflamed tonsils with purulent exudate.

A suitable case for penicillin, I thought, and handed over the pills: not really the time or place for microbiological confirmation. I wrote a note for him to take to his general practitioner in a day or so, explaining my unofficial intervention. A few days later when next I saw him he was bright and bouncy and had seen his GP who, as it turned out, was the wife of a colleague and an aquaintance of many many years. She had apparently dismissed my pharmacological offering as lacking in evidence and basically out of date (or was the phrase she used 'unfashionable')?

This reminiscence was sparked by Robert Centor's recent post about a patient with sinusitis who, whilst recognizing that antibiotics probably aren't the answer, modern medicine wanted for decent alternatives. Sometimes, I think, we can use a little help from our friends.