[devilbunny]

If you’re already sick, you probably have a raging bacterial infection going on. Waiting three days for a culture is unlikely to improve the choice of therapy for someone not sick enough to be in the hospital.

My eustachian tubes plugged up while I was flying home from my honeymoon. Three days later, my ears were still stopped up. I was in medical school at the time, so I went to the student health clinic (run by senior residents). I said that I had ear infections commonly as a child, that this ear had been plugged for three days, and could I have antibiotics? He said, let’s look first. He did. He then said, “no pain, just dulled hearing? No fevers?” Correct. “That’s the worst-looking eardrum I have ever seen in an adult. Here’s some amoxicillin-clavulanate.”

Antibiotics are broadly classified as bacteriostatic (prevents multiplication) or bacteriocidal (kills living bacteria). Amoxicillin (like all beta-lactam antibiotics) is bacteriocidal. Thirty minutes after I took my first dose, I vividly experienced this. Chills, fever, shivering, sweating that lasted for almost two hours as millions or billions of bacteria died and their dead cells entered my bloodstream. The second dose was not as bad but still unpleasant. By the third dose, I just felt a few minutes of unpleasantness. And after three days, my ear finally unplugged.