A prophylactic treatment is a medical treatment used to prevent the appearance of a disease or other medical problem in a patient who is healthy at the time of treatment. A form of preventative medicine, prophylactic treatment can offer a very cost-effective way to preserve health. It can minimize the risk of taking medication because prophylaxis is generally safer and simpler than the treatment of an active medical condition. Many types of prophylactic treatment are in common use. These treatments range from routine vaccinations to the use of post-exposure prophylactics to reduce the risk of contracting HIV/AIDS following exposure.
Vaccination is the most widespread form of prophylactic treatment. When determining whether or not to recommend such treatment, health officials weigh such factors as the cost of vaccine production and distribution, the severity of the disease that is being protected against, and the risk factors, if any, associated with the vaccine. Modern vaccinations are generally very safe except for those few people who have an allergy to the underlying vaccine base, so this is usually not a concern. In the very earliest days of preventative medicine, risk was a major factor, particularly with diseases such as smallpox, for which inoculation could cause the disease.
Antibiotics are, in some cases, used as prophylactic treatment against bacterial infection. The ciprofloxacin used to ward off potential infection by anthrax spores in 2001 is an extreme example of this. Prophylactic use of antibiotics can be very risky, however, as it can lead to a much higher level of drug resistance among bacteria and reduce the efficacy of antibiotics, a problem that has been seen in some cases as a result of the use of antibiotics in animal populations. These risks mean that antibiotics are used with caution as a preventative measure, although they are still very useful in patients with injuries that are especially susceptible to infection or in patients about to undergo some forms of surgery.
In other cases, prophylactic treatment can be provided after a patient has been exposed to an infectious agent but before any symptoms have appeared, in an effort to allow that patient's immune system a better chance to ward off infection. Post-exposure prophylaxis is most often used when dealing with very dangerous infections such as HIV/AIDS. A patient likely to have been exposed to this virus will often be placed on a powerful course of anti-retroviral medication in an attempt to prevent a viral infection from developing.
Types of Prophylactic Care
While all prophylaxes are centered on prevention in one way or another, prophylactic care is generally divided into four tiers of treatment. The tier of preventative care you require will depend on your medical condition, needs, and any recommendations from your primary care team. If you have no special requirements, primary prophylactic care is recommended for all people starting just days after birth.
As you receive care, be aware of your own treatment plan. Self-advocate if you have concerns about overtreatment or inconsistent care. While measures are in place for general practitioners to gatekeep access to other specialists by controlling referrals, you can always request a second opinion on your treatment plan.
Primary Prophylactic Care
Doctors and general care practitioners are not always necessary for primary prophylactic care. In many cases, clinics, nurses, and other health care specialists complete the paperwork and routine maintenance to update medical records for patients.
Measures of Primary Prophylactic Care
Primary prophylactic care is what you receive to prevent or provide resistance to a disease that you have yet to be diagnosed with but have the potential to be exposed to or experience. These measures help prevent injury, illness, or unwanted outcomes before the processes even begin. Standard measures of preventative care include but are not limited to:
- Yearly check-ups
- Vaccinations
- Birth control
- Regular exercise
- Proper nutrition
Secondary Prophylactic Care
Typically preventative or primary prophylactic care is scheduled and administered without any symptoms or signs of the potential disease. Still, as a means of cautionary resistance, if you are diagnosed with early signs or symptoms or illness, the treatment moves to a different tier known as secondary prophylactic care.
Secondary preventative measures are in place to help patients determine what signs or symptoms to look out for and who to report the information to for the proper support.
Measures of Secondary Prophylactic Care
Essentially, secondary prevention is in place when there is a heightened risk or concern that a patient has early signs of a disease developing or is in the early stages.
- Education
- Screenings
- Self-exams
- Smoking cessation
- Weight management
For example, women are specifically instructed to complete self-exams at home between appointments because they are at increased risk for breast cancer. All people are advised to watch moles that change in size or color or have excretions because they risk melanoma.
Tertiary Prophylactic Care
Tertiary prevention is implemented once a disease has been diagnosed, or an illness has been identified and professionally treated. Tertiary care is still focused on prevention, but now the pursuit is to ensure that patients can recover from the effects of the disease or the illness as successfully as possible.
If the illness, injury, or disease is chronic, tertiary care works to help mitigate long-lasting effects through management and rehabilitation options. For example, diagnosing a degenerative disease that affects the spine might require surgery and ongoing medical treatment to manage. However, additional support may be necessary to reduce reliance on medically managed pain control if the patient advocates for alternate therapy.
Measures of Tertiary Prophylactic Care
Tertiary prevention addresses areas other than just injury, illness, or disease. In some cases, risk factors and pathological processes will have to be modified for fuller rehabilitation in the future. Other examples of tertiary or ongoing prophylaxis include but are not limited to:
- Psychological care
- Physical therapy
- Rehabilitation efforts
- Medically managed pain
- Occupational therapy
Quaternary Prophylactic Care
The very care meant to prevent illness or infection is sometimes reported to cause additional harm. Researchers and healthcare specialists maintain that patients should not be subjected to any medical treatment if the benefits aren’t made clear and quantifiable in an immediate sense. Quaternary prophylactic care deals with combatting medical overuse, particularly in the applications of preventative medicine, and identifying the strategies necessary for reduction.
For some bodily autonomy advocates, in addition to healthcare professionals, quaternary prophylactic care is a hot topic right now. There are ongoing arguments within and outside the medical community about how prevention and resistance to disease and illness are best approached.
Those who support reducing the chances of overmedicalization carefully review and question specific prophylactic interventions. Opponents cite research that has saved the lives of millions through preventative vaccinations, screenings, and medical care based on prevention.
Measures of Quaternary Prophylactic Care
Counter data suggests quaternary care is necessary to prevent commonly cited overmedicalization that leads to additional illness or worse. Common conditions that are noted as being overmedicalized include but are not limited to:
- Bodily distress syndrome
- Radiological incidentalomas
- Myocardial infarction or heart attack
- Hormone replacement therapy
- Functional disorders