Antibiotics: Friend and Foe

Antibiotics are considered one of the greatest medical advances ever. Prior to antibiotics, a person could die from strep throat or an infected wound. Today, it is hard to imagine that. However, many people think antibiotics are the solution to all illnesses, which has led patients to inappropriately seek antibiotics and physicians to inappropriately prescribe antibiotics.

What Do Antibiotics Do?

Different antibiotics work in different ways, but they all accomplish the same task: killing bacteria. Bacteria are very small organisms that are present throughout our environment. Although some bacteria do cause diseases, not all bacteria are bad. There are plenty of good bacteria in our bodies that help keep us in balance. When you take an antibiotic and end up with side effects (different from an allergic reaction) like an upset stomach or diarrhea, it is often because the antibiotic has destroyed good bacteria along with the bad.

What Don’t Antibiotics Do?

Antibiotics are useless for treating viruses. A virus is also invisible to the naked eye, but unlike bacteria, almost always causes an infection. Viruses cause most everyday illnesses, such as colds, the stomach flu and influenza, but there are very few medications available to treat these infections. However, our immune systems tend to be very good at fighting off viruses. If you take antibiotics for a viral infection, you will get better, but you would have gotten better on your own anyway!

What About Allergies?

Unfortunately, many people experience adverse effects while taking antibiotics. While some of these symptoms may be true allergies, many of them are actually side effects. You may wonder why this would make a difference, since either way you never want to take that medicine again! This is actually a very important distinction since an allergy to one antibiotic will limit what antibiotics you can take in the future. Each antibiotic belongs to a “class,” which is a grouping of similar antibiotics. An allergy to one drug in that class means you won’t be able to take other antibiotics in that class. A side effect, such as an upset stomach, diarrhea or even some rashes, would not limit other antibiotics in the same class. Some side effects are even treatable with probiotics, which are good bacteria that are normally in our intestinal system.

What are Antibiotics Good for?

Some illnesses require antibiotics to get better, such as urinary tract infections and strep throat. Some illnesses, such as ear infections, may get better with antibiotics, but they may get better without them, too. Pneumonia is another tricky one. A true bacterial pneumonia requires antibiotics, but that can be a hard diagnosis to make, even with an x-ray. Viruses can cause pneumonia as well, and of course, an antibiotic won’t help those. And what about bronchitis and sinus infections? Believe it or not, most of the time those infections will not require antibiotics to clear up either. It may take longer than a typical cold, but your immune system can fight them.

What’s the Harm in Taking Antibiotics?

Besides the risks of side effects and allergies, there is a real risk of resistance. If we continue using antibiotics when they are not necessary, the bacteria start to develop a resistance to them, which means the bacteria are harder to kill. Scientists have to develop new, stronger antibiotics, which is not easy, cheap or fast. If bacteria are highly resistant, it could mean having to be hospitalized for IV antibiotics, or even death if it the bacteria end up not being treatable.

What Can We Do?

Don’t ask for antibiotics when your doctor does not recommend them. If your doctor is giving you a prescription for antibiotics, ask what they are for.

For example, you go to see your doctor for a cough. At the end of the visit, you get a prescription for an antibiotic. Rather than just take the prescription, find out why he or she thinks you need the antibiotic. You may be able to take the prescription and hold on to it, only filling it if you don’t get better in a certain time frame or if your symptoms worsen.

Also, make sure to finish the entire course of antibiotics once you start them to make sure the bacteria are eradicated. Please do not hang on to “leftover” antibiotics or take someone else’s prescription. If you partially treat an infection, it makes our job much harder to make an accurate diagnosis and it also contributes to bacteria becoming resistant to the antibiotics.

Remember that you and your physician are a team working together. Never be afraid to ask questions so you understand what is going on with your (or your child’s) health and body!

By Dr. Shari Eich

Pediatrician at Avera Medical Group McGreevy Clinic, Sioux Falls

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