Antibiotics are truly one of the double-edged swords in medicine. While they have saved many lives from bacterial infections, antibiotics have also been implicated in the development of bacterial mutations to create drug-resistant species. In 2003, approximatlely 20 percent of invasice Streptococcus pneumoniae were resistant to penicillin, and most of these strains also showed resistance to other antibiotics; 42 percent of them are also resistant to erythromycin. These resistant species are associated with more invasive and untreatable infections, especially as we use more broad-spectrum antibiotics. Broad-spectrum antibiotics also kill the good bacteria normally found in the intestine, which can lead to overgrowth of yeast and other pathogenic bacteria, further weakening natural immunity.
There are also many conditions where antibiotics are traditionally given but don’t change the course of disease. For example, an acute ear infection needs to be differentiated from simply having fluid behind the ear drum. Fluid may occur as part of a viral infection or before or after an ear infection, but by itself, does not warrant or respond to antibiotics. Antibiotics are also not effective in cases of simple acute bronchitis. Obviously using antibiotics needs to evaluated differently in high-risk patients, such as infants, the elderly, or patients with other significant diseases or physical or laboratory findings.
While physicians need be more aware of using antibiotics judiciously, patients can also help prevent increasing bacterial resistance to antibiotics. Many of us have been conditioned to only feel like we’ve gotten “treatment” if we leave the doctor’s office with a medicine or prescription. However, if you are dealing with a viral, and not bacterial, infection, there are no prescription drugs your doctor can give you to actually kill the virus in most cases. While none of us like to have a cold, most viral respiratory infections only last 10 to 14 days, and there are many non-antibiotic treatment options for symptom relief. Also discuss additional testing or examination to differentiate viral from bacterial infections. For example, most sore throats are caused by viruses and Strep throat can be easily identified by a throat swab and culture. While a simple bronchitis does not respond well to antibiotics, a prescription may be warranted if testing indicates that the cough is actually due to pneumonia.
Do not take antibiotics for viral infections– they don’t work unless you have also developed a bacterial infection. This is typically rare in the general population, and the antibiotics will kill the bacteria but not the virus.
Specific antibiotics to which a particular bacteria is actually susceptible can also be identified. While this testing may delay treatment for a day, it means that you will be given the antibiotic that will actually work on the infection you have, rather than possibly trying multiple rounds of prescriptions before the effective one is identified. If you are given a course of antibiotics, you need to finish the prescription, even if you are already starting to feel better. If you only take part of the prescription, you may have killed off the weaker bacteria, but the stronger ones will continue to survive and reproduce.
To avoid needing antibiotics, general good health is obviously key. There are also many things you can do at the onset of an infection or for symptom relief, including additional probiotic, homeopathy, hydrotherapy, and extra rest.
© Kimberly Hindman, 2006
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