Appropriate use of antibiotics

As I write this, we are getting closer to a time of year when prescriptions for antibiotics become more abundant.
Children are back in school. It becomes more likely that germs gets passed from one person to another, as pupils and others are more frequently spending time together in enclosed areas such as classrooms. Before long some of them are not feeling well. There is an increase in stuffy noses, runny noses, body aches, fever, fatigue and some other undesirable symptoms. Quite often these individuals are dealing with the common cold. In turn, some pupils—and maybe adults—are staying home because they feel ill.
Could there be a bacterial infection present? Sometimes, but not always. Thus, antibiotics are sometimes—but not always—a good idea.
Many patients, and many parents of pediatric patients, have spent quite a bit of time at their physician’s office due to illness. Quite often, the outcome of such a visit is the prescribing of an antibiotic. Many patients and health care professionals appreciate the idea that an antibiotic will treat some of these illnesses. Once that occurs, the patient should feel better.
There is one big concern with this trend, though. More and more often, the antibiotics that are prescribed are not working as well as they used to. It is due to something called antibiotic resistance.
Sometimes resistance occurs because an antibiotic was prescribed but was not necessary. One example of this is a case where the patient has been infected by a virus, not a bacterial infection. A key point: Antibiotics will not eradicate, or completely destroy, viruses. The pharmacological properties of an antibiotic are of no benefit. They will not stop the virus from infecting a patient.
Tied to this is a response seen by bacteria when they are present in the human body. If the antibiotics are not used properly, the bacteria that they are supposed to eradicate will actually change until they can withstand the antibiotic’s presence. Bacteria have the ability to change their anatomy and physiology so that the antibiotic is no longer able to kill them. At this point, the bacteria are able to continue infecting the patient. It is as if no antibiotics were prescribed in the first place.
As a result, some illnesses that were less of a concern say, 50 years ago, are now increasing in frequency in the United States and other parts of the world. Some antibiotics that were successful back then are no longer worth prescribing. They will not work.
What can patients do? I have three recommendations.
1. Do not seek out a physician or the antibiotic that physician may prescribe unless certain conditions occur. It becomes more acceptable to seek out that physician if you are experiencing any of the following:
– A fever of over 102 F
– A fever of less than 102 F IF it lasts more than four days
–A cough that lasts more than three weeks
– A sore throat that lasts more than a week
– Other cold symptoms that last more than 10 to 14 days
Quite often what happens is that some of these illnesses get better by themselves. If it is a virus, the body usually will get rid of it without the help of antibiotics or other medications. Now that may take some time, so this calls for patience, but that is how the human body works. It is designed to take the time to do it right, when it comes to responding to most viral infections.
In that specific situation, while waiting for the body to get rid of such infections, the symptoms that occur can be treated with non-prescription products. For example, ibuprofen and/or acetaminophen can often treat a fever, body aches, or a sore throat. Ibuprofen can be used up to four times a day (every six hours) on an as-needed basis. Acetaminophen can be used every 4 to 6 hours, again as needed.
By the way, when we say “as needed,” the implied message is this: If you don’t need it, don’t take it.
2. If you do see a physician, follow his/her instructions as to how to take care of yourself. That physician may tell you NOT to use antibiotics. More often than not, that is wise advice. Instead of antibiotics, sometimes the physician will refer the patient back to non-prescription products and tell the patient to “wait and see.”
3. If you do get a prescription for an antibiotic, take it exactly as prescribed. One of the common causes of bacterial resistance is the misuse of antibiotics even when they are a good idea. Research has found that if you use it longer than necessary, or not as long as is necessary, the bacteria involved find a way to become resistant. For example, some antibiotics should be taken twice a day for ten days. If you do get an antibiotic with that type of schedule, take it for ten days, just like the label says. In many cases where 10 days is the recommended period of time to take the drug, a patient will feel better after less than ten days. Splendid! That is what we are hoping for. However, that does not mean the bacterial infection has been completely eradicated. Some of those bacteria may still be in the body, so its wise to continue taking the antibiotic for the prescribed amount of time to make sure all of the bacteria are eliminated. Research has found that if a patient stops taking the antibiotic prematurely, the bacteria that have not been eliminated are more likely to adapt to the presence of the antibiotic and find a way to resist it. Bacteria, like most other organisms in the biological world, have the ability to adapt to a changing environment.
If right now you are ill, I hope this advice helps. I also hope you feel better soon.