Are We Overusing Antibiotics?
By Sheryl Kraft
So many of us are guilty of it: We feel lousy with a sore throat, bronchitis, a cold or a sinus or ear infection. We call or visit our health care professional, insisting that we need antibiotics.
And we have been getting them, in many cases despite the fact that they're unnecessary. Antibiotics account for 47 million excess prescriptions each year.
Why? Antibiotics are meant to treat only bacterial infections—and many respiratory conditions are caused by viruses, which cannot be treated by an antibiotic. For those, the best treatment option might be symptom relief.
You may feel like there's no harm in taking a medication, even though it's not exactly right for your ailment, but you're wrong: Over time, taking unnecessary antibiotics makes the medicine less effective, increasing the chances that when you are ill and really do need an antibiotic, it won't work. That's known as antibiotic resistance—and it occurs when the bacteria in your body continue to reproduce, defying the antibiotics you really need.
Additionally, antibiotics can cause harmful side effects, like allergic reactions and diarrhea known as Clostridium difficile, which can sometimes be deadly. Other side effects include vaginal infections, nausea and vomiting.
New data published a few days ago in the Journal of the American Medical Association says that at least 30 percent of antibiotics that are prescribed in this country are unnecessary, which is why the U.S. Centers for Disease Control and Prevention (CDC) is aiming to get this all under control. The CDC is attempting to reduce unnecessary outpatient antibiotic use by 50 percent by the year 2020. ("Outpatient" use refers to drugs given in doctors' offices and emergency departments.)
Sure, antibiotics can be powerful lifesavers for patients who suffer with life-threatening infections, cancer, burns or trauma. But their power risks being lost if they are overused. For example, methicillin-resistant Staphylococcus aureus, or MRSA, is a form of a bacterial infection that is resistant to many common antibiotics. MRSA can cause skin infections and painful boils and can develop around open sores like cuts, scrapes or bites, as well as skin that is intact.
Not only are health care providers being reminded to contribute to reducing antibiotic use by doing things like watchful waiting or delaying prescribing the drugs, but patients are being urged to have a conversation with their health care providers about when antibiotics are necessary and when they're not.
Unfortunately, many health care doctors think it's faster and easier just to comply with the request for an antibiotic than to explain to their patient why it might be unnecessary. On the flip side is the insistent patient who demands they need it.
So, what are the "rules" regarding antibiotic use? When are they truly necessary and helpful?
Antibiotics can treat things like bronchitis, pneumonia, ear infection, strep throat and even pink eye—but only if these are caused by bacteria.
Duke University experts says that certain tests can be done to help diagnose a bacterial infection, like a complete blood count (CBC) or blood, urine or spinal cultures of a fluid that is concerning. However, these tests take time and may be expensive. Researchers are working on faster tests to distinguish between bacterial and viral infections, but cost is likely to remain an issue.
In some cases, an illness can begin as a viral infection, which may turn into a bacterial infection (known as a "secondary infection"). How do you know? If the symptoms last longer than normal, fever is higher than normal or worsens a few days into the illness, bacteria might be present. (Some common examples of secondary infections include sinusitis, ear infections and pneumonia. A urinary tract infection or UTI can be caused by a bacterial infection as well.)
The Cleveland Clinic stresses that:
- The common cold and flu will not respond to antibiotics.
- Less than 10 percent of acute bronchitis cases are caused by bacteria.
- Most cases of acute ear infections will resolve without antibiotics.
- Sore throats are usually caused by viruses (antibiotics are not recommended unless you have strep throat).
- Almost all cases of acute bacterial sinusitis will resolve without antibiotics.
And remember: If you do take antibiotics, take the entire prescribed dosage, even if you start to feel better. It may be tempting to stop, but you need the full treatment to kill off the disease-causing bacteria. If you stop too soon, you may need to resume treatment later.
And who wants to do that?