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Powers and perils of antibiotics
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When you have a bad cold or the flu, it’s natural to want fast relief. But antibiotics don’t fight illnesses that are caused by viruses. These include colds, influenza, most coughs and sore throats, many cases of acute bronchitis and some ear infections.
Rest and be patient
The best way to treat a viral infection is to rest, drink fluids and let the illness run its course. Over-the-counter pain relievers, cough medicine and decongestants can help relieve symptoms. Antibiotics work on bacterial infections such as strep throat. But taking antibiotics when they are not needed may make bacteria resistant to the medicine. This can lead to longer and more complicated illnesses that require stronger, more expensive medicine.
“People have heard of MRSA, which is an antibiotic-resistant, flesh-eating bacteria,” said Frani Knowles, MD, a family medicine physician with New Ulm Medical Center. “It became a problem because people used antibiotics when they shouldn’t. There has definitely been a shift in prescribing, and it’s because of the resistant bacteria that we see. We’re trying to prevent the next generation of ‘super bugs’.”
People often request antibiotics if they’ve been sick for a week – either to get back to work or before a vacation, Knowles said. “They may have taken an antibiotic in the past in that situation and felt better in a few days, but it wasn’t because of the antibiotic,” she said. “People think antibiotics will help them get better faster, but that’s usually not the case.”
Knowles noted that even though influenza is a viral illness, flu sufferers should go to the doctor if they have any breathing problems or a fever that doesn’t come down with over-the-counter medication.
When antibiotics are needed
Viral illnesses tend to be shorter in duration. Symptoms that linger for a couple of weeks may indicate a bacterial infection that needs antibiotics. If your doctor prescribes an antibiotic, taking all of the medicine as prescribed – even if your symptoms go away – is the only way to completely kill the infection.
A positive rapid test for strep throat means that an antibiotic is needed. “We treat it to prevent complications, including rheumatic fever and kidney disease,” Knowles said. “If the rapid test is negative, we confirm it with a culture test. If a family member gets a sore throat, that doesn’t mean they need antibiotics, too. Strep has only a 15 percent transmission rate within a household.”
You should never take leftover antibiotics from a prescription that you didn’t finish as directed, she said. That can result in a false negative test for strep or a urinary tract infection.
Children’s ear infections pose another challenge. If a baby or child under age 2 has an ear infection or is not able to rest well, Knowles usually prescribes an antibiotic. But physicians have become more cautious about giving older children antibiotics. Unless the symptoms get worse or there is a fever, Knowles said it’s best for the illness to run its course.
Communication is the key
“Be honest with your doctor about your fears,” Knowles said. “Tell us if you are worried because of something you heard on the news or a past experience. Be honest if you took an old antibiotic that you didn’t finish when it was prescribed.”
Appropriate antibiotics use and education will happen when doctors and patients communicate openly with each other, she said.
Source: New Ulm Medical Center - Health Edition
Reviewed by: Frani Knowles, MD
First Published: 02/25/2013
Last Reviewed: 02/25/2013