Sitting here with a terrible respiratory viral infection, I wish for a magic pill to make it go away. But, I know there is no cure for viral infections and I must wait it out. I treat many patients with similar infections and give the same advice I am using to treat myself. Yet, many patients insist on antibiotics for their viral infections. And many doctors give in to these requests. But, inappropriate use of antibiotics is harmful for several reasons.
- When we prescribe antibiotics when they are not needed, this causes antibiotic resistance. It aids in creating organisms that used to be treatable with antibiotics to no longer responding to these same ones. It gives rise to super-infections. There are some bacteria that used to be curable with single antibiotics now requiring 2 or more to be treated. We all witnessed the rise of MRSA (methicillin resistant staph aureus) in the community. This is a very hard to treat infection. With injudicious use of antibiotics, we can expect to see similar infections rising in incidence. DO we really want to see that?
- All medications carry side effects, even antibiotics. Some of them are relatively minor, such as upset stomach or diarrhea. But others can be life-threatening, such as severe allergic reactions, Steven Johnson’s Syndrome and C. diff infections. Is it worth dying for to take a medication that is not going to give any benefit?
- Antibiotics change normal flora in the body. This is why many women get vaginal yeast infections when they take antibiotics. When it changes the flora in the gut, it can lead to long-term diarrhea. There is a reason these normal organisms exist in our body. Do we really want to mess with this bodily ecosystem by taking a medication for no real purpose?
- Antibiotics cost money. Many of them are covered under health insurance plans. This is a waste of health care dollars, which drives up premiums and other expenses. Shouldn’t we all be more conscious of healthcare expenditures?
In the past decade, there are no new antibiotics being brought to the market. We are left with the ones already in our armamaterium. What will happen when these weapons are rendered useless? Antibiotics were one of the greatest discoveries in the 20th century. But, unless they are used only where indicated, they will be soon be ineffective. No one wants to see infections that were easily treated in the past suddenly becoming deadly again. It is going to take an effort on everyone’s part to do this. Doctors are driven to help patients and it is often hard t say no. But, when we give into the request for antibiotics where they are not indicated, we are not actually helping our patients but harming them. We need to say no and we need to learn how to explain this to our patients. And patients need to learn that antibiotics are not a cure-all for every infections. Viruses do not succumb to antibiotics. There is no cure for the common cold. When doctors don’t prescribe antibiotics, it is not because we are trying to be difficult or misdiagnosing you.
Being sick is no fun. It can be rather miserable as I am now feeling. But, we need to know that there are appropriate and inappropriate treatments. And it is always wrong to prescribe or take the wrong one.
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