You may be shocked to learn that nearly half of people who go to the hospital with flu or cold like symptoms walk out with a prescription for antibiotics. They are too frequently prescribed as “just in case” remedies to treat conditions that aren’t even cured by antibiotics in the first place. The list of infections that are becoming increasingly difficult to treat due to antibiotic resistance include  pneumonia, tuberculosis, gonorrhea, and salmonella, and it  only gets longer. Developing new and stronger antibiotics isn’t the answer if our current patterns of over prescription remain the same.

The Pan American Health Organization (PAHO) has been warning us about the need to reform the way we use and prescribe antibiotics and grasp the true gravity of the problem for years. It cautions that antibiotic resistance will continue to pose a serious threat to life across all populations, regardless of age, ethnicity, and other factors.

The emergence and surge of antibiotic resistance is found to be worse in countries where these drugs can be purchased without a medical prescription for human or animal use. In areas that lack therapeutic guidelines and controls, clinicians have a tendency to overprescribe them (and as a result, the general population tends to overuse them.)

To make matters worse, antibiotic resistance is contributing to the surge in medical costs by prolonging hospital stays, among other consequences. The importance of raising awareness about the need for a shift in practices cannot be questioned. This responsibility lies not just with health professionals but also with patients, who must take action to reduce the spread of infections via vaccination, hand washing, safer sex, and better food hygiene.

How and When Should We Take Them?

Antibiotics are drugs that prevent and treat bacterial infections, and using them correctly can save lives. They work by killing or stopping the growth of bacteria. Antibiotic resistance happens when bacteria undergo transformations due to these drugs. In other words, it is bacteria and not humans or animals that can become resistant, causing infections that are harder to treat.

It’s important to note that antibiotics cannot be used to fight infections caused by viruses, such as those that lead to the flu, colds, and most cases of sore throat and bronchitis (unless these are triggered by a bacteria, as in strep throat.) If an illness is due to a virus, not a bacteria, taking antibiotics can actually cause more harm than good. 

In order for antibiotics to be effective, they need to be taken as prescribed, respecting the dosage and length of treatment. Stopping an antibiotic mid-course can help the bacteria re-infect you.

Most bacterial infections improve within 48 to 72 hours of starting antibiotics. If symptoms worsen or do not get better in 72 hours, it’s best to see a doctor again.

Why Is An Excess of Antibiotics Harmful?

A recent study conducted by the Centers for Disease Control and Prevention (CDC) and Pew Charitable Trusts found that 39% of patients who visited a hospital without an appointment were prescribed antibiotics for cold or flu like symptoms. Furthermore, when they were suffering from a respiratory condition that did not require antibiotics, 46% of patients received such prescriptions. Among regular doctor’s visits (non-hospital), 17% of 9.2 million patients who had a cold, the flu, or other respiratory conditions not treatable by antibiotics were told to take them. At urgent care centers, 14% of patients were prescribed antibiotics.

The excessive use of antibiotics is leading to the increase of so-called “superbugs,” bacteria that are resistant to drugs and thus cause infections that are difficult to treat; as such, the over prescription observed by the study is a threat to public health. Not to mention that antibiotics can also lead to the destruction of “good” bacteria in our gut that are necessary to stay healthy.

Global health organizations warn that urgent measures must be taken to change our habits in regards to antibiotic use and prescription, lest even common and otherwise harmless infections and lesions become fatal.

What Can You Do?

There are a number of simple best practices that we can implement to combat this public health crisis:

• Ask your doctor if your infection is viral or bacterial, and ask if you need antibiotics.
• Share your concerns about antibiotic resistance with your doctor.
• Don’t try to persuade your doctor into prescribing antibiotics “just in case”.
• Take preventive measures to avoid contracting and spreading illness in the first place, by washing your hands, covering your mouth when you cough, and getting the necessary vaccines.
• If you must take antibiotics, do so only as indicated, and never share them or take drugs prescribed to another person.

Sources:  

JAMA: Comparison of Antibiotic Prescribing in Retail Clinics, Urgent Care Centers, Emergency Departments, and Traditional Ambulatory Care, Centers fpr Desease Control and Prevention (CDC),  Improving Antibiotic Prescribing in Hospitals Can Make Health Care Safer, World Health Organization (WHO): Antibiotic resistance, Consumer Reports: When to say no to Antibiotics for infection