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Doc, Do I Need an Antibiotic?

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“Doc, don’t I need antibiotics?” is a frequent question heard by many physicians. Some of the most common problems – like colds, sinus infections, urinary tract infections, bronchitis – cause many patients to miss work and feel miserable. The patients assume that they should be taking an antibiotic. What they don’t know is that an antibiotic may be exactly the wrong thing to be taking – for several reasons.

Reason #1: Misuse – Most common infections, including those listed above, are caused by a virus and NOT by bacteria. Antibiotics will not kill viruses. Antibiotics will not make you feel better and will not get you back to work faster. Do not ask for antibiotics if the doctor says you have a virus. If you want to be sure, ask the doctor for a culture.

Reason #2: Inappropriate use – Patients think that because they have the same symptoms now that they had the last time, they should take some more of the medicines that they have left over in the medicine cabinet from the last time. There are two problems here. First, the same symptoms may not be from the same problem (sinusitis last time – allergies this time). Second, why do they have leftover antibiotics? – because they didn’t take all of their antibiotics last time. They quit taking it when they felt better. Antibiotics must be taken in the proper dosage, for the proper time, for the appropriate problem. Don’t self-prescribe your own antibiotic left-overs.

Reason #3: Overuse in animals and in people without infections – Since 1977, the FDA has known that antibiotics have been used in animals (without infections) to promote rapid growth. This has caused several common bacteria that are common to man and animals (E. coli, Salmonella, Enterococcus) to become resistant to some of the common antibiotics. These resistant bacteria are now infecting people, and are difficult to treat. Other bacteria (MRSA and VRE and some strains of tuberculosis) are becoming more common in the general population. THese bacteria are becoming almost untreatable because antibiotics have been so overused that they have developed resistance. Find out how you can add your voice to limiting the inappropriate use of antibiotics in people and animals.

Reason #4: Empiric treatment – Many patients with the infections mentioned above come to the doctor expecting an antibiotic. Many doctors don’t take the time to investigate the infection and treat empirically (i.e., without testing, and simply assuming that the disease is bacterial).

A recent study of chronic sinus infections in over 200,000 patients used a CT scan of the sinuses and a scoping of the nose to reveal that 60% of the patients did not have sinusitis at all – despite having symptoms that suggested that they did. Urinary tract infections, flu, bronchitis, and the common cold are further examples of disease processes that are treated empirically with antibiotics. Ask your doctor if he/she is sure that your problem is caused by a bacterium before taking the prescription offered.

Be part of the answer – not part of the problem. Help keep antibiotics working effectively for all of us by limiting your use of antibiotics to the times they are truly needed.

 

Author

Max Wayne Hammonds was born Aug 3, 1943, in northeastern Indiana, in the county hospital in Wabash. He attended high school and college in his home town of North Manchester and attended Indiana University Medical School in Indianapolis. Following an internship in South Bend, IN and a year of flight medicine in the Air Force, he took a residency in anesthesiology at Wilford Hall Medical Center at Lackland Air Force Base in San Antonio, TX.