by Max Hammonds, MD

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: Antibiotic misuse – Most common infections like those listed above are caused by a virus and NOT by a bacterium. 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 antibiotic 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. Two problems – same symptoms may not be the same problem (sinusitis last time – allergies this time) AND why do they have left over antibiotics? – because they didn’t take all of their antibiotic 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: Antibiotics 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 bacteria are infecting people and are not easily treated.

Other bacteria (MRSA and VRE as well as some strains of tuberculosis) are becoming more common in the general population and are almost untreatable, because antibiotics have been so overused that these bacteria 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 antibiotic 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 (without testing on the assumption that it is probably bacterial).

A recent study of chronic sinus infections in over 200,000 patients with a CT scan of the sinuses and a scoping of the nose revealed 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 the 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 the antibiotics – that are effective – working for all of us by limiting your use of antibiotics to when they are truly needed.