Antibiotics for bacterial infection, not viral

Donya Betancourt, Pediatrician
drdonya@hotmail.com

When it comes to prescribed medication, patients can be divided into three groups.

The first group are those who immediately ask for antibiotics when their child says her throat feels like sandpaper, her nose like a clogged pipe, her eyes are watering and her head throbs. This child probably has a viral cold and antibiotics are useless in treating such illnesses, but the parent still insists that the doctor prescribes them.

The second group are those who have been prescribed antibiotics for a bacterial infection. The doctor stresses that the patient must take the medicine for the entire prescribed period. But the patient stops when they start to feel better, sticking the half-empty pill bottle in the cabinet.

The third group are those who refuse antibiotics, no matter how important it is for them to take them.

These examples illustrate a common problem in health care: the misuse of antibiotics. Prescribed medicine is usually seen as the first line of defense against many infections. However, frequent and inappropriate antibiotic use has led to the development of antibiotic-resistant bacteria. Since these bacteria have outsmarted many standard antibiotics, stronger and more costly medications are needed to treat some infections.

With the discovery of penicillin more than 50 years ago, hundreds of other antibiotics were created to combat bacterial infections. But just a few years after their introduction, a troubling pattern emerged. Bacteria frequently treated with the same antibiotic would eventually develop resistance to the drug and a stronger medication would have to be used. Unfortunately the bugs would soon learn to resist the stronger drug as well. This creates a cycle in which increasingly powerful drugs are needed.

When you take penicillin or another antibiotic for an infection, the drug usually kills most of the bacteria. But sometimes a few persistent germs survive. These surviving bacteria can multiply quickly and thrive despite the presence of an antibiotic.

These antibiotic-resistant bacteria, or "super bugs" as they are often called, no longer respond to first -- or possibly second choice -- antibiotic therapy. This leaves fewer effective drugs available to treat common but potentially life-threatening illnesses. Unfortunately, super bugs can also exchange survival secrets with other bacteria, even different species, allowing additional resistant organisms to grow.

Repeated use and improper use of antibiotics are two of the main causes of the increase in resistant bacteria. Antibiotics are effective in treating most bacterial infections, but they are not useful in the fight against viral infections, such as colds or the flu.

In outpatient settings, antibiotics are most often prescribed to adults for mild respiratory infections such as sore throats and the common cold. Since these infections are most often caused by viruses not bacteria, antibiotics offer little or no benefit. A recent study reported that between 1989 and 1999, 73 percent of people with sore throats received prescriptions for antibiotics. However, only 10 percent of all sore throats are caused by bacterial infections.

Many people do not complete the full course of their prescribed antibiotics. The problem with this habit is that a shortened course of antibiotics often wipes out only the most vulnerable bacteria. This allows relatively resistant bacteria to survive and prosper. A complete dose of antibiotics is needed to kill all of the harmful bacteria.

There are things you can do to help protect yourself and your family.

* Antibiotics are intended for bacterial infections. Don't take them for viral infections such as colds, coughs or the flu.

* If your doctor determines that you don't have a bacterial infection, ask about ways to help relieve your symptoms. Don't pressure him or her to prescribe an antibiotic.

* Take medicine exactly as prescribed.

* Take the antibiotics until finished, even if you're feeling better. Don't save the medication to treat yourself or others later.

* Keep a diary of your antibiotics use, and that of your children, so that you're able to present your physician with a complete antibiotics history.

Despite even the best prevention efforts, sometimes a secondary bacterial infection can occur. If your cold or flu doesn't resolve in a week or two, consider checking with your doctor again.

Above all, a smart use of antibiotics is the key to controlling increased resistance. Your responsibility is to partner with your doctor in the appropriate and sensible use of antibiotics.