Antibiotics – Proper use and overuse

Editor’s note: In this weekly column addressing medical and health care issues, doctors from Mercer University’s medical school provide useful and timely information on a variety of topics. Readers with questions for the doctors can email them at groover_ce@mercer.edu.

Antibiotics are medications used to treat bacterial infection. Their proper use can be lifesaving, but unfortunately their improper use can cause potentially life-threatening issues and side effects.

Because of overuse of antibiotics, many bacteria are becoming resistant to them. Thus, doctors may have a harder time finding an antibiotic that is effective to use against a legitimate bacterial infection when truly needed. According to the Centers for Disease Control and Prevention, of the estimated 154 million prescriptions for antibiotics written in doctors’ offices and emergency departments each year, 30 percent are unnecessary. About 44 percent of outpatient antibiotic prescriptions are written to treat patients with acute respiratory conditions such as sinus infections, middle ear infections, sore throats, colds, bronchitis, asthma, allergies, influenza and pneumonia. An estimated half of these outpatient prescriptions are unnecessary. Again, antibiotics help fight infections caused by bacteria, not viruses. Bacterial infections can include strep throat, pneumonia, bladder or kidney infections and some sexually transmitted diseases such as gonorrhea, chlamydia and syphilis. Antibiotics are useless against viral infections such as the common cold, influenza, sore throat (except strep throat) and acute bronchitis in a patient without chronic lung disease. Coughing up phlegm does not necessarily mean a bacterial infection is present, as phlegm can occur with viral infections as well.

A very common use of antibiotics is to treat sinusitis. The sinuses are hollow areas in the bones of the face that have a lining that can become infected. Most cases of sinusitis are caused by a virus and can occur with a common cold. Antibiotics are not indicated to treat viral sinusitis. Symptoms can include stuffy or blocked nose, yellow or green discharge from the nose, tooth pain and face pressure. Usually, you can use over-the-counter pain medication, nasal irrigation with salt solution, oral decongestants or nasal decongestant sprays to treat the symptoms. If these symptoms persist greater than 10 days (or if you get better and then relapse) or if there is high fever (higher than 102 degrees) or other symptoms such as sudden and severe pain in the face and head, trouble seeing or seeing double, trouble thinking clearly, swelling or redness around one or both eyes or a stiff neck, see your doctor, as this could indicate a bacterial infection that may indeed require antibiotics.

Besides bacterial resistance, inappropriate use of antibiotics can cause side effects such as nausea, vomiting and diarrhea. Allergic reactions can occur even if you have taken the antibiotic in the past without a problem. These allergic reactions can potentially be life threatening. There is also a risk of secondary infections such as yeast infections in women and intestinal infections. These intestinal infections can be very serious. So don’t pressure your doctor to prescribe an antibiotic for you if he/she does not feel that an antibiotic is indicated. If you are prescribed an antibiotic for a legitimate reason, make sure that you take it exactly as prescribed and for the length of time specified, even if you start to feel better. Also, never ever take antibiotics that were prescribed for someone else as this could be extremely harmful or even dangerous. There are even new studies that are questioning the use of antibacterial soaps, as they can potentially lead to resistant bacteria. Standard soap is just as effective as antibacterial soap, and because of these studies the U.S. Food and Drug Administration recently banned the use of 19 chemicals frequently used in antibacterial soaps. Alcohol-based hand cleaners are probably acceptable to use.

This story was originally published December 30, 2016 at 11:45 AM with the headline "Antibiotics – Proper use and overuse."