Antibiotics: Are they always the answer?

You wake up feeling you have a scratchy throat. As the morning goes by the nose starts running. By the evening the headache and muscle pains have developed, and by the next morning the chills and coughing cause you to call in sick at work. At the doctor, the words we so often use are, ”Doctor, I can't afford to be off for much longer. I need something to make me feel better quickly.”

I grew up thinking that antibiotics were the cure for all infections. With my dear mother being a pharmacist, the antibiotic would come home almost as soon as any of us developed a cough. But let's look at the word  'Antibiotics': The Latin word  'anti' means against and 'biotics' means bacteria. Hence antibiotics are active against bacterial infections. But were you aware of the fact that 80 to 90 % of the upper respiratory, and even lower respiratory infections that we get are actually viral infections?

The above symptoms described are typical of a viral infection, and can be treated with non-prescription medicines like decongestants, cold formulas, cough syrups, paracetamol and aspirin. The viral infections can sometimes even linger for 7 to 14 days, so one must sometimes be patient for it to clear, but still it is not an indication for antibiotics. Antibiotics are not at all effective against viral infections!

Antibiotics are a brilliant discovery of modern medicine, and when used in the correct place, are a vital part in the management of bacterial infections. Namely life threatening illnesses like pneumonia, meningitis, dysentery and blood poisoning. But when overused and misused, organisms become resistant and antibiotics become less effective against them, making these illnesses very difficult, or even impossible to treat! Resistance is when an organism changes its structure to try and fight off the antibiotic. I attended a lecture recently where it was said that there is such a huge problem worldwide with antibiotic resistance that we are moving towards the 'Post Antibiotic Era'. This means that there will probably come a time where the antibiotics that we have available won't work anymore, which is a very serious prediction! Another source said that half the 100 million antibiotics prescribed a year in the US are unnecessary.

Bacteria can also cause more common illnesses such as ear, urinary and sinus infections. An antibiotic may only reduce symptoms of the infection in these cases with a day or two. So if it is not a serious infection, or if the risk of complications is low, then in most cases, your body's immune system is capable to fight off the infection without an antibiotic.

And so you ask, what can I do about this problem of antibiotic resistance? How can I preserve the availability of antibiotics for future generations?

 The following is from a  publication by the American College of Physicians, as pointers regarding the role we all need to play in reducing the incidence of antibiotic resistance:

1. Don't insist on antibiotics for yourself and your children.
2. Ask your doctor, “Is this antibiotic really necessary?”
3. Take antibiotics only with a doctor's instructions – don't take antibiotics left over from old prescriptions, given to you by friends or family, or purchased without a prescription.
4. Prevent infections by washing hands thoroughly with soap. (Although the use of  'antibacterial' handwashes have been implicated in causing resistant infections.) Wash fruits and vegetables thoroughly. Avoid raw eggs and undercooked meats.
5. Keep immunizations up to date – especially for influenza and pneumonia if you are a senior citizen or have a chronic illness.
6. Finish each antibiotic prescription – even if you feel better. If you don't, some resistant bacteria may stay with you and multiply, requiring a different – likely stronger – antibiotic when the infection returns weeks later.

The above information is especially important for us in the cold winter season we are in at present, where the Influenza and other viruses are making their way through almost the whole community and back again. Be aware that antibiotics are not always the answer!

Dr Christine Boshoff