are excellent for treating bacterial infections.
viral illnesses? Not so much.
this has long been known, it hasnít been a very easy message
to get across to people who are sick with cold symptoms and
want something to make them feel better fast.
years, overuse and abuse of antibiotics have resulted in a big
problem. Many bacteria have become resistant to the
antibiotics that once were able to kill them. Newer, stronger
antibiotics have been developed to fill the gap, but some
bacteria are even resistant to the most powerful agents we
why health officials at the federal, state and local levels
have been waging a campaign to educate both doctors and
patients about the dangers of taking antibiotics when they
arenít really warranted.
weeks ago, I wrote about the long-lasting hacking coughs that
have accompanied so many upper respiratory infections for so
many people I know. I mentioned what Iíve heard so many
times: That antibiotics should be avoided unless a viral
infection lingers and turns into a bacterial infection, such
as bronchitis, sinusitis or pneumonia.
response, I heard from Dr. Janice Huff, a Charlotte, N.C.,
family physician, who pointed out that most bronchitis is
viral and that antibiotics are often inappropriately
prescribed. "Too many people think they need antibiotics
for bronchitis, and we need to combat this ignorance."
viral infections are sometimes followed by bacterial
infections, which may be treated with antibiotics, Huff said
distinguishing one from another is very difficult.
years, patients with upper respiratory infections have been
coming to doctors after being sick for a day or two and asking
for antibiotics. "Two days of cold symptoms is not
usually bacterial," Huff said.
doctors should not consider giving antibiotics unless a
patient has already been sick for 10 to 14 days or has
complications such as high fever and severe facial pain. Such
patients should see their doctors because they may have
developed bacterial infections. "There is a small
percentage of people who really do need antibiotics,"
Huff said. "I donít want anybody not to take them when
they need them."
companies offer rapid tests for influenza and other viruses,
but doctors say theyíre not always accurate and wonder if
the expense is worth it, especially because the illness would
likely have improved on its own with time.
takes a determined doctor to refuse antibiotics for patients
who have paid to come to the office and expect a prescription.
takes a lot longer to have the conversation with people about
why weíre not going to give the antibiotics," Huff
said. "A lot of doctors just give antibiotics because itís
faster and easier. .ÖBut itís wrong. We should spend time
talking to each other to make the right decision."
David Priest, medical director for infection prevention for
Novant Health, leads the Winston-Salem, N.C.-based hospital
systemís effort to reduce inappropriate antibiotic use. He
says patients should be as concerned as doctors.
example, if you give a healthy volunteer an unneeded
antibiotic, his remaining natural bacteria will be resistant
to that specific antibiotic for six to 12 months, Priest said.
The antibiotic will have killed off susceptible bacteria,
leaving only the resistant ones.
danger is that if you do that many times over, the whole
population will be resistant to the last antibiotic they
got," Priest said. "If the public and the physicians
thought about it that way, they would be a little more
hesitant to take antibiotics unless it was absolutely
significant problem is the rise of C. diff, short for
Clostridium difficile, a diarrheal infection most likely to
affect patients in hospitals or long-term care centers.
Victims often have conditions that required treatment with
antibiotics, and those drugs killed off the intestinal
bacteria that had kept C. diff bacteria in check. The
infection is potentially life-threatening because C. diff has
also become resistant to many antibiotics.
one more reason why everyone should think seriously before
assuming antibiotics are the answer.
live in a world that wants things fixed quickly," Priest
said. "People underestimate how long it takes to get over
a bad viral bronchitis. Weeks and weeks and weeks."