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Ask A Doctor... When Do I Need an Antibiotic?

November 15, 2016 | By Lisa Schwenk
Published in: Question Answer, Pharmacy

CDC infographic with 6 facts about antibiotic use

Adam Rochman, MD

Answer provided by Adam Rochman, MD, Medical Director of the Augusta Health Emergency Department. Dr. Rochman attended medical school at the University of Miami, and completed his internship and residency at the University of Virginia.

November 14-20 is 'Get Smart about Antibiotics Week', a national annual observance, coordinated by the Centers for Disease Control and Prevention, to raise awareness of antibiotic resistance and the importance of appropriate antibiotic use. For more information, visit www.cdc.gov/getsmart/week.

This is an area of great debate in my family, and depending on whom you ask you get multiple answers. If you ask my grandmother, who has no medical training and was born before the invent of antibiotics in the 1930s, she will tell you that anytime you have a cough, green mucus, or fever she recommends taking an antibiotic. In fact, take it right now… what are you waiting for! If you ask me you will likely get a long-winded answer that probably ends with, "Just take some Tylenol and eat some chicken soup and you'll be fine." The truth lies somewhere in between and depends upon a host of factors including your age, your health status, other medical problems, and what type of symptoms you are experiencing.

To help answer this question we first need to know some important facts:

  1. Antibiotics kill bacteria but do not have any effect on viral infections.
  2. The vast majority of bronchitis, upper respiratory infections, and sinus infections are caused by viruses and therefore antibiotics will not help in their outcomes.
  3. Not all bacteria are bad. Humans are colonized by trillions of bacteria that work together with your body in many important symbiotic relationships.

So why not take an antibiotic just in case? First, antibiotics kill many of the good bacteria along with any of the potentially harmful bacteria. This can lead to diarrhea as the good bacteria are important in digestion. More importantly this can lead to something called C. difficile Colitis. This occurs when the good bacteria in your intestines are killed off by an antibiotic and the C. difficile bacteria that reside in your gut multiply and go haywire. This can become quite serious and even life threatening in certain situations. Lastly, by taking an antibiotic you put yourself at risk at becoming colonized with bacteria that develop a resistance to antibiotics. We now know that bacteria have an ability to mutate or change when they are exposed to antibiotics and can become resistant to that antibiotic in the future. This can lead to some pretty scary bacteria that can be difficult and expensive to treat.

So then when are antibiotics appropriate? The truth is when it's used to treat bacterial infections. This is a bit of an oversimplification and the decision is often best made in conjunction with your doctor. However, odds are that if you are a relatively healthy person and have come down with what you think is a cold, bronchitis, or a sinus infection more than 95% of the time these are caused by viruses and antibiotics will not help the situation. In these cases you are better off treating your symptoms, gets lots of rest, and with time you will improve. If there is ever a question, please do not hesitate to contact your doctor or health care provider to help determine if your illness might be benefit from antibiotics or not.