Stop popping Antibiotic pills indiscriminately – they may do more harm than good!

Mar 21,2017

Do you tend to assume that antibiotics are a quick solution to a runny nose, cough or a sore throat? You are certainly not alone if you do! Doctors say that many of their patients explicitly ask them to prescribe antibiotics for a number of ailments including cold and sore throat, to facilitate a speedy recovery. While this is perfectly understandable, a word of caution must be sounded. Antibiotics are designed to kill bacteria (as long as the right drug is matched to the right germ) and they are ineffective at tackling viruses. More than 90% of all respiratory ailments are caused by a virus and a very small minority can be traced to bacterial causes. According to Dr Hicks of the Centers for Disease Control and Prevention, approximately 2% of sinus infections are due to bacteria and can be treated with antibiotics.

On hearing this sobering fact, patients may remember what was said by the German philosopher Friedrich Nietzsche – anything that doesn’t kill us makes us stronger. The evidence is increasing by the day that popping antibiotics indiscriminately is dangerous for public health and safety. Antibiotics can breed drug-resistant bacteria and can even destroy healthy bacteria in the body, which lets toxic germs fill the void left by them. This does not mean one should abstain from antibiotics entirely, however. There can be some instances where a stubborn cough or terrible cold could benefit from antibiotic treatment. The key question to be answered is – how do you know when?

Doctors have some guidelines to deal with this difficult topic but it is still quite a grey area nonetheless. It can be challenging for even the foremost medical experts to accurately differentiate between bacterial infections versus viral ones on the basis of symptoms alone. This is not 100% accurate and can be considered more of an art than a science. Therefore, physicians rely on their so called spider sense – a combination of both scientific knowledge and instinct – when they deal with antibiotics. The five most important aspects considered by doctors when making this crucial decision are given below –

  1. Fever – Fever, shakes and chills could be symptomatic of a bacterial infection but could also be caused by viral flu. Doctors consider the probability of their patients having the flu based on – Is there is a flu epidemic in the locality? How many other patients suffering from the flu have been treated on the same day? If the flu is indeed within the area and the patient has a high fever, the doctor has a lesser chance of prescribing antibiotics and will suggest a flu shot for the next year.

  2. Duration of sickness – Viral infections that have persisted for a while can become bigger problems; a classic example is sinus infections. Bacteria could also become a factor to consider. So if a patient has been suffering for several weeks, the chance of being given an antibiotic goes up. Most of the time, these symptoms are because of viruses and not bacteria and duration alone cannot be considered a strong reason to prescribe antibiotics.

  3. Goo colour – During a viral infection, nasal secretion is typically thin and clear. Yellow or green mucus is usually linked to bacteria but this can be quite tricky as even some viruses have greenish discharges! Mucous colour alone is considered a fairly unreliable metric for determining the need for antibiotics.

  4. Sore throat – Although a sore red throat is an eyesore indeed, a doctor may look for white spots that could be a sign of bacteria before prescribing antibiotics. Colds begin with a sore throat but a sore throat without any other cold symptoms like a runny nose could be indicative of strep throat. Strep throat does need antibiotics to kill the dangerous bacteria. To be completely sure, a rapid antigen or culture test is undertaken in less than 20 minutes on the spot while the patient waits.

  5. Testing – A lab test is the only guaranteed way patients can be assured that they truly require antibiotics. A throat swab or a phlegm sample can be collected and a culture where bacteria can be grown and tested usually takes two or three days. This is quite expensive and time-consuming and is avoided by doctors in favour of a combination of the above four guidelines.

 

       

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