Everyday I probably receive a patient call or see someone in the office regarding a request for antibiotics. The patients express to me their symptoms: cough, low-grade fever, and muscle aches. They then proceed to make me aware of their recent Google search and they inform me that “their research” suggests antibiotics are warranted, so that they can halt the progression of their illness. Even though their symptoms are more than likely viral and even though 50 percent of prescriptions for antibiotics are unnecessary, patients are convinced that an antibiotic is the solution to the problem.
I get it! When you are feeling bad, you simply want relief and to wake up the following day feeling like a normal person again. You took off from work, you paid a $20 dollar co-pay, and you expect your doctor to provide treatment. For you at the moment, antibiotics seem like the logical next step.
However, infectious disease 101 and microbiology 101 tell us something entirely different. Viruses and bacteria are two organisms that often behave differently and as such, are treated differently. Therefore, it is the responsibility of the healthcare provider to recognize the difference so that appropriate therapy is provided. Internet research is a wonderful tool to utilize but it does not compare to formal medical training and an actual examination of the patient.
Trying to curb the overuse of antibiotics is a huge issue in our country right now. For example, in one year, roughly 262.5 million courses of outpatient antibiotics were written in the United States. Azithromycin and amoxicillin were the most commonly prescribed drugs. Most prescriptions were written in the winter months and were prescribed for various diagnoses such as pharyngitis, upper respiratory infection, and bronchitis.
Viruses that cause your garden-variety colds are generally treated symptomatically. Recommendations include rest, fluids, and a fever reducer like acetaminophen or ibuprofen. On the other hand, a urinary tract infection is generally caused by bacteria and needs antibiotics for resolution.
Simply put, overuse of antibiotics leads to resistance and resistance results in unnecessary deaths. Per the CDC, each year at least 2 million people in the US are infected with resistant bacteria and 23,000 of them die. Nothing worse than having an infection but being told that we have no medication that will help you.
With all of this in mind, recently the FDA announced a ban on certain chemicals found in antibacterial soaps. The FDA warns that chemicals like triclosan are no better than soap and water for hand cleansing and substances like it may actually be contributing to antibiotic resistance.
Obviously, halting the rise of resistant bacteria will be a joint effort of health officials on a national stage and those of us on the frontlines. However, patients also have an obligation to assist in this serious matter. First of all, if a prescription for antibiotics is written, take all of it and not save some for later. Finally, if the provider diagnoses you with a virus, be patient. Most viruses take seven to 10 days to resolve. Let us vow to use antibiotics appropriately so that when we truly have a bacterial infection, the medication we are given actually works.
Your family doctor,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
