Antibiotics aren't always the answer

1/2/2005

An old health myth surfaces every winter during common cold and influenza season: Antibiotics can help.

From frazzled parents to individuals who can't afford days away from work or school, people think that antibiotics will cure colds and flu.

They bring sniffles, sneezes, and sore throats to the doctor's office, often expecting to exit with an antibiotic prescription. Many insist and get one, even though doctors know the truth.

Viruses cause colds and flu. Antibiotics don't kill viruses. They treat infections with bacteria.

The result? Millions of unnecessary antibiotic prescriptions each year, according to the U. S. Centers for Disease Control and Prevention (CDC). Over-prescribing of antibiotics has been going on for years. The CDC got up in arms over the situation last year, launching a consumer education program to make patients more aware that antibiotics don't kill viruses.

Experts are concerned about over-prescribing of antibiotics because it is one factor in a huge global health problem. That's the emergence of antibiotic-resistant bacteria, new strains of bacteria that shrug off antibiotics.

Over-prescribing gives bacteria more exposure to antibiotics, and they evolve, mutate, and develop defense mechanisms. The greater the exposure, the faster the emergence of resistant strains.

CDC and health groups sponsoring the education campaign - which uses the slogan, "Get Smart: Know When Antibiotics Work" -- want to enlist patients in the society-wide battle against antibiotic resistance. The program, of course, also aims to help patients avoid inappropriate medical treatment, since viruses shrug off antibiotics.

Consumers are smart enough to know that unnecessary prescriptions are just one reason for the problem with antibiotic-resistant bacteria. Livestock producers are another.

About 70 per cent of the antibiotics produced in the United States are given to cattle, chickens, and other livestock. Antibiotics boost "feed efficiency," so that livestock gain more weight on less feed and farmers save money. In animals like chickens, antibiotics also may reduce the levels of bacteria that can cause food poisoning in people who eat improperly prepared meat.

However, those agricultural uses of antibiotics also foster the emergence of antibiotic-resistant bacteria.

Doctors can have difficulty telling whether a patient has a viral infection or bacterial infection. Although it is not widely known, bacteria do cause a small percentage of common colds. One 1998 study put the figure at 3 percent -- 3 cases in 100. For the rest, antibiotics would be a waste.

Make that a waste of money, too. Even patients lucky enough to have prescription drug insurance may face stiff out-of-pocket payments for each prescription.

There may be some situations in which a request for an antibiotic is smart. People who can't afford to miss school or more days off from work without pay, for instance, may want a "just-in-case" prescription to take until test results are in.

Never demand a prescription for an antibiotic or any other drug. Discuss your personal circumstances with the doctor, why your case is an exception, and negotiate.