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Are Antibiotics The Answer?

published on 03-21-2008

Nothing is Easier than self-deceit.
For what each man wishes, that he also believes to be true.


sick womanAs I am writing this article I am one more victim of this year’s influenza that our annual vaccination has apparently missed. In our household this has sparked a lively debate between my wife and I, as well as our extended family regarding proper treatment with antibiotics. I realize not even this article is likely to be persuasive enough to change one’s beliefs but I hope it will help clarify some of the misunderstandings that surround antibiotics. As the lyrics of a Simon & Garfunkle song go “Still, a man hears what he wants to hear, and disregards the rest.”

My wife became ill approximately a week ago; she had a sore throat, a bit of a fever and was sore and achy all over. At the office we have been seeing upwards of twenty cases of the flu a day and I suspected that she was coming down with it as well. The only catch is that we have also been seeing several cases of strep throat and a number of people who were unfortunate enough to have both strep and influenza at the same time! My wife reasoned that having a husband who is a doctor came with a few perks, and that I should simply call in an antibiotic so she could be on the road to recovery as she was sure she had strep throat. After all it was the worst sore throat she has ever had! I then had the unfortunate task of convincing her that I needed to cart her into the office to test her for strep and influenza as the two illnesses can look exactly alike in terms of symptoms but the treatments are vastly different. As it turned out she had influenza and was promptly started on an antiviral.

Now, as Paul Harvey would say, the rest of the story. In about the same time period my brother- in- law went to see his doctor after feeling for approximately two weeks. He was told he probably had influenza and now likely had a secondary infection, was put on an antibiotic and was feeling much better. Meanwhile, my sister- in- law was beginning to develop a sore throat and fever and called my wife to see if I would call her in an antibiotic as well. Well, I went through the same rigmarole as I had with my wife and convinced her to go in and be checked. In my sister- in- laws case her doctor didn’t do any testing and automatically put her on an antibiotic. The interesting thing is my wife felt much better after starting her antiviral for the flu but was still sick for a week, my sister in law felt much better after starting the antibiotic and was over it in two days. Naturally, I became the center of the debate surrounding antibiotics and their efficacy.

Now the difficulty with making these assumptions is that my sister- in- law’s doctor didn’t run tests so we are unable to establish the illness as being viral verses bacterial but brings up many myths and beliefs about antibiotics.

Myth #1 Antibiotics are useful against colds and flu. By now most people should realize that antibiotics do not kill viruses. However, many physicians continue to prescribe them for viral conditions. The rationale is to prevent secondary infections or possibly to make the customer happy. After all, despite all evidence to the contrary there are certain people that are convinced of their need for an antibiotic because their mucous is green.

Myth #2 Antibiotics are harmless. Just as with any other drug antibiotics may cause allergic reactions, May cause resistant strains of bacteria, cause overgrowth of yeast, and may cause conditions such as chronic fatigue syndrome.

Myth #3 Antibiotics are needed for high fevers but not for low grade fevers.
Although many viruses such as the common cold produce low grade fevers many can cause very high fevers. Influenza is a good example and often can produce a fever of 102 degrees F.

Myth #4 If an antibiotic did not work for my child before, it won’t work now.
Normal colonies of bacteria in our body change over time and have different resistance and susceptibilities over time not to mention that pervious failures may have been secondary to using an antibiotic on a virus.

Myth #5 It’s okay to stop taking an antibiotic after your symptoms go away.
Absolutely not. You need to finish the entire prescription in order to prevent bacterial resistance from occurring. If you do not kill an infection completely it allows remaining bacteria to adapt and resist future attempts to kill it.

To sum up this article I want to talk a little about viruses. In short, we have little weapons in our arsenal to fight most viral infections. The best strategies have tended to be vaccination but as this story goes, especially with the flu, vaccines do not always work. We now have some medications that can fight viruses but they work much differently than antibiotics. The big difference with medications that fight viruses is that they are very time dependent. Unlike strep throat for instance, you may have had the infection for a week or more but once starting an antibiotic you are going to feel better in just a couple of days. Not so with an antiviral. The medicines we use for viruses often need to be started within 48 hrs of symptom onset and if not they are unlikely to be helpful, prompting a return visit to the doctor requesting an antibiotic. If you think you have a case of the flu, strep or the unknown make sure to come get tested and treated as soon as possible at Plum Creek Medical.

To your good health,

Christopher A. Carpenter MD

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