Teach Me

Do I Really Need an Antibiotic?

Do your stuffed-up nose, headache and sore throat have you down for the count? 

When you’re sick, chances are you want relief — and ASAP. You’re not sure what it is, but your go-to zinc, elderberry and vitamin C don’t seem to be doing the trick, and you’re running out of patience — not to mention, your last box of tissues. 

Your first inclination may be to get an antibiotic prescription from your health care provider, but in some cases, a course of antibiotics may not be the answer. Antibiotics treat a wide range of bacterial infections and won’t help you if your illness is due to a virus. 

“Antibiotics are powerful medications that have saved countless lives over the past century, but many people rely too heavily on them when they aren’t necessary,” said Gina Montion, MD, a pediatrician with Banner Health Center in Phoenix, AZ.  

Why is this a problem? Because it’s led to a surge in antibiotic-resistant bacteria, such as methicillin resistant staphylococcus aureus (MRSA). 

Before you ask your provider for a prescription (or before they prescribe you one), learn why antibiotic-resistant infections are so scary and antibiotics may or may not help you the next time you feel crummy. 

The rise of drug-resistant bacteria 

According to the Centers for Disease Control and Prevention (CDC), nearly one-third of antibiotics prescribed in the U.S. aren’t appropriate for the conditions being treated. 

It may seem harmless to take an antibiotic, but the overuse of these medications causes them to be less effective, even if you only take them rarely. “This could be a big problem if you develop a life-threatening infection from a bacterium that has grown resistant to all the antibiotics available.” 

Bacteria are smart and have evolved to survive future antibiotic use. This is even true if you don’t use it for its intended purpose, like for a viral infection.  

“Antibiotics do not work to cure the viral infection, but it will attack bacteria that weren’t causing you harm, and the bacteria will adapt to avoid future attacks,” Dr. Montion said.

To help combat antibiotic resistance, health care professionals are taking several steps to protect patients from drug-resistant infections, including:

  • Prescribing antibiotics only when they are needed 
  • Using a specific type of antibiotic, at the right dosage and for the right duration
  • Educating patients on the risks associated with the antibiotics they’re taking
  • Encourage patients to discard any leftover medication after completing their prescribed treatment course

What can antibiotics treat?

Antibiotics treat bacterial infections only. “They work against specific types of bacteria, like streptococcus or staphylococcus, by either killing them or preventing their replication,” Dr. Montion said.

Antibiotics should be taken when prescribed by a provider for certain bacterial infections that aren’t likely to resolve on their own.

Examples of bacterial infections include:

What can’t antibiotics help treat?

Antibiotics don’t work on sicknesses caused by virus germs, also known as viral infections. Unfortunately, most viral infections, like the common cold and flu, just have to run their course, which could take two to four weeks. 

Examples of viral infections include:

“Keep in mind that most coughs can last up to 18 days after an upper respiratory infection, so you’ll need to be patient,” Dr. Montion said. “Coughs don’t require antibiotics, and this is hard for some people who want instant gratification.”

Viruses, like COVID-19, HIV, and flu, aren’t treated by antibiotics but may sometimes be treated by antiviral medications. Antiviral medications can help ease symptoms and shorten the length of a viral infection. 

What are the possible side effects of antibiotic use?

Antibiotics can have mild to life-threatening side effects, such as diarrhea, rashes and allergic reactions. According to the CDC, adverse reactions to antibiotics are responsible for 1 in 5 medication-related emergency room visits. 

“Many think antibiotics are no big deal, but in reality, there is a risk of side effects and they can happen to anyone — even if they’ve tolerated the antibiotics before,” Dr. Montion said. “One of the most common side effects is diarrhea since not only do the antibiotics kill the infection but they also kill good bacteria that live in your gut.”

Your digestion and mood could be affected since 90% of our happy hormone, serotonin, is from our gut and removing the microbiome, or good gut bacteria, can lead to diarrhea, cramping and gas. In the worst cases, long-term use can even lead to C diff, a severe infection that causes colitis, or inflammation of the colon.

When should you schedule an appointment?

If your symptoms start to get better on their own, or with relief from over-the-counter medications after a week, there’s a good chance it’s viral. However, if your symptoms continue for 10 days or get worse after initially improving, there may be bacteria involved that could require a prescription. 

“Seek immediate attention if you’re having trouble breathing or are in severe pain,” Dr. Montion said. 

Bottom line

Antibiotics should only be used to treat bacterial infections and won’t help treat infections that are viral. Taking unnecessary antibiotics can lead to antibiotic resistance as well as possible side effects.

You shouldn’t fear antibiotics, but we do need to use them responsibly to ensure they continue working when we need them in the future. 

To find a Banner Health specialist near you, visit bannerhealth.com. 

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Cold and Flu Primary Care Wellness Infectious Disease