Part of an ongoing series dedicated to raising health and safety awareness across the Temple community.
When you’re feeling terrible from a cold, sore throat, flu or sinus infection, it’s tempting to look to antibiotics as a solution. However, antibiotics don’t treat viruses, which cause many of our most common illnesses — and their overuse can have serious consequences. So when are antibiotics effective, and how can you avoid using them too often?
A brief history
The development of antibiotics has been one of the great accomplishments of medicine in the past century. Since the discovery of penicillin shortly before World War II, their use in the treatment of bacterial infections, such as strep throat, pneumonia, tuberculosis and meningitis, has led to decreased complications and death from these diseases.
On the other hand, with the rapid increase in the variety of antibiotics (from penicillin to Cipro to Z-packs) and their widespread use, there has been a rise in what are called “antibiotic-resistant bacteria.” The usual antibiotics can no longer defeat these bacteria.
MRSA (pronounced MUR-sah) is one such bacteria type, which has received attention in the press over the past few years. MRSA, which stands for methicillin-resistant Staph aureus, is a type of bacteria that is no longer killed by common antibiotics, such as penicillin. Outside of hospitals, MRSA is becoming a common cause of infections of the skin. Luckily, there are still some antibiotic pills in addition to more powerful, intravenous antibiotics, which can defeat this infection. However, with continued, widespread antibiotic use, it is possible that MRSA will become even harder to treat. (See the recent Health&Safety article “MRSA: What it is and how to prevent it” for more about MRSA.)
When I am sick, do I need antibiotics?
Antibiotics work only against bacterial infections. However, most infections that people in the community get, such as the common cold, flu, bronchitis, sinus infections and sore throat, are caused by viruses. For example, strep throat, caused by the Streptococcus bacteria, only causes about 15 percent of all cases of sore throat in adults; the rest are caused by viruses. Furthermore, viruses are responsible for more than 90 percent of cases of acute bronchitis.
Despite this fact, many patients, when they are sick with a cold, flu, bronchitis or sore throat (symptoms of which can last for up to two weeks), feel that antibiotics will make them better. They often expect and even demand them from their doctors. Doctors sometimes write the prescriptions because they do not want to upset their patients or because they find it easier than going through an explanation of why the antibiotics are unlikely to be helpful.
Downsides to antibiotics
Some people may think, “So if my illness is due to a virus, what’s the harm of taking antibiotics, just in case?” The answer: In addition to leading to more antibiotic-resistant bacteria, there are other potential harms of taking antibiotics.
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Allergic reactions to antibiotics can occur, ranging from rashes and hives, to shortness of breath and closing of the windpipe.
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Antibiotics also kill the “good” bacteria that normally inhabit our bodies. This can lead to diarrhea, yeast infections in women, and the opportunity for more harmful bacteria to replace the “good” ones.
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Antibiotics can interact in a harmful way other medications that you may be taking.
How can I avoid “catching a cold” or prevent myself from giving it to others?
Hand washing, with soap and water, before eating a meal or after coming into contact with others who may be sick can prevent the spread of viral infections.
If you are sick, simple things, in addition to hand washing, such as staying home from school or work, and covering your nose and mouth when coughing or sneezing, will help to prevent passing your infection on to others.
In the special case of influenza, yearly vaccination is the best chance at preventing the disease, in addition to the above-mentioned strategies.
What should I do if I get sick?
Inevitably, you are likely to develop an illness such as a cold, sore throat, flu, bronchitis or sinus infection. In almost all cases, they are caused by a virus and will resolve with time. Things that you can do to help you through the illness are:
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Get plenty of rest
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Drink fluids that do not contain caffeine (caffeine can cause dehydration)
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Avoid alcohol and tobacco
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Take over-the-counter medications specific to the symptom that is bothering you the most (e.g., Tylenol for aches and fevers, Robitussin for cough or congestion)
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If you find that your symptoms are getting worse after several days despite these recommendations, see a healthcare provider.
What if I am prescribed antibiotics?
In the rare event that you are prescribed antibiotics, make sure to take them as directed and for the entire amount of time on the prescription. Do not stop taking them once you feel better. It is important for the antibiotics to kill all the harmful bacteria to prevent them from developing resistance, which may occur if the complete course of antibiotics is not taken.
For more information, visit the Centers for Disease Control and Prevention’s topic page on antibiotic use, www.cdc.gov/Features/GetSmart.
— Written by Dr. Joshua Rosenzweig, M.D., M.P.H., Employee Health physician at Temple University, as part of an ongoing series of health and safety articles aiming to raise awareness among Temple University employees, faculty and students about a range of health and safety issues. The initiative was developed by Temple’s Health and Safety Awareness Committee, comprising members from across the university community. If you have health and safety questions, concerns and/or suggestions, please contact the Health and Safety Committee at healthandsafety@temple.edu.