4 Things you need to know about antibiotics

Cold weather brings a rise in upper respiratory infections — sneezing, coughing and stuffy heads. These symptoms and others bring a common request from patients: Can I get antibiotics?

The answer is not always “yes.” Being sick is unpleasant to say the least, so it’s no wonder people seek fast relief in pill form. But when it comes to antibiotics, overuse is a major issue. Below are some facts you should consider the next time you visit your doctor.

“If you take the wrong medication, it won’t be effective. On top of that, it may have unpleasant and unwanted side effects.” Kathryn Teng, MD

Center for Personalized Healthcare

1. Antibiotics don’t work for everything Antibiotics fight bacterial infections, but they won’t work against viral infections. That means they are not effective against the flu or the common cold.

If that sounds like common sense, consider this: In a 2012 survey, one in three surveyed Americans believed that antibiotics work effectively against colds.

When you visit your doctor, be as specific as possible about all of your symptoms so he or she can narrow down the cause. Figuring out whether it’s likely bacterial or viral is step one.

For example, symptoms such as a consistently high fever (above 101.5 degrees), nasal discharge and severe facial pain may indicate a bacterial sinus infection. Most sinus infections are viral, but if these symptoms linger for many days without improvement, the cause may indeed be bacterial.

Likewise, that same high fever combined with ongoing ear pain may be signs of a bacterial ear infection. In both cases, antibiotics would be appropriate. But not all infections are bacterial. A stuffy head and low-grade fever might be signs of a virus, for instance. It’s critical to work with your doctor to get as clear a diagnosis as possible — then proceed with the proper treatment. That treatment is not always antibiotics. Sometimes easing your symptoms while letting your body fight off a virus is the proper course of action.

2. Taking unnecessary antibiotics may do more harm than good Here’s the biggest problem with overusing antibiotics: Bacteria adapts. Bacteria become resistant to drugs over time, making it harder to treat them. In rare cases, this leads to deadly drug-resistant bacterial infections. For individuals, drug-resistant bacteria make it harder to find drug options that work when you do face a severe infection. On the broader group level, this resistance can be dangerous, making it easier for an infection to spread.

3. Antibiotics are not one-size-fits-all The antibiotics that work for a urinary tract infection aren’t the same as the ones that will fight your strep throat. The “broad-spectrum” antibiotics used to fight infections in hospitals aren’t the same as the very specific antibiotics your doctor may prescribe to treat a bacterial ear infection. Here’s why that’s matters: If you take the wrong medication, it won’t be effective.

On top of that, it may have unpleasant and unwanted side effects. In most cases, side effects of antibiotics are pretty benign. But, for example, taking those broad-spectrum antibiotics for an extended period of time can put you at risk for C. diff, a severe and hard-to-treat infection.

4. You should not save old antibiotics “just in case” I often hear this from patients: “I had some antibiotics left over from the last time I was sick, so I started taking them.”

That’s a bad idea. For one thing, as mentioned above, different antibiotics treat different types of bacterial infections. You can’t just assume that your leftover medication will work. And, again, taking the wrong medicine when it won’t help means you risk side effects and future drug resistance. I’ve also had patients tell me, “Last time I had a cold, I took them, and I got better.” But if it was truly a cold, time was what helped them get better — not antibiotics.

None of this information should scare you away from taking antibiotics as prescribed when you truly need them. But doctors should prescribe them with caution — and patients should know that they are not a risk-free cure-all.

By Kathryn Teng (Cleveland Clinic)