It goes like this…I’m feeling “off.” Could I be getting sick? No, no, I don’t have time for it this week. Oh wait, oh no, I’m sick, I’m definitely sick. I need meds. NOOOOOOW!

Unfortunately, medication isn’t always the easy solution to feeling better. Antibiotics, in particular, are not “cure-alls” for every sickness: They only work to treat bacterial infections. It can even be dangerous to take antibiotics when not indicated, like for a viral infection.

So before you chew out the doctor for not writing you a script, let’s take a look at how antibiotics work, why they might not work, and how they may be used most effectively.

Illnesses from infection

Antibiotics are some of the most frequently prescribed medications in medicine. They work quickly to destroy the spread of bacteria in the body when it’s been taken over by a nasty bug. Bacterial infections include strep throat; whooping cough; some pneumonias, ear infections, and sexually transmitted diseases; and tuberculosis, to name a few. Antibiotics are often part of the treatment plan for these illnesses.

The most common conditions in the U.S. this time of year—like colds and the flu—are typically viral infections. Many sore throats, sinus and ear infections, and cases of bronchitis are also due to viruses that will not improve with an antibiotic medication.

While penicillin is the most commonly known treatment for bacterial infections, there are actually more than 100 different kinds of antibiotics that work in different ways to kill specific bacteria. A doctor will choose the medication that’s right for you based on the most likely cause for your body’s infection. A bacterial ear infection will be treated with a different medication than would be used to treat bacterial pneumonia, for example. A physician will sometimes request a culture to confirm infection type and make a decision about the treatment plan.

Prescribing gone bad: Superbugs and more

If we’re feeling sick, we want the quickest fix on the road to recovery. But for many illnesses, there’s no quick fix or medication that will “solve” our problem. Still, a patient will demand antibiotics for a viral cold. Or physicians, motivated to satisfy a patient, will prescribe an antibiotic for an illness that’s likely viral.

The Centers for Disease Control and Prevention estimates that 30 percent of all antibiotics prescribed in outpatient clinics and 30 percent of antibiotics used in hospitals are unnecessary.1 In all, there are 47 million unnecessary antibiotic prescriptions written in U.S. doctors’ offices and emergency departments each year.1 They are unnecessary because they’re written for colds, sore throats, and other acute respiratory infections that won’t be affected by the medication.

This isn’t just wasteful and unnecessary, it’s dangerous. By giving antibiotics so freely, you’re not just killing the bad bugs in your body, you’re killing the good bugs. These actions can have devastating consequences on how bacteria evolves. Bacteria becomes resistant to our treatments and to those antibiotics, creating the potential down the line that real illnesses won’t be curable by antibiotics. If they won’t work to cure a bad infection, we’re really in trouble.

Antibiotic resistance has become such a problem that in 2016, the U.S. Congress allotted $160 million for the CDC to implement a solution to improve antibiotic use, contain resistance, and stop the spread of these dangerous infections in healthcare.1 About 2 million Americans are infected with antibiotic-resistant bacteria every year, and 23,000 of these Americans die.3

Medication musts

To lower the risk of spreading antibiotic-resistant bugs, the CDC explains that patients should not ask for antibiotics if their doctor does not think they’re necessary. Taking these meds unnecessarily could affect the body’s natural flora and make it more prone to infection.

Patients should also take their medications exactly as prescribed, taking the entire course until it’s finished—even if they start feeling better. Stopping mid-course could only partly treat the bacteria, leading to resistance. Patients should never share antibiotics with others or use leftover medications.

It’s important to understand that it’s not the body that becomes resistant to antibiotics: The bacteria becomes resistant and spreads illness through the community. This means anyone—even typically healthy individuals—can get an infection that’s resistant to antibiotics.3

Antibiotics can cause side effects such as stomach upset and diarrhea, or even allergic reactions like shortness of breath, rash, and swelling. Talk to your doctor if you’ve ever had bad reactions from medication. Sometimes, infection symptoms will continue after an antibiotic course is complete due to resistance; talk to a doctor about alternative options.

Teladoc physicians are U.S. board-certified to diagnose, treat, and prescribe medication like antibiotics if medically necessary. Reach us 24 hours a day, seven days a week for a diagnosis and treatment plan that best corresponds to your illness.

References

1https://www.cdc.gov/antibiotic-use/stewardship-report/pdf/stewardship-report.pdf
2Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011. JAMA: The Journal of the American Medical Association. 2016; 315(17): 1864-73.
3http://time.com/4114345/antibiotic-resistance-common-myths/

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