The problem of too many antibiotics
For at least three decades, doctors have been aware that they over prescribe antibiotics, a practice that raises the risk of antibiotic-resistant bacteria. Like the well-known MRSA (mersa), methycillin-resistant staphylococcus aureus.
But they still do it.
A recent report from researchers at Brigham and Women’s Hospital in Boston shows that between 2000 and 2010, doctors wrote antibiotic prescriptions for 60% of sore throats, even though they were only appropriate—for strep throat— about 10% of the time.
Antibiotics were also prescribed for bronchitis (cough) in 73% of cases; antibiotics never help bronchitis, a condition caused by a virus.
Last month, the Centers for Disease Control (CDC) released a warning that the over prescribing of antibiotics and the resulting emergence of more antibiotic-resistant bacteria was a “quickly growing, extremely dangerous problem.”
Why do doctors prescribe too many antibiotics?
Why too many antibiotics are prescribed is a two-fold problem:
- Patients demand antibiotics.
- Doctors either give in too easily to patients’ demands, or write a prescription precipitately, presuming—perhaps incorrectly—that the patient will insist on an antibiotic.
I know from experience that many patients come to the doctor’s office with the firm expectation that they will be given an antibiotic. “But I had the same cough last year and Dr. So-and-so gave me an antibiotic!” or ” My friend got an antibiotic and felt better the next day!”
But the patient comes in with a predetermined idea of what the outcome will be—a prescription.
And a few months ago I posted about an experience I had with my son, when I think he was unnecessarily prescribed azithromycin for a sinus infection. I didn’t ask for it; the doctor just gave it to me although I thought there was little indication for it.
As I quoted a doctor in that post, prescribing an antibiotic “makes the patient feel like the doctor is doing something for the patient who paid the co-pay and waited 2 hours in the office.”
I like to think I am paying for a doctor’s experience and knowledge, not condescension.
Ask if you really need that prescription
The thought of creating a race of “superbugs” aside, getting a prescription you don’t need:
- costs more money;
- sets up the expectation that every doctor’s visit must result in a prescription; and
- leads to avoidable side effects.
Common side effects from antibiotics are nausea, diarrhea, yeast infections, and allergic reactions. Yuck. You don’t want to risk these if you don’t absolutely have to.
If you see a doctor about a suspected strep throat or bacterial sinus infection or pneumonia, don’t insist on an antibiotic. Listen for the word “virus.” A virus is a different animal from a bacteria and will not be killed by an antibiotic.
If your doctor offers you a prescription, ask that important question: “Do I really need it?” If you really need it, your doctor will tell you, but make sure he or she understands that you do not want an antibiotic if it is not necessary.
According to Dr. Richard Klein, who wrote the excellent book Surviving Your Doctors: Why the Medical System is Dangerous to Your Health and How to Get Through it Alive,
I will wager that if you ask your doctor if the medicine that he just prescribed for you (for your sore throat, or congestion, or whatever) was absolutely necessary the answer 50 percent of the time would be no!
So ask. Ask why the doctor suspects a bacterial rather than a viral infection. Ask if waiting for a day or two before prescribing an antibiotic is an option.
Use antibiotics responsibly
Avoiding unnecessary antibiotics is important, but so is taking them properly when you need them. You will feel better faster and hopefully avoid some side effects.
- Don’t use someone else’s antibiotics. It’s a lousy idea, but people share prescriptions with friends and family all the time. Don’t.
- Don’t use antibiotics that were prescribed for another condition. Antibiotics are not all the same.
- Don’t save antibiotics to use another time. Antibiotics lose potency over time, and different antibiotics are needed for different infections.
- Do take all the pills prescribed. Most of the time, you will feel better within a day or two of starting an antibiotic, but if you don’t finish the entire course, some bacteria will survive. These hardy bacteria lead to future drug-resistant bacteria.
- Do follow the dosing directions. Pay attention to the list of foods to avoid.
Used wisely, antibiotics are powerful weapons in the medical arsenal.
By not insisting on an antibiotic when we don’t need one, we can not only keep this weapon strong and effective, but avoid unnecessary costs and side effects.