Family Health Magazine - PHARMACY CARE
Why won't my doctor treat me with antibiotics?
You wake up one morning with every bone in your body aching. You feel so miserable that you wish you could cover your head and shut out the world for a few days. As the day progresses, you do not feel any better. Your biggest worry is that you want to be in top shape for a family event on the weekend. You hope your family doctor can help by prescribing an antibiotic.
Unfortunately, a cure is often not that simple. Your illness is likely due to a virus that is not cured by antibiotics. If so, when you see your doctor, an antibiotic will not be prescribed.
The use of antibiotics when not needed can be harmful. Their misuse can allow resistant germs to multiply and cause illness. These resistant germs might be very difficult to treat if they infect you or someone else in the future. This problem has caused doctors to be very careful to use an antibiotic only when necessary so that it will work when it is really needed.
A prescription for 'no antibiotics?'
Increasingly, doctors are deciding not to prescribe an antibiotic until they know that one is required. Some doctors now give their patients a prescription for “no antibiotic at this time.” This advice about other things you can do to help yourself feel better is preferable for you, your family and others in your community, than is a prescription for an unnecessary antibiotic.
Antibiotics have been overused
The reasons why they have been overused include:
- Most antibiotics are safe (unless the recipient is allergic to the one prescribed).
- Effective antibiotics used to be inexpensive.
- Antibiotics were usually effective against bacteria before resistant strains emerged.
- Patients often expect to receive antibiotics for coughs, colds, fevers or sore throats.
What has changed?
- New antibiotics are expensive. They can cost up to $3 per pill, totaling $60 - $70 for a course of treatment.
- Resistant bacteria have emerged. For instance, bacteria called enterococci have now become resistant to all antibiotics. Fortunately, these bacteria only cause infections in a person whose resistance is already very low. However, that is little comfort if you are the person with low resistance.
Doctor’s instructions for 'no antibiotics at this time'
To help your body fight the illness:
- increase fluid intake (water, fruit juice, clear soup)
- sleep and rest more.
Relief of symptoms
- For fever, aches and pains: use acetaminophen, ibuprofen or acetylsalicylic acid (ASA, Aspirin™). Ask your doctor or pharmacist to recommend the best one for you. (Do not use ASA if you suspect a viral infection (particularly chicken pox or influenza) in a child under age 18. This could cause a serious reaction called Reye’s Syndrome )
- For ear pain: pain relievers, ear drops, heat and oral medications to relieve ear pain
- For nasal congestion: saline nose drops or spray; vaporizer
- For cough: lozenges, cough drops, cough medicines (some require a prescription)
- For sore throat: ice chips, lozenges, throat spray, gargle with mouthwash or salt water.
Use medicines as directed by your doctor or the package instructions.
See your doctor for a recheck if:
- new symptoms occur, especially vomiting, severe headache or stiff neck.
- your current symptoms become worse.
- fever persists for more than 48 hours.
- you are not improving in two to three days.
Recently, some staphylococcus bacteria have developed resistance to all antibiotics. Staph, as it is usually called, can cause serious illness such as abscesses, blood poisoning and bone infections in otherwise healthy people. When a resistant strain of staph becomes widespread, it will be as if we were in the era before antibiotics were discovered. At that time, staph infected and killed many people. This will be our future if the development of new treatments cannot outpace the emergence of resistant strains.
How do resistant bacteria emerge?
Bacteria multiply rapidly; some reproduce every 20 minutes. Within a day, a few original bacteria can produce billions. During multiplication, changes in structure called mutations occur. If the mutation produces a resistant bacterium, it has a greater chance of surviving than the non-resistant ones. A resistant bacterium that survives and multiplies may be the one that causes the next infection.
Why do I need to take my antibiotic as prescribed?
If your doctor does prescribe an antibiotic, it is your responsibility to take it as ordered. A resistant bacterium that emerges during treatment might be destroyed if the antibiotic continues to be taken in the prescribed dose for the prescribed duration (usually six to 10 days). If the antibiotic is stopped too soon, the resistant bacteria will remain and will be able to reinfect you or someone else later.
What can I do?
- Do not insist your doctor prescribe an antibiotic for every cough or cold. If your doctor gives you a prescription for 'no antibiotic at this time,' understand this is an attempt to help you and other people in the future. Remember, overuse of an antibiotic can eventually cause it to become useless.
- Follow the advice on the no-antibiotic prescription and be aware of the signs that the illness is becoming worse.
- If your doctor prescribes an antibiotic, take it in the dosage prescribed for as long as prescribed. This may prevent you from being the next victim of resistant bacteria.
Your family doctor did not prescribe an antibiotic when you sought relief for your aching bones. Instead you received a list of instructions aimed at helping you feel better while your body fought the illness. When the day of the family event arrives you may still feel a little‘under the weather but you will be pleased to know that you have not had an unnecessary antibiotic that would not have made you feel better anyway.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2018, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1 [PC_FHa99]