By Dr. David Hays and Dr. Todd Canon
The cold-and-flu season is upon us. This is an important time to understand when antibiotics are useful and when we don’t need to use them.
Bacteria and viruses
To understand how antibiotics work, it is important to understand the two most common types of germs – bacteria and viruses. Although certain bacteria and viruses cause infections with similar symptoms, bacteria and viruses are very different types of organisms that multiply and spread quite differently. Antibiotics are effective against bacteria but are not effective against viruses.
Bacteria are single-celled, living organisms that are important for life. Our skin is covered with bacteria. They help protect us from other, more harmful, bacteria; and our colons are packed with bacteria that are necessary for digestion. Our oral cavities carry a huge number of helpful bacteria. Bacteria are everywhere in the environment and are frequently in food that we eat, yet we don’t usually get sick from them. Yogurt is, in fact, made up largely of good bacteria.
There are many different types of bacteria with different properties and biochemistry; and they can cause different types of infections. Bacteria can cause illness by invading healthy tissue, making toxins that harm us or rapidly reproducing in ways that interfere with normal body processes.
Although we tend to think of some antibiotics as being stronger than others, that really isn’t the case. Different antibiotics are effective against different types of bacteria, so physicians choose an antibiotic not based upon its strength, but on the type of infection and the likely type of bacteria that causes such an infection.
Viruses, on the other hand, are not living organisms and cannot exist on their own. They require living cells to survive, because they can only “live” and reproduce inside cells they have invaded. They spread between cells so they can survive for periods of time outside of cells, but they cannot grow or reproduce outside of other cells.
Some viruses produce illnesses that are very similar to illness caused by bacteria. Many viruses and bacteria are fought off by the body’s own immune system before they cause significant illness. This is true of upper respiratory infections (URIs) including colds, sinus infections, sore throats and bronchitis. Both viruses and bacteria can cause such infections, and they simply run their course and resolve on their own. Treating them with antibiotics is rarely necessary.
Why antibiotic overuse is harmful
Over-prescribing and overuse of antibiotics is problematic for several reasons.
First, the more bacteria that are exposed to antibiotics, the more likely they are to develop or acquire resistance to those antibiotics. Bacteria seem to be developing resistance faster than we are developing new antibiotics, so such antibiotic resistance is a real concern. The more antibiotics are taken for unnecessary reasons, the less useful those antibiotics will be when you really need them.
Second, people who take antibiotics run the risk of adverse reactions, such as allergic reactions, stomach upset and diarrhea. Those risks are acceptable if you really need the antibiotic, but the risks are unwarranted if the antibiotics are being used in situations in which they are not helpful – when the causative infection is likely viral, for instance.
What should you do?
It is important to realize that most URIs are viral infections and do not require or benefit from antibiotics. Repeated studies have shown that antibiotics are not helpful in making most patients better faster. Although the symptoms of nasal congestion or cough may be quite prolonged, often lasting several weeks, that doesn’t mean that antibiotics are necessary or will be at all helpful. Instead, when you have a cold, talk to your doctor about ways you can help relieve your symptoms while your body is fighting off the infection.
Todd Canon, MD, and David Hays, MD, specialize in family medicine and are on the staff at GreenField Health, 2606 N.E. Broadway, Suite C. They welcome questions during this cold-and-flu season and can be contacted atmoc.h1516115392tlaeH1516115392dleiF1516115392neerG1516115392@nona1516115392C.ddo1516115392T 1516115392 or moc.h1516115392tlaeH1516115392dleiF1516115392neerG1516115392@syaH1516115392.diva1516115392D1516115392. For more information about the clinic, call (503) 292-9560.