When Joseph developed a persistent cough, he booked a visit with his longtime family physician. The doctor diagnosed bronchitis and recommended rest and plenty of fluids. “What about antibiotics?” Joseph asked. “The flu is going around my office, and I have deadlines to meet.” The doctor hesitated. Then he saw how anxious Joseph was and agreed to call in a prescription.
What’s wrong with this picture? Joseph and his doctor are unknowingly contributing to the rise of “superbugs,” or drug-resistant germs. Treating a cough with an occasional Tylenol or Advil won’t do any harm, even if the medication doesn’t relieve your symptoms. But antibiotics are different, as overuse and misuse can harm you ― and the people you love ― in the long term.
Read on to learn which flu treatments are most effective, how to avoid unnecessary antibiotics, and ways you can help fight the rise of dangerous superbugs.
Antibiotics have no effect on the flu. The drugs won’t relieve your symptoms, reduce the length of your illness or boost your immunity to other germs. Sure, you may feel better after taking antibiotics, for a simple reason: You were already on the road to recovery. We all tend to seek treatment when our symptoms are at their peak. Over the next few days, as the virus runs its course, you start to feel better. But that would have happened even without medication.
Sometimes, antibiotics can actually make you feel worse. “Antibiotics are generally quite safe, but they do carry some risk,” says Daniel Knecht, MD, MBA, VP of clinical strategy and policy for Aetna. “They may cause diarrhea, allergic reactions and various other side effects.” It’s something to keep in mind if you’re tempted to take unnecessary antibiotics “just in case.”
The best medicine for the flu depends on the timing. Besides the usual over-the-counter cold-and-flu formulas, doctors recommends the following:
Antibiotic resistance refers to the ability of some germs to survive the drugs we take to kill them.
Viruses and bacteria are two types of germs that can cause infection and disease. Antibiotics kill bacteria, but have no effect on viruses. Some illnesses always require antibiotic treatment: strep throat, staph-based skin infections and common sexually transmitted diseases like chlamydia.
Other conditions may be caused by either bacteria or viruses, and it can be hard to tell the difference. If you develop pneumonia, pink-eye or a urinary tract infection, for instance, your doctor may test for bacteria before recommending antibiotics.
|E. coli||Pneumonia||Yeast infection|
Most illnesses that send people to their doctor are caused by viruses or allergies. That means antibiotics won’t help. Typically, you just have to let a virus run its course. Yet 30% to 50% of antibiotics are prescribed for viral illnesses, like bronchitis. “It’s very validating and comforting for patients to receive an antibiotic prescription when they’re not feeling well,” Dr. Knecht explains. “And doctors want to help.” But such overuse is a major contributor to antibiotic resistance.
Antibiotic resistance refers to the ability of some germs to survive the drugs we take to kill them. This can happen as a result of overuse, described above, or misuse, as when a patient with strep throat misses doses of their antibiotics or stops taking their pills once they feel better. Instead of being killed, the strep bacteria are, in the words of one scientist, “educated” in how to fight the drug. Then, if those germs are passed to someone else, the same antibiotic will be less effective.
“Superbugs” are germs that are resistant to many antibiotics. The best-known superbug is MRSA (pronounced MER-suh), a drug-resistant form of staph. Other superbugs cause hard-to-treat forms of pneumonia, tuberculosis, gonorrhea and UTIs. Every year, 2 million Americans fall ill with antibiotic-resistant infections.
Superbugs take more time and money to treat. Today, a simple sore throat or UTI might inconvenience you for a week, until your inexpensive generic antibiotics kick in. In the future, that week could turn into a month ― and multiple rounds of pricey specialized antibiotics.
That’s not all. “Antibiotics are the unsung hero that support many medical breakthroughs,” Dr. Knecht says. “There’s a whole slew of technologies we wouldn’t be able to use if antibiotics stopped working: surgery, dialysis, chemotherapy, gene therapy, bone marrow transplants.” All of these treatments would be too dangerous without effective ways to head off and treat infection.
The good news is that we’re making progress in the battle against superbugs. Aetna is working to educate doctors about the dangers of overprescribing antibiotics for common complaints like acute bronchitis, in collaboration with the Centers for Disease Control and Prevention (CDC) and state Departments of Health. In 2018, the program reduced unnecessary prescriptions by 16%. In 2019, the initiative will be expanding to additional states.
But we need your help. You can fight the rise of antibiotic-resistant superbugs by asking the right questions and taking your medication as directed. If your doctor offers to prescribe you antibiotics, ask if they’re really necessary. “Doctors may think people are coming to them for antibiotics,” Dr. Knecht says. “Asking doctors if antibiotics are needed lets them know that you’re there for the right treatment, whatever that is.” And if you do need antibiotics for a bacterial illness, don’t skip doses and do take all the pills prescribed to you, even after you feel better. And don’t share antibiotics with others.
“Imagine a world where you don’t know if antibiotics will work,” Dr. Knecht urges. “Many people don’t recognize how important they are. We need to elevate their status and preserve this precious resource.”
Maureen Shelly is a health and science geek living in New York City.
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