Should I take an antibiotic?
Here are some tips to help you get a better understanding of antibiotics and how they may or may not be able to help you.
During the winter, more patients suffer from sinus infections, sore throats, headaches, fevers, chills and more. Anytime you’re sick, your first inclination is likely to see a doctor to get a prescription. However, in some cases your ailment might not be treatable by antibiotics.
Lawrence Richmond, MD, Park Nicollet Clinic Plymouth, explains what conditions can be treated with antibiotics, and which ones can’t. For example, most upper respiratory infections, like colds, coughs, sore throats and sinus infections, are typically viral, which means they can’t be treated with antibiotics.
Here are some tips to help you get a better understanding of antibiotics and how they may or may not be able to help you this winter.
When do we know, for sure, that an antibiotic can help treat a condition?
The easiest to diagnose (and most common) condition are those that involve the ears and throat. Ears that are infected with bacteria have a very distinct appearance, making it easy for your doctor to identify this and treat appropriately. Because it is bacterial, there is a good chance that antibiotics will help.
If you have a sore throat, a rapid strep test will help me decide if antibiotics should be prescribed. If tonsils are enlarged and inflamed, antibiotics are usually the way to go.
If I am coughing up a lot of green phlegm, does that mean I need an antibiotic?
No. Studies have shown that the color or thickness of the sputum does not indicate a bacterial infection.
If I have a fever, an antibiotic is probably needed, right?
Viruses can cause a high fever, which is why this is a common symptom of the flu or mono. Unfortunately, these can’t be treated by antibiotics.
Speaking of viruses, most illnesses with cough, congestion and runny nose are caused by viruses, meaning that antibiotics simply won’t help in those cases either. There are some occasions where these conditions can be caused by bacteria, however, which makes diagnoses a little more tricky.
How do you know if a cough is caused by bacteria?
One of the most serious conditions associated with coughing is Pneumonia. This can be diagnosed by listening to chest sound carefully and by getting a chest x-ray. Helping your doctor understand the duration of the cough as well as the severity of your illness can be helpful as well.
For symptoms that have persisted for weeks, we often resort to trying antibiotics. But if they are caused by a virus, antibiotics won’t help.
But most sinus infections improve with antibiotics, right?
No. Most sinus infections are viral and therefore shouldn’t be treated with antibiotics. I try to convince my patients to treat their condition with rest, warm liquids, over the counter pain relievers or decongestants instead. Unfortunately there isn’t a “quick fix” that comes in pill form.
I'm sick, there’s no harm in taking an antibiotic, right?
This isn’t true at all. Overuse of antibiotics causes them to be less effective, even if you only take them rarely. As a result, we may have to treat infections with intravenous antibiotics which can be extremely expensive and sometimes have dangerous side effects. In fact, thousands of people die each year from drug-resistant bacteria that used to be treatable.
In addition to weakening their effectiveness, many antibiotics cause severe diarrhea which can lead to C. diff. This is a serious intestinal infection we can get from taking antibiotics, which requires long treatments of additional medications to cure.
It’s pretty standard to need an antibiotic a couple of times each year, right?
No. If you’re generally in good health, most upper respiratory infections will respond to time and rest. Of course, you should see your doctor if you’re concerned.
What if I have asthma or I’m wheezing?
An antibiotic is definitely necessary, right? Again, it’s often a virus. Having adequate inhalers and an aggressive asthma management plan is usually more protective against respiratory symptoms. You should make sure you have a good asthma management plan.
Dr. Richmond, do you and your family use antibiotics for respiratory infections?
I have not in the past 10 years, maybe longer. My school-age kids get strep throat occasionally, and this treatment is pretty straight forward.
I welcome all questions from patients about when antibiotics are indicated. I know how debilitating it is to be in sick, unable to work or do your usual activities. However, we are often pressured by patients to prescribe antibiotics when we would not recommend them otherwise.
Fortunately, most of us are armed with immune systems which will provide the necessary defense against these infections. Regular exercise, avoiding smoking, getting adequate sleep, hand washing and staying home when you are sick are very practical ways to improve your odds against a respiratory infection.