Antibiotics are effective when prescribed and administered properly
By Melonee Hurt, Special to the Herald
Although antibiotics are one of the top three most prescribed medicines in this country, they are also among the most misunderstood and misused. There aren’t many things a good dose of antibiotics can’t fix, right?
Although very effective for bacterial infections, one of the biggest misconceptions, according to a team of Williamson Medical Center pharmacists, is that people think antibiotics can cure just about anything and expect them to be prescribed for every sniffle.
“So many people think if they go to the doctor, they should come away with a prescription for an antibiotic,” said Kyle Williams, PharmD. “It’s important for people to realize that a lot of times, the first thing they need to do is watch and wait. It may be seven to 10 days before you should be prescribed an antibiotic.”
Oftentimes, physicians will prescribe an antibiotic just in case the infection is bacterial and therefore the medicine might help. But there are cases where just the opposite could happen.
“Antibiotics do not work against viruses like the cold or flu,” said Valerie D’Alesio, PharmD. “Taking an antibiotic for a viral illness may potentially contribute to antibiotic resistance, because it becomes less effective against the bacteria it is intended to treat.”
Williams said just because you hear the word “infection” doesn’t mean it’s something an antibiotic can fix.
“There are three types of infections: fungal, bacterial and viral,” he said. “Fungal, which is the least common, requires an anti-fungal medication. Bacterial infections are where antibiotics come in, but the most common by far, especially in children, are viral infections. While there are anti-viral medications, most viral infections only require treatment of the symptoms.”
Debra Davis, DPh, said that of the children who develop bronchitis, approximately 30 percent of those cases are bacterial, with the remainder being viral.
“Another thing many people don’t realize is that most pink eye is viral,” she said. “It’s the same with ear infections. They are mostly viral and many times, the child will get better without medication. However, I must admit it can be difficult to tell a mom with a fussy child to let the illness run its course.”
The second-biggest misconception with antibiotics is that patients don’t always understand they need to take the entire duration of the prescription.
“Antibiotics kill the weakest bugs first, which helps you to feel better initially,” said Angela Dyer, PharmD. “However, the stronger ones, known as ‘super bugs’, can still be lingering in your system. That’s why it’s so important to take the entire course as prescribed or you can be susceptible to getting sick again. So don’t stop taking the medicine as soon as you start to feel better. ”
Williams added that people have been known to save a portion of a prescribed antibiotic to treat a future illness.
“Some people get a 10-day course of antibiotics and take it for five days and think they can save the rest for the next time they get sick,” he said. “Not only does that open the door for bigger problems, the medication will expire and isn’t effective after a certain date.”
Another common issue that can arise with antibiotics is when certain pharmacies offer them for free. Although this is a wonderful option for parents, it sometimes can inhibit the healing process without a patient even realizing it.
“Let’s say a patient has a bacterial infection that requires Augmentin,” Davis said. “It is one of the more expensive antibiotics, but Amoxicillin might be free. The parents choose to go with the free option and it doesn’t work. Now you have to go back and try something stronger and eventually you can run out of options.”
Antibiotics come in different spectrums, with some being very broad and designed to cover many things. D’Alesio said it’s important for physicians to always prescribe the most narrow therapy possible to avoid killing good bacteria and developing resistance to the medication.
“You want to save the big guns for when you might have a serious infection,” she said. “If you take broad-spectrum antibiotics for minor infections, you put yourself at risk of resistance. This means those same antibiotics can be less effective when needed the most.”
Davis added that the issue of resistance is not just a personal concern, but something that affects society.
“The germs mutate, or get smarter as we keep treating them down with the antibiotics we have,” she said. “We have to keep creating newer drugs to keep up with the growing resistance to the ones we already have.”
In addition to a full course of an antibiotic being cut short because the patient starts to feel better, Williamson Medical Center pharmacists say there are other reasons patients are noncompliant.
Williams said many of the common antibiotics can leave a metallic taste in your mouth, upset your stomach or make you sensitive to light and sun. Some don’t mix with dairy and some can even diminish the effects of oral contraceptives.
“Antibiotics can kill other bacteria, like the good flora in your gut and that can take a while to get over,” Davis said. “We are seeing more and more people ask about probiotics, which definitely help with that. Doctors are recommending them and the general population is asking for them.”
Despite all of the misconceptions, misuses and side effects, when prescribed and taken properly, antibiotics do work. They just shouldn’t be over used to avoid growing resistance to them.
“The responsibility lies with the physicians to know what and when to prescribe, the pharmacists to properly counsel and the patients to follow all pertinent instructions,” Williams said. “Also, it’s important to have open communication with your healthcare provider.”
Melonee Hurt is a senior writer with Williamson Medical Center’s Marketing & Public Relations Department.
Posted on: 7/31/2013