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Antibiotics: When Do You Really Need Them?


Antibiotics are medications that can kill or inhibit the growth of bacteria. Globally, they are one of the most commonly prescribed drugs and play an essential role in combating disease. Doctors use antibiotics to treat various illnesses, from ear infections to pneumonia. However, they're not effective against viruses, such as the common cold or flu, so it's critical to use them responsibly.

Using antibiotics too frequently or when not needed can trigger side effects and lead to antibiotic resistance. In recent years there's been an increase in antibiotic-resistant strains of bacteria, making these medications less effective.

Although antibiotics have become an indispensable part of healthcare, they are not always necessary. This article discusses the role of antibiotics, when they're needed, and how to use them safely.

What are antibiotics?

Antibiotics are prescribed medications that can kill or inhibit the growth of bacteria and so treat bacterial infections. You can take them as tablets, creams, eye-drops, or intravenously through a vein.

Before the discovery of these life-saving drugs, people died from even minor bacterial infections. Then, in 1928, Scottish scientist Alexander Fleming discovered the antibiotic penicillin and revolutionized healthcare.

Nowadays, numerous types of antibiotics are available that can treat a wide range of infections. Some are effective against many kinds of bacteria and are called 'broad-spectrum.' Conversely, others only target specific bacteria and are referred to as 'narrow-spectrum.'

Manufacturers derive some antibiotics from natural substances, such as penicillin, which is produced by the fungus Penicillium, or erythromycin, which comes from a soil-dwelling bacterium.

Others are synthetic and developed in laboratories, such as ciprofloxacin, which became patented in 1980.

What can antibiotics treat?

The human body contains trillions of bacteria. In fact, there are around 10 times more bacterial cells in your body than human cells, amounting to over 2 pounds of bacteria in a 200-pound adult.

You need some types of bacteria to stay healthy. Bacteria live on your skin and in your gut, where they help with digestion and produce vitamins, including folic acid, niacin, and vitamins B6 and B12. These are so-called 'good' bacteria. They also protect us from harmful microorganisms by crowding them out and producing substances that kill them.

Although bacteria are necessary for health, sometimes they cause infections. Bacteria can enter the body through the nose, eyes, mouth, or openings in the skin. Once inside, they multiply quickly and cause symptoms such as fever, diarrhea, or vomiting. Fortunately, antibiotics can kill or inhibit the growth of these bacteria and treat infections.

Common infections that antibiotics can treat include:

  • Ear infections
  • Strep throat
  • Urinary tract infections (UTIs)
  • Skin infections
  • Meningitis (swelling of the brain and spinal cord)
  • Dental infections
  • Bacterial pneumonia

Antibiotics are only effective against bacterial infections and, to a lesser extent, parasites like amebae. Many common illnesses such as colds, flu, coughs, and stomach flu are viral, not bacterial, so antibiotics won't work.

If you're ill with a viral infection, you'll need to take care of your symptoms and wait till your immune system manages the infection on its own. That said, antiviral drugs can help with some viral illnesses.

When should you take antibiotics?

You should only take antibiotics when prescribed by a doctor. They'll decide that antibiotics are appropriate based on the type of infection and its severity, and your general health.

Even if you have a bacterial infection such as sinus or ear infections, doctors may not prescribe antibiotics because they usually clear up by themselves.

If a doctor decides that antibiotics are suitable, you should take them exactly as prescribed. This means following the correct dosage and taking the full course. You shouldn't have any antibiotics left over from your prescription, but if you do, you shouldn't save them. Instead, you should ask your pharmacist for advice on safe disposal.

Sharing your antibiotics or taking those prescribed for someone else is risky. It can cause serious side effects or even make the illness worse.

What are the side effects of antibiotics?

Because the intestines are full of helpful bacteria, using antibiotics can cause digestive side effects while treating an infection. These happen in around 1 in 10 people and include:

  • Vomiting or nausea
  • Diarrhea or loose stools
  • Indigestion
  • Loss of appetite
  • Bloating or feeling full
  • Abdominal pain or cramping

Women may also develop yeast infections. These issues are typically mild and should disappear once you finish the course of antibiotics.

Around 1 in 15 people taking antibiotics have an allergic reaction to them, particularly with penicillin or cephalosporins. They may develop:

  • Hives (a raised, itchy skin rash)
  • Coughing
  • Wheezing
  • Throat tightness
  • Breathing difficulties

Usually, you can treat these mild to moderate allergic reactions with antihistamines. But if you're concerned about symptoms, or they don't improve with treatment, contact your doctor.

Rarely, antibiotics can cause a severe and potentially life-threatening allergic reaction called anaphylaxis. If someone develops any of the following symptoms, they should seek emergency medical attention:

  • Feeling faint or dizzy
  • Breathing difficulties
  • Rapid heartbeat
  • Clammy skin
  • Confusion
  • Anxiety
  • Losing consciousness
  • Facial swelling
  • Stomach pain

Excessive or inappropriate use of antibiotics can also cause antibiotic-resistant infections.

What are antibiotic-resistant infections?

Antibiotic-resistant infections are caused by bacteria that have become resistant to the effects of antibiotics. That means the bacteria don't die and continue to grow even with antibiotic treatment. Therefore, these infections are difficult to treat and can sometimes be life-threatening, especially if they affect vulnerable or older adults.

Nearly 3 million antibiotic-resistant infections happen in the U.S. annually, and around 35,000 people die as a result.

Antibiotic resistance is one of the world's most pressing public health issues. Therefore, it's critical only to use antibiotics when necessary and always follow your doctor's instructions.

If you have any questions about antibiotics, talk to your doctor or pharmacist.

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