Wholly Healthy: Antibiotics — What’s the Big Deal?

Spring, summer, fall or winter, we all get assorted infections. Among the most frustrating are head colds that leave us with aches, runny noses, sore throats, fevers and general misery. When that happens, many folks go to their doctors and ask, in fervent hope of relief: “Can I just get an antibiotic?”

The answer is frequently yes. However, most of those simple infections we get are viral. Which means that no matter how many Z-packs, penicillin shots or Cipro pills you receive, the virus will just get better in its own sweet time.

Why do doctors do it? Why does it seem that kids and adults alike are constantly bathed in antibiotics? Several reasons, actually. First, physicians like to please their patients. Which is sweet, but not necessarily right. Second, many times they fear complaints to their administrators. “Patient satisfaction scores” are all the rage these days, and when a doctor gets enough unsatisfactory scores (because people didn’t get the drug they wanted), that doctor can face loss of money and, ultimately, loss of employment—or at the least, a meeting in the administrator’s office. Third, some doctors practice medicine that does not reflect sound science. The research is clear. Antibiotics designed to fight bacteria are not helpful against viruses. (Not only are they not helpful, they’re dangerous … we’ll get to that in a minute.) Fourth and finally, patients are sometimes very insistent. “Every time I see other doctors, I get an antibiotic, and I think I need one now. The last time I took one, I was better the very next day!” Doctors not only like to please, they also fear lawsuits. So they often give in and write the prescription.

What’s the big deal, you ask? Why not, it’s just a pill, right? Well, no. And because I care about the health of my readers, I’ll explain. Antibiotics can cause dangerous allergic reactions, so they aren’t benign. Also, the use, and over-use, of antibiotics has resulted in bacteria that are resistant to those drugs. It’s no concession to Darwin to say that bacteria mutate and change over time, and some develop changes that make them impervious to antibiotics. This has resulted, for example, in drug resistant strains of tuberculosis and gonorrhea. It has also led to methicillin resistant Staph Aureus, or MRSA, which used to plague mostly hospitalized patients, but now is loose in the population causing all sorts of misery. (By the way, that big red bump your friend keeps getting lanced probably isn’t a spider bite. It’s likely MRSA.)

But among the worst side effects is a kind of colon infection that occurs when antibiotics kill many of the other bacteria in the intestine, leading to an overgrowth of a nasty bug called Clostridium difficile. This is called “colitis” and causes diarrhea and dehydration, requiring more antibiotics and sometimes hospitalization. In some instances, patients may require removal of their colon and a colostomy.

Antibiotics are wonderful gifts, passed from God through researchers and physicians. But like so many things, they must be used with caution. So the next time you have an infection, ask your doctor if you really need an antibiotic. If she says no, just keep sniffling and taking Tylenol. Apply a little “tincture of time.” And remember that a snotty nose beats a colostomy any day.