Antibiotics Are Not The Cure For Everything

Mrs. Jones brings her 7-year old son, Arnold, to see Dr. Marcus.  Arnold has had a sore throat, runny nose, cough and intermittent fever for 3 days. His mother is concerned that he continues to feel bad and is missing too much school. Her next-door neighbor’s son had similar symptoms 10 days ago, and after 3 days, his doctor gave him an antibiotic for his “cold.” Two days later, he was much better.

This is a common scenario which brings up a number of misconceptions.

Myth:            “Antibiotics will cure my cold.”

Fact:    Colds (also called upper respiratory infections (URI’s)) are caused by viruses.  Standard antibiotics treat bacterial infections and do not affect viruses.  Most colds will run their natural course in 5-10 days with rest, fluids, and symptomatic treatment.

Myth:   “If I treat my cold early with antibiotics, it will prevent complications such as sinusitis or bronchitis.”

Fact:    Antibiotics will destroy many friendly bacteria that normally live in your respiratory tract and which serve as a natural barrier against invading germs (viruses and bacteria).  Also, overuse of antibiotics eventually leads to resistant bacteria which will not respond to these antibiotics in the future.  Antibiotic resistance is becoming an increasingly serious problem.

 Myth:   “If my mucus drainage turns yellow or green, that means I need an antibiotic.”

Fact:    Not necessarily.  By itself, a change in the color of mucus does not indicate a bacterial complication.  Cold viruses, as they are being expelled from the body, along with other “cellular debris” will cause one’s mucus to turn from clear to yellow, green or even brown or bloody.

 Myth:   “If I take an antibiotic for my cold and I am improved in 2 days, that proves the antibiotic worked.”

Fact:    Many people get better in spite of antibiotics rather than because of them.  It is probably more common not to get better dramatically with antibiotics because they weren’t needed in the first place.   In any case, it is one’s immune system that does the majority of the work in fighting infections.

In summary, there is a great tendency to over-prescribe antibiotics for conditions that will naturally resolve with time, rest and symptomatic treatment.  Some doctors do this out of habit or for convenience (it is simpler to just write a prescription).  Patients contribute to the problem by having unrealistic expectations about the effectiveness of antibiotics.

The solution to this problem lies in better communication between patients and their physicians.  Better informed patients can serve themselves well as their own advocates.  No one should be afraid to ask their doctor questions such as “Do I really need an antibiotic?” 

 --Kenneth Marburg, MD

Dr. Marburg graduated from Wesleyan University and the University of Maryland Medical School and is board certified in Emergency Medicine and Family Practice. Dr. Marburg has been a practicing physician with Medac Health Services, P.A. since 1984 and can be reached at (910) 791-0075.