Tuesday, July 23, 2024

Should Physicians Prescribe Antibiotics For Viral Infections

Must read

When Are Antibiotics Needed

Why You Shouldnt Take Antibiotics for a Cold or Virus

This complicated question, which should be answered by your healthcare provider, depends on the specific diagnosis. For example, there are several types of ear infectionsmost need antibiotics, but some do not. Most cases of sore throat are caused by viruses. One kind, strep throat, diagnosed by a lab test, needs antibiotics.

Common viral infections, like coughs or a cold, can sometimes become complicated and a bacterial infection can develop. However, treating viral infections with antibiotics in order to prevent bacterial infections is not recommended because of the risk of causing bacterial resistance:

  • Remember that antibiotics do not work against viral colds and the flu, and that unnecessary antibiotics can be harmful.

  • Talk with your healthcare provider about antibiotics and find out about the differences between viruses and bacteria, and when antibiotics should and should not be used.

  • If your child receives an antibiotic, be sure to give it exactly as prescribed to decrease the development of resistant bacteria. Have your child finish the entire prescription. Don’t stop when the symptoms of infection go away.

  • Never save the left over antibiotics to use “just in case.” This practice can also lead to bacterial resistance.

  • Do not share your antibiotics with someone else or take an antibiotic that was prescribed for someone else.

  • Antibiotic resistance is a problem in both children and adults.

Antibiotics Are Only Effective Against Bacterial Illness

Most of the infections patients come in for have a viral or allergic cause, explained Aparna Vaikunth, MD, a family medicine doctor at Duke Primary Care Green Level Family Medicine in Cary. Antibiotics are only effective against bacterial illnesses, and over-prescribing antibiotics can render these drugs useless in the long run.

Karl R. Bernat, Jr., MD, FACP, a primary care doctor at Duke Primary Care Heritage Internal Medicine in Wake Forest, agreed. The majority of colds and other upper respiratory symptoms we see in primary care, the ER, and urgent care are almost always viral illnesses and dont respond to antibiotics, he said. We try to reserve antibiotics for symptoms that have been going on for longer than a week or when theres fever.

Do Not Prescribe Antibiotics For Common Cold Doctors Urge

A patient with a common cold should not be prescribed antibiotics, so say two medical bodies in the US, who in a bid to reduce inappropriate use of antibiotics have joined forces to advise about appropriate prescribing of antibiotics for acute respiratory tract infections in adults.

The American College of Physicians and the Centers for Disease Control and Prevention issue the new advice in a paper published in the Annals of Internal Medicine.

The purpose of the paper, described as high-value care advice, is to amplify and update rather than replace messages from recent guidelines on appropriate antibiotic prescribing, note the authors.

It is aimed at general practitioners and health care professionals who see patients with acute respiratory tract infections in outpatient settings.

The authors note that ARTIs such as the common cold, uncomplicated bronchitis, sore throat and sinus infection are the most common reason for outpatient antibiotic prescriptions for adults in the US.

As a result, they note, inappropriate use of antibiotics for ARTIs contributes significantly to the spread of antibiotic-resistant infections and the rise of so-called superbugs.

The CDC estimate that every year, at least 2 million people in the US become infected with and at least 23,000 die as a result of bacteria that are resistant to antibiotics.

You May Like: What Can I Do To Stop Recurring Yeast Infections

Patients Often Demand Antibiotics And Doctors Cave

Patient demand is another reason. Doctors often cite requests from their patients as a driver of unnecessary antibiotics use. They may be overstating this factor research has shown that fewer than 40 percent of people who went to the emergency room wanted antibiotics but at the very least, doctors’ perceptions can lead to some unnecessary prescriptions.

Doctors often want to please their patients, and they may not have the time to explain why the drugs aren’t necessary. As Ashish Jha, a physician-researcher at Harvard Medical School, told me, “I completely understand why doctors do this: Its so much easier to write a prescription than to spend 15 minutes persuading somebody they don’t need antibiotics.”

Doctors even joke that they wish they could just write a placebo in these cases, he added. “Though that raises its own ethical issues.”

Simple exhaustion can play a role, too. In research published last year in JAMA Internal Medicine, doctors found that decision fatigue impairs a clinicians ability to say no to an inappropriate prescription. Doctors were more likely to write an unnecessary prescription later in the course of the day when their defenses and clarity of thought were already worn down after seeing several patients. “But even at the beginning of the session,” said lead author Jeffrey A. Linder, a Brigham and Women’s Hospital physician-researcher, “there’s still too much antibiotic prescribing.”

Most Ear Infections Are Still Treated With Antibiotics

Are Antibiotics a Good Idea for the Treatment of Acne?

Ear infections, or acute otitis media, affect a majority of children by age three . Research has shown that without treatment, 80 percent of ear infections clear on their own . Despite this, 95 percent of ear infections were treated with antibiotics in the United States in 2001 .

Antibiotics absolutely have a place in medicine and should be prescribed in severe cases, but over-prescription has contributed to widespread antibiotic resistance and gut microbiome destruction. As I have covered numerous times, including here, here, and here, a properly developed gut microbiome is vital to good health. Wiping out gut bacteria with antibiotics should only be done when truly necessary, since damage to gut bacteria populations is not easily reversed .

Recommended Reading: Amoxicillin Vs Penicillin For Tooth Infection

Drivers Of Antibiotics For Covid

Why did so many clinicians prescribe antibiotics for Covid-19 with no evidence to support it, especially given the harm of antibiotic resistance?

Many doctors likely prescribed antibiotics to Covid-19 patients because they feared the possibility of secondary infections, when damage caused to the nose or lungs from a virus leads to a bacterial infection. Early reports from China had warned about drug-resistant infections in Covid-19 patients, but doctors later found that these warnings turned out to be overly cautious.

For some doctors, using antibiotics was an act of desperation early in the pandemic, driven by a lack of effective treatments.Many physicians were inappropriately giving antibiotics because, honestly, they had limited choices, said Dr. Teena Chopra, director of epidemiology and antibiotic stewardship at Detroit Medical Center, in The New York Times.

Many clinicians do not see antibiotic resistance as a real threat, despite the fact that 2.8 million of these infections occur every year. Especially in the stress of a pandemic, the constant drive for clinicians to do something can be more powerful than the future potential threat of superbugs.

Do Antibiotics Work For Viruses

The change in temperature as winter settles in often leads to increased respiratory symptoms such as sneezing, congestion and coughing. But how do you know if your symptoms are due to a virus or bacteria?

In this Q& A, pediatric infectious disease specialist Paul Krogstad, MD, sheds light on viral versus bacterial illnesses. And he talks about when you should use antibiotics for infections.

Read Also: Can I Take Z Pak For Sinus Infection

Why Antibiotics Were Not Prescribed For A Viral Infection

Colds, flu, and many other upper respiratory infections such as bronchitis and rhinosinusitis are usually caused by viruses.

Antibiotics do not kill viruses. Viral infections are almost always cured by your bodys own immune system.

Based on your history and physical examination, it is likely that your illness is caused by a virus. Your illness is unlikely to be helped by an antibiotic. Antibiotics do not shorten the length of time that you will feel sick from a virus. Antibiotics do not prevent you from spreading an illness caused by a virus. Patients given antibiotics may start to feel better, but this is because the virus infection is resolving on its own and not because of the antibiotic.

In addition, taking antibiotics can come with certain risks:

  • Almost one in every four persons taking antibiotics experiences side effects .
  • Rarely, people can have severe allergic reactions to antibiotics.
  • Using antibiotics when they arent needed can lead to the antibiotics not working against other infections in the future, also known as antibiotic resistance.
  • Taking antibiotics can increase the risk for Clostridium difficile infection, a form of diarrhea that requires additional treatment with antibiotics and even stool transplant in severe cases.

Seek re-evaluation by your healthcare provider if you experience any of the following:

  • You dont get better after a week
  • You get better, but then get worse again
  • You have a high fever

Doctors Prescribe Way Too Many Antibiotics Experts Offer Tips On Cutting Back

How to use antibiotics — know the difference between viral and bacterial infections

The Annals of Internal Medicine on Tuesday reminded physicians that they shouldnt routinely prescribe antibiotics for upper respiratory infections like bronchitis, sinusitis, sore throats, or the common cold. Why not? Most upper respiratory infections are caused by viruses, and antibiotics dont work against them. In addition, antibiotics can cause unwanted side effects like upset stomach and diarrhea they account for one of every five emergency department visits for drug reactions. And their overuse contributes to the frightening rise of antibiotic-resistant infections.

Ive been hearing the admonition not to prescribe antibiotics for upper respiratory infections for at least 20 years. My first reaction to the new paper: Why cant doctors get this right?

It turns out that some much? of the blame goes to doctors patients. In the infamous words of the cartoon character Pogo, We have met the enemy, and he is us.

Robert L. Wergin: Prescribing antibiotics an individualized decision

Weve known for 20 years or more that most upper respiratory infections are caused by viruses, not bacteria, rendering antibiotic therapy less than useful and potentially harmful. Yet many physicians are still prescribing antibiotics for these illnesses. The American College of Physicians undertook the review published in Annals of Internal Medicine to offer the best advice available today and to refocus attention on appropriate antibiotic prescribing.

Read Also: What To Use For Inner Ear Infection

Why Dont Antibiotics Work On Viruses

Viruses are different to bacteria they have a different structure and a different way of surviving. Viruses dont have cell walls that can be attacked by antibiotics instead they are surrounded by a protective protein coat.

Unlike bacteria, which attack your bodys cells from the outside, viruses actually move into, live in and make copies of themselves in your bodys cells. Viruses can’t reproduce on their own, like bacteria do, instead they attach themselves to healthy cells and reprogram those cells to make new viruses. It is because of all of these differences that antibiotics dont work on viruses.

Preserving The Usefulness Of Antibiotics

More prudent prescribing can be helpful in other ways. By reducing the use of antibiotics, we also help to preserve the usefulness and effectiveness of our currently available antibiotics, Dr. Bernat explained. Doctors are particularly concerned about keeping the current arsenal strong, because very few new antibiotics are being developed.

Patients can play a role in maintaining this important resource by resisting the urge to request antibiotics for minor infections. Doctors may feel pressured by patients to prescribe antibiotics in some cases. So it will take a team effort, including both providers and patients, to tackle this expanding problem.

Recommended Reading: Will Macrobid Treat Yeast Infection

Should I Avoid Antibiotics Altogether

Not at all. Antibiotics can save people’s lives, and if you need them, you should get them as quickly as you can. Since only a doctor can prescribe antibiotics, this means that you should talk to your doctor if you think you might need them .

However, it is the grave over-reliance and inappropriate use of antibiotics that have contributed to the global antibiotic resistance crisis that we face.

A study by the CDC showed that many adults believe that if they are sick enough to see a doctor for a cold, they should get an antibiotic treatment. The study also showed that patients are not aware of the consequences of taking the drugs if they are not needed. And when antibiotics are misused, bacteria can become resistant.

What You Can Do To Feel Better

For a normal cold, why are some doctors quick to prescribe antibiotics ...
  • Ask your healthcare professional about the best way to feel better while your body fights off the virus.
  • If you need antibiotics, take them exactly as prescribed. Talk with your healthcare professional if you have any questions about your antibiotics.
  • Talk with your healthcare professional if you develop any side effects, especially severe diarrhea, since that could be a C. diff. infection, which needs to be treated immediately.
  • Do your best to stay healthy and keep others healthy:
  • Clean hands by washing with soap and water for at least 20 seconds or use a hand sanitizer that contains at least 60% alcohol
  • Cover your mouth and nose with a tissue when you cough or sneeze
  • Stay home when sick
  • Get recommended vaccines, such as the flu vaccine.

To learn more about antibiotic resistance, visit CDCs Antibiotic Resistance website.

Don’t Miss: Do You Need Antibiotics For Bladder Infection

Tips For Patients To Use Antibiotics Responsibly

We need your help as well. There are three ways you can help fight antibiotic resistance:

We also often field calls from patients who want an antibiotic prescription but dont want to come in for an exam. Its important we evaluate you in person because so often these illnesses are viral, not bacterial. We may not be able to tell the difference on the phone.

Its not unusual for patients to tell me, Well, last time I had this, antibiotics cleared it right up. I explain to them that every infection is different. They may have had a bacterial infection last time, in which case the antibiotics would have been effective. Its also possible that it was a viral infection and their symptoms disappeared after a couple days not because of the antibiotic, but because thats how viral infections work. The symptoms subside on their own.

If you are prescribed an antibiotic, follow these guidelines:

Why Your Doctor Won’t Prescibe Antibiotics

Why are some doctors so stingy with antibiotics? House Call Doctor reveals the dangers of antibiotic overuse. Plus – the reason why it’s so hard to get a prescription for antibiotics over the phone

Scientific American presentsHouse Call Doctorby Quick & Dirty Tips. Scientific American and Quick & Dirty Tips are both Macmillan companies.

Have you ever wondered why doctors seem so stingy with antibiotic prescriptions?

I mean, here you are suffering from a nasty cold and you simply cannot be sick right now . Whats the harm in taking a few anti-bacterial zappers? They couldnt hurt, right? Why cant these stuffy doctors just give in a little?

A new patient recently came to see me in clinic. He decided to switch primary care doctors after his previous doctor wouldnt write a prescription for a second round of antibiotics without seeing him in clinic.

Initially, the patient self-diagnosed with a sinus infection, called his doctor, was given one round of antibiotics that didnt seem to work. So he tried to call in for another round but was denied. He was distraught and angry.

I cant come in for every little thing just because he wants to collect my copay and make money off every visit, he exclaimed. So I told him Im finding a new doctor!”

It’s a valid question: Why are some doctors hesitant about prescribing antibiotics, especially without a visit?

Unfortunately, in spite of what you may have heard, antibiotics dont do a thing for viruses.

Recommended Reading: Can Flagyl Cure Yeast Infection

When Antibiotics Are Needed

Antibiotics are only needed for treating certain infections caused by bacteria, but even some bacterial infections get better without antibiotics. We rely on antibiotics to treat serious, life-threatening conditions such as pneumonia and , the bodys extreme response to an infection. Effective antibiotics are also needed for people who are at high risk for developing infections. Some of those at high risk for infections include patients undergoing surgery, patients with end-stage kidney disease, or patients receiving cancer therapy .

Q Are Antibiotics Effective For Covid

Prescribing antibiotics for acute respiratory tract infections (ARTIs) in adults

A. If youre hospitalized with COVID-19, there is a high likelihood your provider wont prescribe antibiotics since a virus is the cause of your illness. Physicians operate under the cardinal rule of first, do no harm. We want to deliver treatment that helps you recover without causing other potential concerns. Antibiotics could be unsafe for people with COVID-19 because they alter how the body handles other vital medications. We are judicious in thinking about you holistically your kidneys and heart so we dont offer medicine that could potentially do more significant harm.

If you are experiencing symptoms such as cough, runny nose, congestion or fever, you can reach out to your primary care provider. He or she will determine if you should seek testing or treatment.

Read Also: Yeast Infection For A Month Now

Take Antibiotics Exactly As Prescribed If You Need Them

Dispose of Unused Medicines

If your doctor decides an antibiotic is the best treatment when youre sick:

  • Take them exactly as your doctor tells you.
  • Do not share your antibiotics with others.
  • Do not save them for later. Talk to your pharmacist about safely discarding leftover medicines.
  • Do not take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects.

Talk with your doctor and pharmacist if you have any questions about your antibiotics.

More articles

Popular Articles