Doctors, Colds and Antibiotics. Oh My!

My father had a cold a few weeks ago. When I called his doctor to get a prescription refill, I mentioned the cold. Without even looking at him or asking any questions, our doctor offered him an antibiotic. I thought doctors stopped this practice years ago.

If you have a cold, antibiotics will most likely do nothing for you. Most colds and sinusitis are caused by a virus. Antibiotics are ineffective against viruses but are effective against bacterial infections. If you have strep throat or pneumonia, it might actually be helpful.

If you don't need it, don't take it. Doctors have prescribed them in the past for people with colds just in case it turned into something that an antibiotic could fix. It was kind of an "insurance policy" in case things got worse. Now we are finding that the overuse of antibiotics is creating something we never planned for. Superbugs! Bacteria are smart. They evolve just like the rest of nature. Many of them are becoming antibiotic resistant. The scary thing about all of this is that they may evolve to the point that we have nothing to fight them with.

I had a really nasty cold back in the 1990's and went to my doctor for evaluation and treatment. I was having a really rough time sleeping and I had to miss work for a few days. He checked me out and told me to go home, drink plenty of fluids, get some rest and wait it out. What? No antibiotics? No magic pills? No nothing? He explained the difference between a virus and bacteria and told me that antibiotics would not do me any good. How refreshing. How honest. I think the majority of doctors know that antibiotics will not treat most cold symptoms but are afraid to not prescribe one. Patients have come to expect the doctor to give them something. If they don't get something, the patient might go to another doctor who might be more willing to write a prescription. If you have a fever that will not go down with aspirin or Tylenol or if you have thick, yellow mucus, you probably have a bacterial infection. If you have itchy eyes and a runny nose with thin, clear, whitish or yellowish mucus, you likely have a virus.

Sinusitis is the fifth most common diagnosis for antibiotic prescriptions. And, there is much evidence that antibiotics are inappropriately prescribed for many patients.

• A major analysis reported that antibiotics helped only one child out of eight who had persistent nasal discharge for at least 20 days. Even when they were helpful, benefits were modest in reducing duration of the infection. No long-term benefits have been reported. This study backed up a number of small studies that have found no significant benefit from antibiotics for most children. In a 2001 study, for example, 87% of children improved regardless of their treatment.
• Although antibiotics may prevent complications and reduce the risk of recurrent or chronic sinusitis, few well-conducted studies have been performed to confirm or refute their benefits in most cases for which they are prescribed.

Of great concern, the intense and widespread use of antibiotics--not only for sinusitis but also for other upper respiratory tract infections--is leading to a serious global problem, which is bacterial resistance to common antibiotics. For example, according to reports in 2002 and 2001, in Canada 15% of S. pneumoniae strains are resistant to penicillin, in the US between 30% and 40% are resistant, and in Hong Kong between 70% and 80% of strains no longer respond to penicillin. Furthermore, in the US about 23% of S. pneumoniae are currently resistant to at least three antibiotics. High rates of resistance strains are even being observed in infants. In general, regions and institutions with the highest rate of resistance are those in which antibiotics are heavily prescribed.

Encouraging studies are now reporting that inappropriate antibiotic prescriptions are on the decline. For example, children diagnosed with sinusitis in 1998 were significantly less likely to have antibiotics prescribed than in 1995.

When to Use Antibiotics. Because the great majority of sinusitis cases resolve themselves on their own, experts recommend antibiotics for the following:

• Patients with severe sinusitis that does not clear up within seven days (some experts recommend waiting 10 days).
• Symptoms that include one or more of the following: green and thick nasal discharge, maxillary facial pain, or tooth pain or tenderness.

Antibiotic Side Effects
Common side effects of antibiotics include upset stomach, diarrhea, and, in women, vaginal yeast infections. Some side effects are more severe and, depending on the antibiotic, may disrupt the function of the kidneys, liver, bone marrow, or other organs. Blood tests are used to monitor such adverse reactions.

Some people who receive antibiotics develop colitis, an inflammation of the large intestine. The colitis results from a toxin produced by the bacterium Clostridium difficile, which grows unchecked when other antibacteria are killed by the antibiotics.

Antibiotics can also cause allergic reactions. Mild allergic reactions consist of an itchy rash or slight wheezing. Severe allergic reactions (anaphylaxis) can be life threatening and usually include swelling of the throat, inability to breathe, and low blood pressure.

Antibiotics Might Make You Sick
There are some other problems with antibiotics. Not only do they kill the bad bacteria that cause infection, but they kill the good bacteria that your body needs to function in a healthy way. Not all bacteria are bad. Most strains of bacteria are harmless… or even beneficial. They peacefully co-exist with us the vast majority of the time. In fact, there are normally more bacteria in your colon then there are cells in your body.

Researchers are just starting to unravel the importance of normal bacteria to our health. Meanwhile we know that things go wrong when antibiotics take out the good with the bad.

Antibiotics don’t discriminate between bacteria that are causing disease and bacteria that are doing a good job for us. You may be taking an antibiotic for an infection, but the antibiotic doesn’t just go to the area of infection. It kills any bacteria in your body that are sensitive to it. This causes problems in a couple of ways.

First, it allows for the development of bacteria resistant to the antibiotic.

More immediately, you may experience diarrhea, a yeast infection, or a colon infection caused by Clostridium difficile. (Clostrium difficile - "C diff" in medical jargon - is a spore-producing bacterium that can overgrow and cause disease when normal bacteria in the bowel are disrupted.)

Taking a couple of steps will reduce your risk of these problems. First, take antibiotics only if you really need them. Second, if you do need them, take probiotic capsules (beneficial bacteria) while you’re taking the antibiotics and for at least a few weeks after you finish treatment.

Probiotics
Probiotics contain healthy bacteria that your body needs. An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. These microorganisms (or microflora) generally don’t make us sick; most are helpful. Gut-dwelling bacteria keep pathogens (harmful microorganisms) in check, aid digestion and nutrient absorption, and contribute to immune function.

Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.

Probiotic-laced beverages, Kefir, acidopphilus and yogurt are becoming quite popular. Try to stay away from the ones with too much sugar as this tends to negate their healthy benefits.

I have no connection with the following companies or products. I only offer them as examples of probiotics that are available. I offer them for educational purposes only.

Natren Health Products

Lifeway Kefir Stay away from the kind that has sugar in it. Mix a little fresh fruit in if you want instead.
Acidophilus

Complete Probiotics