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  • October 23, 2014

Antibiotics: How Much is Too Much? - Ladue News: Health-wellness

Antibiotics: How Much is Too Much?

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Posted: Thursday, December 20, 2012 12:00 pm

When seasonal sniffles and coughs arrive, it’s tempting to call the doctor and ask for a prescription of good, old-fashioned antibiotics to make it all better. But antibiotics are the wrong treatment for colds, flu, bronchitis, most ear infections and other common viral ailments. In fact, taking antibiotics for anything other than a bacterial infection can cause serious harm.

Antibiotic-resistant bacteria are becoming an increasingly serious public health concern, and misuse of antibiotics is one of the driving forces. For example, taking unnecessary antibiotics, taking those prescribed for someone else, or not taking an entire course of antibiotics even if you quickly feel better are costly mistakes. “The course of antibiotics is intended to allow the antibiotic time to completely clear the bacteria,” says Dr. Julia Young, a pediatrician with Docs 4 Kidz. “If the course is shortened, this may allow the bacteria to multiply or even develop some resistance.”

In light of such concerns, hospitals and medical centers are developing teams and pro-grams to address ‘antibiotic stewardship,’ explains Dr. Matthew Broom, a pediatrician at Danis Pediatrics at SSM Cardinal Glennon and assistant professor of pediatrics at Saint Louis University School of Medicine. “This describes the process of using the right (i.e., most narrow-spectrum) antibiotic, for the right amount of time, at the right dose for the appropriate clinical indication. These teams evaluate the inappropriate use of broad-spectrum antibiotics when they are not needed and talk with medical providers about the importance of judicious use of antimicrobials.”

Antibiotics work by attacking bacteria directly, either killing the bacteria (bactericidal) or causing it to no longer be able to produce significant disease (bacteriostatic). Powerful, broad-spectrum antibiotics are not indicated to treat many simple infections, Broom notes. “Over time, these habits will assist bacteria in the development of resistance against some of medicine's strongest antibiotics.”

Educating the public about the dangers and causes of antibiotic resistance has helped decrease the incidence of patients seeking—or even demanding—antibiotics for themselves or their children unless a physician believes the drugs are truly warranted.

Even if antibiotics are prescribed, they may not be without unpleasant side effects or ad-verse events. Skin rash and diarrhea, which are rarely serious but can be very unpleasant, are among the most common side effects.

“Be willing to discuss the risk/benefit of antibiotic use with your physician,” Broom says. “If it is recommended that your child needs an antibiotic, have the clinician explain why. If not, have them also define why not. Ask for a good follow-up plan if your child has a fever-producing illness and is diagnosed with a virus. Though this remains the most likely diagnosis for a common cold or upper respiratory infection, some of those children may develop or actually have bacterial infections, so good follow-up for a repeat assessment is important if the child is not improving.”

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