When Do You Need an Antibiotic?

December 1st 2015
Melissa J. Holley, DNP, MSN, APRN, FNP-C

Antibiotics are medications used to kill or stop the growth of bacteria that cause illnesses, some of which may be contagious or life-threatening.

Q: WHAT ARE ANTIBIOTICS?

Antibiotics are medications used to kill or stop the growth of bacteria that cause illnesses, some of which may be contagious or life-threatening.1Not all bacteria require treatment; some of these microbes help our bodies fight off infection, aid in digestion, and assist with vitamin production.

Since the development of antibiotics in the 1920s, these medications have been instrumental in our ability to treat simple infections in humans and animals. If left untreated, these infections could be fatal.1Antiobiotics can be life-saving, when used appropriately; however, when they are not used correctly, they can become ineffective and make it difficult to treat common infections. This is called antibiotic resistance.

Q: WHAT ARE COMMON INFECTIONS THAT ANTIBIOTICS TREAT?

Antibiotics are most commonly prescribed for bacterial infections such as strep throat; pneumonia; urinary tract infections; Lyme’s disease; sexually transmitted diseases such as gonorrhea and chlamydia; and the skin infection cellulitis. These medications are not effective in treating fungal infections or viruses such as the common cold, most sore throats, the flu, bronchitis, and some sinus infections. According to Hicks et al, 8 out of every 10 patients were prescribed an antibiotic in 2011.2Despite strong evidence that antibiotics do not cure viral infections, many providers continue to prescribe them.

Q: WHAT COULD HAPPEN IF ANTIBIOTICS ARE NOT TAKEN CORRECTLY?

Taking antibiotics when they are not needed may cause you to experience unnecessary medication side effects, allergic reactions, repeat visits to your health care provider, more out of pocket costs for co-pays and prescriptions, and visits to the emergency department, and can contribute to antibiotic resistance. When antibiotics are not used properly, it may be difficult for your infection to be treated without having to use very strong antibiotics, or more than one antibiotic at a time. An example of this is methicillin-resistantStaphylococcus aureus(MRSA). There are even circumstances when an antibiotic will no longer work for your infection.

Drug-resistant bacteria are harmful to public health and contribute to prolonged infections and even deaths.3Unfortunately, there haven’t been any new antibiotics developed over the past few years, which contributes to the problem.4,5As a result, infections caused by drug-resistant bacteria claim the lives of at least 23,000 people a year in the United States.3

Q: HOW CAN I PROTECT MYSELF AND LOVED ONES FROM ANTIBIOTIC RESISTANCE?

  1. Talk to your health care provider to determine if an antibiotic is the best treatment for your illness.
  2. Avoid demanding antibiotics for suspected viral illnesses such as upper respiratory infections, colds, bronchitis, and the flu.
  3. When diagnosed with a viral infection, talk to your health care provider about recommendations to manage your symptoms.
  4. When you are prescribed an antibiotic, take the prescription as directed by your health care provider.
  5. If you are prescribed an antibiotic and experience side effects or an allergic reaction, inform your health care provider immediately.
  6. Dispose of any antibiotics you have not used.
  7. Do not take leftover antibiotics from a prior illness when you are sick.
  8. Do not share your antibiotics with others.
  9. Talk to your health care provider about the benefit of vaccinations that prevent illnesses that may require an antibiotic.
  10. Cover both your nose and mouth when you cough or sneeze with a tissue, then discard in a trashcan. If a tissue is unavailable, sneeze or cough into your elbow.
  11. Practice good hand hygiene/washing with soap and water.

Q: DO PROBIOTICS MINIMIZE MY RISK OF ANTIBIOTIC RESISTANCE?

Probiotics are live bacteria and yeast that may improve your health when delivered in small quantities. There is no evidence to support that probiotics reduce your risk of antibiotic resistance.1

Q: ARE THERE ANY INITIATIVES TO PROMOTE THE PROPER USE OF ANTIBIOTICS?

Yes. The Centers for Disease Control and Prevention has an initiative called “Get Smart: Know When Antibiotics Work.” This program provides education and resources to patients, providers, and communities about the proper use of antibiotics. They also provide treatment guidelines for common illnesses for providers to use as a reference. For more information on this program, visit www.cdc.gov/getsmart. There is also a US government initiative, the National Strategy for Combating Antibiotic-Resistant Bacteria, working here in the United States and around the globe to reduce antibiotic resistance.6

Melissa J. Holley, DNP, MSN, APRN, FNP-C, is a doctorally prepared family nurse practitioner who works within the LifeBridge Health System as the Director of Medical Specialties for Carroll Health Group. She also serves as a clinical faculty member for the Johns Hopkins University School of Nursing master’s program.

References

  1. Centers for Disease Control and Prevention. Get smart: know when antibiotics work. www.cdc.gov/getsmart/community/about/antibiotic-resistance-faqs.html. Updated April 17, 2015.
  2. Hicks LA, Bartoces MG, Roberts RM, et al.US outpatient antibiotic prescribing variation according to geography, patient population, and provider specialty in 2011.Clin Infect Dis. 2015;60(9):1308-1316. doi: 10.1093/cid/civ076.
  3. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf.
  4. Arias CA, Murray BE. A new antibiotic and the evolution of resistance.N Engl J Med. 2015;372(12):1168-1170. doi: 10.1056/NEJMcibr1500292.
  5. Outterson K, Powers JH, Daniel GW, McClellan MB. Repairing the broken market for antibiotic innovation.Health Aff (Millwood). 2015;34(2):277-285. doi: 10.1377/hlthaff.2014.1003.
  6. The White House, Office of the Press Secretary. Executive order—combating antibiotic-resistant bacteria. Exec. Order No. 13676, 3 CFR. www.whitehouse.gov/the-press-office/2014/09/18/executive-order-combating-antibiotic-resistant-bacteria. Effective September 18, 2014.

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