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Antibiotics are not Always Good for What Ails You

Antibiotics are not Always Good for What Ails You...

Uh, oh. There it is again, that annoying tingle in your nose. Your eyes start to water...AACHOO! Once and then again. With each sneeze, your nose gets stuffier and breathing becomes more difficult. You hope it will go away, but after several hours of sniffling and sneezing you know it won’t. A cold...you have a dreadful summer cold. Or do you?

“There are a number of upper respiratory conditions that mimic the common cold,” explains Internist David Cos, M.D. “and while most of them are unpleasant, few are serious or life-threatening. The important thing is not only to know the difference, but to know when antibiotics and other prescription medications will help and when they won’t.”

“For a usually healthy adult,” he continued, “watchful waiting might be appropriate. If the symptoms -- runny nose, sneezing and perhaps a scratchy throat and a hacking cough -- it is probably a cold, caused by one of a hundred or more rhinoviruses, which will go away by itself in three to four days, a week at most. Amazingly enough, no one knows for sure exactly how cold germs are transmitted, but it is generally understood that they enter the body through the mouth or nose.

Rhinoviruses can survive outside the nasal passages on the hands or inanimate objects for up to three hours. Blowing the nose and then touching almost any object -- the phone, a doorknob, the refrigerator door handle -- can put the germs in the path of another family member. I think just about everyone understands it’s important to wash hands and avoid sneezing on others when they have a cold, but it does help to be cautious.”

Research into the common cold over the years, including studies conducted by the National Institute of Allergy and Infectious Diseases (NIAID), has pointed out that colds can sometimes be traced to excessive fatigue and stress. Loading up on Vitamin C to avoid catching a cold appears to have little or no affect,however, but some studies show that taking this old standby may lessen a cold’s severity. If you have cold symptoms, get some rest and drink plenty of liquids. Over-the-counter pain relievers, decongestants and antihistamines might help relieve the discomfort, but remember to read the label carefully and follow dosage instructions.

What if it won’t go away?

Plain old colds generally go away within a week, so if symptoms linger or worsen, or if your temperature rises over 101, a cold may not be to blame for your misery. The flu is another upper respiratory ailment caused by viruses (Influenza viruses A and B) and it, too, is spread by droplets airborne by coughs and sneezes. Sometimes, the first clue that it’s the flu is how fast the symptoms seem to appear and take hold. One minute you’re fine and the next you’re feverish, feeling exhausted, achy all over, and your head hurts. All you want to do is go to bed, and actually, that’s probably the best place for you.

For most healthy adults, the flu is just a minor annoyance and inconvenience, but for older people or for those whose immune system might be compromised by heart disease, cancer or other medical conditions, the flu can lead to some potentially serious problems. If the symptoms are not relieved by over-the-counter remedies, or if the sufferer is at high risk for complications, a visit to the doctor is certainly appropriate to obtain an accurate diagnosis.

“Sometimes the symptoms not only linger, but get worse,” Dr. Cos said. “Another condition that mimics the common cold is sinusitis. It affects millions of people each year and can even become chronic for some people. While sinusitis may start with a cold, the congestion can lead to a bacterial infection in the sinus cavities, that can cause facial pain as well as cold or flu-like symptoms. Since this is a bacteria caused infection, once the diagnosis is confirmed, antibiotics are often effective in treating it, along with a decongestant to relieve the stuffy nose.”

There is another, more serious respiratory illness that can follow a cold or flu. Pneumonia, an inflammation of the bronchial tubes and the tiny air sacs in the lungs, can not only prolong recovery, but can worsen into a potentially life-threatening condition for seniors and other high-risk people. It can be caused by both viruses and bacteria. The warning signs of bacterial pneumonia are a high fever and a productive cough, and some sufferers also experience sharp chest pains when they breathe, along with chills, and a pounding headache. In viral pneumonia -- which tends to occur in older adults -- the symptoms include a high fever, headache, muscle aches and fatigue, and a dry, hacking cough.

“Again, a diagnosis is important to make sure the sufferer gets the right kind of medication and treatment,” Dr. Cos said. “Remember, pneumonia can be potentially very serious for those in the high-risk group and it is certainly something that calls for prompt medical attention. Even though the symptoms can be described over the phone, it is absolutely necessary to see the patient in person to reach a definitive diagnosis. While antibiotics can be effective in treating bacterial pneumonia, they are not useful in treating viral pneumonia. That calls for rest, plenty of liquids, and over the counter remedies that treat multiple symptoms to take care of it. The patient’s progress should be monitored, however, to make sure the recovery is complete.”

Won’t an antibiotic cure it?

“The bottom line -- when it come to upper respiratory illnesses -- is that it’s important to get an accurate diagnosis so no time is wasted in getting the right medication and treatment underway. There have been so many changes in our healthcare system over the past decade,” the doctor said, “that a lot of people are confused about when to go to the doctor and what to expect. Some people think that they have to avoid office visits whenever possible, so they put off getting medical attention until the problem just gets worse. Obviously, everyone is different, and for some people -- who are generally healthy, who know their bodies, and can put up with minor, cold-like symptoms -- putting off an office visit is not a big thing. But, for people who have trouble fighting off the complications of colds and flu, an office visit is much more important as symptoms develop.”

Dr. Cos points out that while most people have come to think of antibiotics as “miracle cures” for just about anything that ails us, there is growing world-wide concern that the over-use of antibiotics is creating a whole new generation of bacteria that are -- or will soon be -- immune to the drugs. Some health officials have begun to sound an alarm that, while scientific research develops stronger new drugs to combat resistant bacteria, we ought to be more conservative in our use of antibiotics.

“This makes a lot of sense to me,” Dr. Cos said. “There is no reason to prescribe antibiotics for illnesses that are caused by viruses because they don’t respond to them. I know folks have trouble with this, because they know from experience that antibiotics can really do the job in some cases. People have an almost overwhelming confidence in these drugs to solve all their medical problems. There’s no question that antibiotics are important weapons in the war against a whole variety of diseases, but we need to make sure they are used correctly.”

“When antibiotics are prescribed appropriately -- and they are taken as directed -- they can remain effective. For example,” Dr. Cos suggested, “take the full prescription, and don’t skip a dose until it is all gone. If you feel sick, get medical attention...don’t take leftover antibiotics or someone else’s medication. If your condition warrants it, you’ll get a new prescription for what’s wrong with you. Help us by not asking for medications you don’t need, and in reverse, don’t hesitate to ask why a particular medication is being prescribed for you. Ask if there are any side effects, and what to expect as far as how long it might take to work.”

“I know how miserable a cold or flu can be,” Dr. Cos said, “but let’s be sure to use antibiotics appropriately so they will work when we really need them.”

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