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Antibiotics Needlessly Overused

 

 

Provided by Dayton Daily News on 12/23/2003

by Kevin Lamb

 

 

 

 

 

 

When we're feeling miserable with a cold, bronchitis or the flu, we all want to

feel better five minutes ago. We want to go back to work, back to play, back to

life, and we're even more desperate if it's our kids looking forlorn in their

sickbeds.

So we take antibiotics, which is as helpful as reading a book to quench our

thirst. Or worse, we're one of more than 1.5 million Americans each year who go

to emergency rooms with colds, which is an excellent strategy for coming home

with something worse. Where a cold is uncomfortable, the flu is debilitating.

As flu dominates health news this winter, doctors are bracing for an increase in

unnecessary patients along with the rise in truly sick ones.

Even in a normal year, flu infects about one in four Americans, according to the

Centers for Disease Control and Prevention, knocking 100,000 into hospital beds

and causing complications that killed 65,000 in 2002. From all indications, this

winter's flu will be more widespread and more serious.

Antibiotics won't put a dent in it. Flu is a viral infection, not bacterial, as

are colds and most bronchitis. Colds can lead to bacterial infections, but only

about 2 percent of the time, researchers have found. Antibiotics not only won't

help most of us get better more quickly from respiratory illnesses, they'll

leave us more vulnerable to serious infections later on.

What can we do then? Americans aren't very good at doing nothing, but, in most

cases, our immune systems are better at dispatching respiratory infections than

anything our technology or willpower have contrived. There are some ways we can

help our immune systems, but they're low-tech and methodical.

`For most viral infections, you just have to tough it out,' said Dr. Howard

Wunderlich, an infectious-disease specialist in Washington Twp. Sleep,

nutritious food and fluids help, as can Tylenol and decongestants. Antiviral

drugs can attack flu within 72 hours of the first symptoms, but even they don't

hasten a recovery dramatically, studies show. `Most people get better on their

own,' Wunderlich said.

Exceptions are usually the elderly, children younger than 2 and people with

diseased lungs, hearts or immune systems, for whom precautionary antibiotics are

useful in warding off secondary bacterial infections. Generally healthy folks

develop some secondary infections, too, but they can wait on antibiotics until

it happens.

Fifty million antibiotic prescriptions each year are unnecessary, the CDC says.

When people take antibiotics they don't need, they're breeding supergerms.

Antibiotics don't have to kill every bacterium to cure an infection. The

strongest ones survive, especially when someone doesn't finish all the pills in

the bottle because he feels better.

The most common cause of bacterial pneumonia is now resistant to penicillin 25

percent to 30 percent of the time, Wunderlich said, and serious staph

infections, once seen only in hospitals, are showing up anywhere. The

antibiotics that control them are more expensive and cause more complications,

if they exist.

The CDC attributes 45,000 hospital deaths a year to drug- resistant bacteria.

Even common bacterial infections don't necessarily require antibiotics,

researchers are finding. The more than 20 million annual ear infections in

children generally clear up just as fast with only pain-relieving ear drops, Dr.

Paul S. Matz's team at Brown University Medical School reported in 2001.

About two-thirds of children recover from pain and fever of ear infections on

their own within 24 hours, the Agency for Healthcare Research and Quality

reported the previous year.

`If, after 48 hours, the child is still in pain, which happens in 5 to 10

percent of cases, then it's appropriate to prescribe antibiotics,' Matz said.

That's standard procedure in some European countries.

Antibiotics don't attack symptoms. They usually don't help us feel better any

faster than we would on our own. And aside from the higher-risk exceptions, it's

generally safe to see if our bodies can root out the infection without help

before turning to drugs. On many occasions, the best medicine for patients is

patience.

Kevin Lamb is the Dayton Daily News health writer. His column appears on

alternate Tuesdays.

 

 

© 2003 Dayton Daily News. via ProQuest Information and Learning Company; All

Rights Reserved

 

 

 

 

 

 

 

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