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Why taking too many antibiotics can be harmful

Few things are more frustrating than feeling sick and finding out there’s nothing you can do to speed recovery. That frustration might be what leads so many individuals to ask their doctors for antibiotics — prescription medications that are well known for killing bacterial germs. But antibiotics are not a surefire solution for curing all illnesses and in fact, the rampant overuse of these medications may be responsible for an imminent public health threat. Here’s what you need to know before requesting, considering, or taking antibiotics.

Why taking too many antibiotics can be harmful

Few things are more frustrating than feeling sick and finding out there’s nothing you can do to speed recovery. That frustration might be what leads so many individuals to ask their doctors for antibiotics — prescription medications that are well known for killing bacterial germs. But antibiotics are not a surefire solution for curing all illnesses and in fact, the rampant overuse of these medications may be responsible for an imminent public health threat. Here’s what you need to know before requesting, considering, or taking antibiotics.

What are antibiotics — and when should they be used?

Antibiotics fight bacterial infections and these medications are definite necessities in some cases. By either killing the harmful bacteria or making it difficult for that bacteria to grow and multiply, antibiotics can actually be life-saving in some serious infections. Antibiotics, however, do not work on viral infections like colds or flu, which are not caused by bacteria.

“Antibiotics are commonly prescribed to treat bacterial infections like strep throat, E.coli, and urinary tract infections,” says Solv’s Chief Medical Officer, Rob Rohatsch, MD. “They are not effective in treating viral infections and they are not even necessary to treat all types of bacterial infections. For example, you may not need antibiotics to treat a sinus infection. Taking these medications when they’re not needed isn’t just ineffective, but can actually lead to serious side effects.”

According to the Centers for Disease Control and Prevention (CDC), antibiotics should only be used to treat certain infections, including, but not limited to:

  • Strep throat
  • Whooping cough
  • Urinary tract infection (UTI)
  • Life-threatening conditions like sepsis

Antibiotics are usually not needed to treat sinus infections or some ear infections, which typically get better on their own. And antibiotics should not be used to treat the following illnesses, which are caused by viruses, not bacteria:

  • Colds
  • Most sore throats (other than strep throat)
  • Flu
  • Most chest colds (aka bronchitis)

Are Americans overusing antibiotics?

While experts are clear on the illnesses that merit antibiotic use — and those that do not — research has shown that antibiotics are frequently overused and misused. A 2016 CDC study found that at least 30 percent of antibiotics prescribed in the United States were unnecessarily prescribed for issues like common colds, viral sore throats, bronchitis, and sinus and ear infections. A press release about the study stated that “these 47 million excess prescriptions each year put patients at needless risk for allergic reactions or the sometimes gastrointestinal disorders like Clostridium difficile.”

Another recent study published in the journal BioEssays found that a large number of Americans are taking unnecessary antibiotics that may actually cause harm. The report reviewed over 200 peer-reviewed studies to examine the reasons why antibiotic use is so prevalent. According to an interview with lead researcher Martin Blaser in Rutgers Today, “the global use of antibiotics between 2000 and 2015 increased 39 percent, with a 77 percent increase in low- and middle-income countries.”

“The study found that one-third of antibiotic prescriptions dispensed from non-hospital pharmacies in 2015 were unnecessary,” Rohatsch says. “The majority of those prescriptions were written for patients with upper-respiratory illnesses which are most likely caused by viruses, not bacteria. And doctors also wrote more prescriptions for powerful, broad-spectrum antibiotics, rather than targeted ones, which can lead to serious — even fatal — infections if used inappropriately.”

Why is this happening? According to Joseph Toscano, MD, UCA/CUCM Clinical Content Coordinator, “This is a bad habit that patients and clinicians have gotten used to over time. We all seem to feel more comfortable when ‘something is being done’ for an ill patient, rather than the watchful waiting that is all that's truly needed for many infections. It's a problem because overuse leads to potential complications for patients (allergic reactions, diarrhea, etc).”

Along with the potential for deadly consequences, the overuse or misuse of these medications can lead to a phenomenon known as antibiotic (or antimicrobial) resistance, which the CDC has called “an urgent global public health threat.”

What is antibiotic resistance?

Antibiotic resistance can occur when bacteria develop the ability to change and defeat the medications that were designed to destroy them.

According to Dr. Toscano, “Exposure to antibiotics creates a situation of ‘survival of the fittest’ where the bacteria that survive treatment with antibiotics, and some do, are resistant to that antibiotic and make up a larger percentage of circulating bacteria into the future. This makes it harder and harder to treat future infections with the same antibiotics, so stronger antibiotics are needed, and the cycle continues. When antibiotics are overused or used when not needed, that resistance occurs for no good reason.”

The CDC reports that there are over 2.8 million antimicrobial-resistant infections in the U.S. every year, resulting in the death of over 35,000 people.

“If antibiotics are no longer effective in treating bacterial infections, health professionals don’t have the tools to treat these illnesses,” Rohatsch says. “This means that over time, infections that were once considered minor can become deadly, and we won’t have effective strategies for controlling their spread.”

What questions should you ask your doctor when prescribed antibiotics?

As experts have indicated, antibiotic resistance is accelerated by the overuse and misuse of antibiotics. That means there are actionable steps patients and healthcare providers can take to reduce antibiotic use and slow the speed and spread of resistance.

“The most important thing patients can do is to only use antibiotics if and when they’re prescribed by a certified healthcare provider,” Rohatsch says. “And if a healthcare provider says an illness does not require antibiotics for treatment, do not demand antibiotics — at best, they will be unhelpful, and at worst, they can lead to serious harm and long-term consequences.”

If a healthcare provider does prescribe antibiotics, it’s worth asking some important questions to ensure the correct amount is taken for the right length of time. Consider asking your healthcare provider:

  • What is my diagnosis and what is the reason I need to take antibiotics to treat it?
  • Are there potentially safer alternatives to try instead of antibiotics or is this the most appropriate option?
  • What is the appropriate dosage and how long should I take this medication?
  • What are the potential risks or side effects I should be aware of?
  • What else can I do to help manage my symptoms?
  • What other steps can I take to keep myself safe and healthy in the future to avoid antibiotic use?

“You should work with your healthcare provider to get answers to all these questions,” Rohatsch says. “And if you have questions or concerns about your diagnosis or the recommended treatment, be sure to voice them. Antibiotic resistance is a serious public health threat, and understanding why antibiotics are used — and when — can help reduce the amount of unnecessary prescriptions written and keep patients safe.”



The views expressed by authors and contributors of such content are not endorsed or approved by Solv Health and are intended for informational purposes only. The content is reviewed by Solv Health only to confirm educational value and reader interest. You are encouraged to discuss any questions that you may have about your health with your healthcare provider.


Sources:

  1. Antibiotic Use Questions and Answers (October 6, 2021) https://www.cdc.gov/antibiotic-use/q-a.html
  2. CDC: 1 in 3 antibiotic prescriptions unnecessary (May 3, 2016) https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html
  3. Accounting for variation in and overuse of antibiotics among humans (January 6, 2021) https://onlinelibrary.wiley.com/doi/abs/10.1002/bies.202000163
  4. Why People Overuse Antibiotics (January 26, 2021) https://www.rutgers.edu/news/why-people-overuse-antibiotics
  5. Combating Antibiotic Resistance (October 29, 2019) https://www.fda.gov/consumers/consumer-updates/combating-antibiotic-resistance
  6. About Antimicrobial Resistance (October 5, 2022) https://www.cdc.gov/drugresistance/about.html
  7. Antibiotic resistance (July 31, 2020) https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
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