Maybe this has happened to you before: your recent cough kept you up one more night, so you went to the doctor. The nurse took your vitals, the doctor asked you a few questions, listened to your lungs, maybe looked at your ears and throat, and recommended rest, fluids, over-the-counter treatments, and time. Everything seemed fine until you got home to find the doctor “didn’t do anything for you”.
Why didn’t the doctor prescribe an antibiotic? What could it hurt?
The use of antibiotics has been a blessing and a life saver. On the other hand, antibiotic resistance and opportunistic infections are increasing.
Our bodies naturally produce good, beneficial bacteria in our gut and on our skin. Antibiotics can kill some of these good bacteria and cause diarrhea or a yeast infection. Other problems caused by antibiotics are not immediately apparent. For example, normal bacteria on your skin can become resistant and cause methicillin-resistant Staph aureus, or MRSA, which can cause a stubborn infection the next time you cut or scrape.
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With less competition from normal bacteria in your gut, the bad pathogen Clostridioides difficile, or C. diff, can take hold and cause severe diarrhea and inflammation of the colon that is difficult to treat and even harder to eliminate. Or maybe you’re having an allergic reaction to an antibiotic, or worse, a severe skin peeling condition called Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. All of this can lead to hospitalization and even death.
Most cold symptoms, such as a sore throat or cough, are caused by viruses. Antibiotics are not effective against viruses, and using antibiotics early, often in the first week of symptoms, has not been shown to reduce the risk of bacterial infection. In fact, if you get stuck, it can become even more resilient.
Your doctor wants to help you feel better. It would be quick and easy to immediately prescribe an antibiotic, but that may not be the best for you and your health. After listening to you, reviewing your medical history, medications, vital signs and exam, and after further discussion with you, I trust that if a test, X-ray or antibiotics are required, the doctor will likely recommend it.
If you feel like the doctor has done nothing for you, please consider the risks of antibiotics. Of course, if your condition is not improving and you feel worse, let your doctor know. But if you’re feeling better without additional tests and antibiotics, you should be thankful. The human body is a miracle.
Andrew Ellsworth, MD, is part of The Prairie Doc® medical team and currently practices family medicine in Brookings, South Dakota.