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Antibiotics: When to use them, when not to, & side-effects
Learn about antibiotics. When it's good to use it, when not to use it, and what happens when you abuse it.

Introduction

The word antibiotic means “against life.” Any drug that kills germs in your body is technically an antibiotic. But most people use the term when they’re talking about medicine that is meant to kill bacteria.

Ways to prevent bacterial infections

Before we look at antibiotics let's first discuss how we can prevent any infections in the first place. After all, prevention is better than the cure.

Simple tactics can make a difference in the fight against infections, such as washing your hands regularly, avoiding close contact with people who are sick, cleaning surfaces that are touched often, avoiding contaminated food and water, getting vaccinations, and taking appropriate medications (1).

Hand-washing

Hand-washing is one of the simplest and most effective ways to prevent infections.

Wash your hands thoroughly before preparing or eating food.

After using the bathroom, after coughing or sneezing, and after changing a baby's diaper.

When soap and water aren't available, alcohol-based hand-sanitizing gels can offer protection (1).


Vaccines

Vaccination is your best line of defense for certain diseases. The number of diseases that can be prevented by vaccines continues to increase as researchers understand what causes disease. Many vaccines are given in childhood. But adults still need routine vaccinations to prevent some illnesses, such as tetanus and influenza (1).


Medicines

Some medicines offer short-term protection from certain germs. For example, taking an anti-parasitic medication might keep you from becoming infected with malaria if you travel to or live in a high-risk area (1).

What do antibiotics treat?

Antibiotics are used to treat and prevent certain types of bacterial infections. The antibiotics move through the body and kill disease-causing bacteria, and there are a number of different types of antibiotics available. Antibiotics do not work for viral infections such as viruses that cause colds and flu, and most coughs and sore throats. Antibiotics also do not work for many skin infections (2).

What Antibiotics Can and Can't Do

The human body is host to a lot of different kinds of bacteria. Most bacteria are harmless and some bacteria assist our bodies with certain functions that our cells are ill equipped to do such as:

  • the absorption of fatty acids which cells need to grow,
  • the breakdown of carbohydrates,
  • the breakdown of toxins,
  • they promote the repair of damaged tissue,
  • and they act as a protective barrier against infections in the intestine (2).

When To Use Antibiotics

Antibiotics have long been a part of the standard treatment for many ailments. They are widely used, and have led to the eradication of many diseases. But now, some experts are beginning to question whether we need antibiotics as much as we think (2).

When should you use antibiotics?

What are the side effects?

Which type of antibiotic drugs should you get?

It turns out, not much.

Antibiotics are only used to treat some infections, mainly bacterial in nature. Antibiotics are used to treat life threatening conditions such as pneumonia and sepsis because the body's response to an infection is extreme. People who are at high risk for infections should be using effective antibiotics (2).

Antibiotics work for the following conditions:

  • Dental infections
  • Some ear and sinus infections
  • Skin infections
  • Bladder and kidney infections
  • Strep throat
  • Meningitis (swelling of the brain and spinal cord)
  • Bacterial pneumonias
  • Whooping cough

When NOT To Use Antibiotics 

Not too long ago some doctors prescribed antibiotics for seemingly anything that they couldn't make a clear diagnosis on. Some parents insisted that they need antibiotics for their kids for anything from the sniffles to a headache. What ultimately happened was that more and more antibacterial resistant strains of bacteria started developing, effectively making most commonly used antibiotics obsolete (3).

Today, it is recommended that doctors will only prescribe antibiotics if needed. It is also advised that people who are prescribed antibiotics, follow their health care practitioner's advice and always finish a full antibiotic course. If the antibiotic course is stopped mid-course, you run the risk of the bacteria that's causing the problem within you, becoming resistant to antibiotics. This means that you will simply become sicker the next time a bacterial infection grabs hold of you (3).

Antibiotics cannot be used for the following: 

Viruses, such as those that cause:

Colds and runny noses, even if the mucus is thick, yellow, or green

Most sore throats (except strep throat)

Flu

Most cases of chest colds (bronchitis)


For some infections, antibiotics are not needed, including:

Many sinus infections

Some ear infections (2)

Why antibiotics shouldn't be overused

Increase Fatal Diarrhea Cases in Children

Antibiotics aren't effective in treating common colds because most of them are viral, and can cause unwanted side effects. Half of the antibiotics that children are prescribed are for upper respiratory infections associated with the common cold, according to studies.

A study by the CDC shows that children who are given antibiotics for upper respiratory infections are more susceptible to aggressive antibiotic- resistant strains known as C. diff.

More than a quarter of a million infections in hospitalized patients and over fourteen thousand deaths every year among children and adults are caused by a C. diff bacterium in the gut. (4).

It Upsets Sensitive Gut Flora

Your intestines contain around 100 trillion bacteria of various strains. Antibiotics throws the natural bacterial balance out, which impacts proper digestion and immune function negatively.

While aggressive antibiotics are helpful for serious infections, they kill off a large portion of the natural gut bacteria that helps us. This in turn can cause bacteria that are resistant to antibiotics to flourish and cause a wide range of health related issues, as is the case with C. diff diarrheal infections.

Many people, especially children, are vulnerable to unwelcome side effects of unnecessary antibiotics, sometimes with lasting changes to their gut flora (4).

Help Teach Good Bacteria to Go Bad

In the process of horizontal gene transfer, bacteria has evolved its defenses.

They don't need to reproduce to protect themselves from antibiotics. They can simply pass along these genes to fellow bacteria like someone passing a message along to someone else (4).

Increasing Cases of Untreatable Gonorrhea

Other than C. diff, the CDC is tracking cases of antibiotic-resistant gonorrhea. This untreatable gonorrhea not only causes pain but also has been linked to pelvic inflammatory disease, ectopic pregnancy, tubal infertility, and neonatal eye infections, among other conditions.

One specific strain, Neisseria gonorrhoeae, has developed resistance to the antibiotics typically used to treat these infections. Cephalosporin antibiotics are currently the only class of antibiotics that meets the CDC’s standards to fight resistant gonorrhea (4).

Helps To Drive Up Drug and Hospital Costs

Many common antibiotics -including the generic variants have to be retired prematurely, because of the spread of antibiotic resistance in bacteria. The implications of this is that it takes longer, costs more, and have less chance of success to treat these bacterial infections.

In the U.S., the cost to the average patient that's infected with an antibacterial resistant infection was expected to be between $18,588 and $29,069 in 2009. This led to a total health care cost of $20 billion per year according to the Alliance for the Prudent Use of Antibiotics at Tufts University.

It's estimated that in 2000, the U.S. lost $35 billion because of premature deaths, hospital stays, and lost wages related to antibiotic-resistant infections (4). 

What are the side effects of antibiotics?

Since your gut is full of bacteria -- both good and bad -- antibiotics often affect your digestive system while they’re treating an infection. Common side effects include:

  • Vomiting
  • Nausea
  • Diarrhea
  • Bloating or indigestion
  • Abdominal Pain
  • Loss of appetite


Occasionally, you may have other symptoms, like:

  • Hives
  • Coughing
  • Wheezing
  • Tight throat or trouble breathing

These symptoms can mean you’re allergic to your antibiotic, so let your doctor know right away if you have them (5).

If you’re taking birth control pills, antibiotics may keep them from working as well as they should, so speak to your doctor about whether alternative birth control methods might be a good idea. Women can also get vaginal yeast infection while taking antibiotics. The symptoms include itching, burning, vaginal discharge (looks similar to cottage cheese) and pain during sex. It's treated with an anti-fungal cream (5).

Conclusion

Antibiotics is one of the cornerstones of modern medicine. It fights and protect us from a wide variety of infections and diseases, but it needs to be used responsibly. The overuse of antibiotics in recent years have lead to some unforeseen side-effects and have rendered a lot of antibiotics obsolete in the process.

Using antibiotics as intended can mean the difference between life and death, so speak to your doctor and only use antibiotics as recommended.

(1) https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/art-

20045289

(2) https://www.cdc.gov/antibiotic-use/do-and-dont.html

(3) https://www.who.int/en/news-room/fact-sheets/detail/antibiotic-resistance

(4) https://www.healthline.com/health-news/five-unintended-consequences-antibiotic-

overuse-031114

(5) https://www.webmd.com/a-to-z-guides/what-are-antibiotics