When do we really need antibiotics?

Recent headlines have warned of disaster on the horizon, with antibiotics useless because of resistance and simple cuts or minor surgery becoming fatal. We're not there yet, but we can all do our bit to cut antibiotic resistance without risking our health.

What is antibiotics resistance?

We have a huge problem across the world with resistance to antibiotics. Bacteria are very clever - they evolve through the generations. If one germ is 'born' better equipped to cope with attacks on it, it's more likely to survive and pass on its genes to its offspring. But bacteria can multiply every few minutes, rather than every few years like humans. They can also produce hundreds of offspring. That means evolution happens with terrifying speed.

If you are given a course of antibiotics, I'm sure you know that you're supposed to take the whole course and not miss doses. You should start to feel better within 24 hours - if you're no better after two days or your symptoms worsen, let your GP know. You should never stop the course once you feel better so you can 'save some' for another occasion. And you should never share them with other people. All these things increase the risk of resistance to bacteria building up.

When antibiotics are suitable treatments - and when they aren't

One of the most common reasons I'm asked for antibiotics is because of coughs. These are almost all caused by viruses, so antibiotics don't do any good and can cause side effects. But there are exceptions. If you cough up blood or rusty coloured sputum; get short of breath or wheezy; or have sharp, stabbing chest pain when you breathe (rather than just when you cough) you should see your doctor. Likewise, if your cough goes on for more than two weeks, you should get it checked out.

Some people are more likely than others to get bacterial infections. This includes a weakened immune system (cancer, cancer treatments and 'immune suppressing' treatments for conditions like rheumatoid arthritis or asthma. If you have chronic obstructive pulmonary disease (COPD) your GP may give you a course of antibiotics to keep and take as soon as you start coughing more, or bring up more or different coloured sputum. For people with these conditions or experiences, 'normal rules' about antibiotics may not apply - ask your GP if in doubt.

Sore throats, likewise, are usually caused by viruses. However, a sore throat without a cough; fever; tender glands on the front of your neck; and white spots on the back of your throat may spell bacterial infection; if you have three or more of these, or if your throat is too sore to swallow liquids, see your GP.

Acute sinusitis is a miserable condition which can give rise to pain over your face (often worse when you lean forwards); runny or blocked nose, fever, tiredness and bad breath. Unlike coughs and colds, it may take up to three weeks for acute sinusitis to settle. Painkillers and decongestant nose sprays (for up to five to seven days) or saline nose drops can help. Your pharmacist can help with all of these. So can warm face packs held over your sinuses. If your symptoms are accompanied but swelling around your face or eye, or bloodstained discharge, see your doctor.

Cystitis - inflammation of the bladder causing burning urine, needing to wee more often and low tummy pain - is much more common in women than men. Even though it's usually caused by a bacterial infection, you may be able to 'flush it out' with lots of fluids. Cranberry juice may help prevent it happening and sachets to de-acidify your urine (from your pharmacist) can relieve symptoms. If an attack goes on for more than three days, or you have severe symptoms, loin pain or high fever, see your GP.

Not sure if you need antibiotics?

If you have toothache, don't ask your GP for antibiotics - they know no more about teeth than you do! See your dentist instead. If you're in doubt about whether antibiotics are likely to be needed to treat your symptoms, your pharmacist should be your first port of call. They're a mine of medical information with no appointment needed, and can advise on whether you need to see a GP. They also have far more 'self-help' remedies on offer than your GP does!

With thanks to 'My Weekly' magazine where this article was originally published.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.


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