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When Are Antibiotics Needed?

Viruses or Bacteria Chart


Often when you’re sick with a cold, you just want to feel better as quickly as possible. Unfortunately, the only option may be to ride out the symptoms, or use over the counter medications that target specific symptoms for improvement. That’s little consolation when a stuffed nose or cough is keeping you awake at night, but there is good reason explains Dr. Barry Fox, an infectious disease specialist at UW Health.

“Antibiotics are only effective against bacterial infections – they do not work for infections caused by viruses, such as colds, bronchitis, flu or most sore throats,” he says.

Fox, who is the medical director of the Antibiotic Stewardship Program, explains that when antibiotics aren’t needed, they won’t help – and the side effects could hurt more than just you.

“Taking antibiotics can create resistant bacteria, meaning the bacteria will no longer respond to the antibiotics designed to kill them if needed in the future,” explains Fox. “Antibiotic resistance is due to the overuse and misuse of antibiotics.”

Antibiotic-resistant bacteria is a growing problem, and one with lethal consequences. Each year in the U.S., at least 2 million people become infected with antibiotic-resistant bacteria and at least 23,000 die as a result.

Reactions to antibiotics are also responsible for 1 out of 5 medication-related visits to the emergency department. And in children, reactions from antibiotics are the most common cause of medication-related emergency department visit.

While it’s clear antibiotics should only be used in conditions caused by bacteria, it can seem a little vague. Antibiotics may or may not be used to treat a sinus infection, for example, or a middle ear infection.

“Some of the most common infections, such as sinus infections and bronchitis, are caused by viruses more than 90 percent of the time, but there are cases when it is caused by bacteria,” comments Fox. “While a patient may have received antibiotics for a previous sinus infection, it may not be warranted for a subsequent one.”

It’s impossible to tell whether a sinus infection is caused by a virus or bacteria by the symptoms alone. Instead, doctors look at the duration of the symptoms to help determine the underlying cause. If your symptoms start to improve on their own, or with symptom relief medication after 5-7 days, there’s a good chance it’s viral. But if your symptoms persist for 10 days, or gets worse after initially improving, there may be bacteria involved that might require a prescription. Even so, there can be a grey area. To help ensure providers are making the best decisions related to antibiotic use, after 16 years of hospital based oversight, UW Health is beginning an outpatient antibiotic oversight program.

Based on recent recommendations from the Centers for Disease Control and Prevention (CDC), the outpatient antibiotic stewardship program will help healthcare providers know when antibiotics should be prescribed or if it would be better to abstain from prescribing them.

“Improving the way we prescribe antibiotics, and the way we take antibiotics, helps keep all of us safe, and healthy now and for future generations,” says Fox.


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Date Published: 06/12/2018

News tag(s):  infectious diseaseshealthy living

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