How to navigate the antibiotic highway

As many as 50% of the antibiotics prescribed in the United States may be unnecessary or inappropriate. This contributes to antibiotic resistance, avoidable side effects, and increased cost of care.

Like driving on a multilane highway, using antibiotics appropriately can be complex. But like driving, it’s made easier by following some basic evidence based rules, while unexpected events may intervene to change the route.

this post updated October 28, 2022

stoplight
Most medical experts believe we need to STOP using unnecessary antibiotics. (photo from Pixabay)

As many as 50% of the antibiotics prescribed in the United States may be unnecessary or inappropriate. This contributes to

  • antibiotic resistance ,
  • avoidable side effects of the drugs, and
  • increased medical cost without benefit.

The best source of medical advice for you personally is your own doctor, or one who talks to and examines you.

Exceptions to rules exist, every medical situation is unique.  So although these recommendations are firm, they are not absolute. This is just a partial list which includes most but not all common infections.

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STOP- don’t treat these with antibiotics

Most upper respiratory infections including

Acute viral gastroenteritis, aka stomach flu, with nausea, vomiting, and/or diarrhea

Some of these may be treated with anti- VIRAL medication, not antibiotics.

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SLOW DOWN- these may not need an antibiotic, at least not immediately

Ear infections -otitis media

Sinusitis– sinus infections

spider or tick bites– many of these are not bites at all, but are other skin diseases, including bacterial infections (see below)

sore throats– pharyngitis or tonsillitis

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GO- these infections usually need antibiotics to resolve successfully

Urinary tract infections- this includes the kidney, bladder, prostate

Skin infections including animal and human bites

Pneumonia (although can can be due to viruses, especially in children)

Whooping cough –pertussis

Lyme disease and Rocky Mountain Spotted Fever- these are both transmitted by tick bites; but not all tick bites result in infection

Sexually transmitted diseases caused by bacteria – gonorrhea, chlamydia, syphilis

Any infection severe enough to require admission to a hospital- including infections of any internal organ, bones, joints, brain; included here are infections which develop during a hospital stay

Check out the links for more info.

(By the way, I hope you enjoyed the photos. I took them at a Veterans Day parade.)

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exploring the HEART of responsible antibotic use

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

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Dr Aletha

Preventing bacterial infections

 

Prevention is a focus in healthcare now  and immunization has  been one of the most effective ways to prevent disease ever developed.

The list of diseases that are “vaccine preventable” is long and continues to grow.

Go here for the latest recommendations and guidelines on immunization from the  National Center for Immunization and Respiratory Diseases (NCIRD)

Vaccine recommendations may be based on a person’s

  •  age,
  • gender,
  • ethnicity and
  • concurrent conditions, especially diabetes mellitus, chronic lung diseases, heart disease and  immune suppressing disorders.

Vaccine administration may vary by

  • the number of doses recommended,
  • how far apart the doses should be given, and
  • which vaccines can be administered at the same time.

Immunization protocols have  become so complex that even physicians have difficulty keeping it straight without the use of paper or digital checklists. This is one area where the Internet and EMRs (electronic medical records) can be useful.

Find out what vaccines your child needs for protection against common  infections. 

 

 

Vaccines for infections caused by bacteria

I use the name of the disease and/or the bacteria, rather than the vaccine name, since there are different brand names for the vaccines depending on the manufacturer.

So successful have these vaccines been that most young doctors have never seen a patient with these diseases (unless perhaps they specialize in infectious disease, immunology, emergency medicine or critical care). And even I, who graduated medical school in 1978, have only seen a few, and none in recent years.

Diphtheria-primarily a respiratory tract illness in young persons

Pertussis, better know as whooping cough, also a respiratory illness, which has made a comeback in recent years, apparently due to a waning of immunity

Tetanus, also called “lockjaw”– due to a toxin which may contaminate a dirty wound

Menigococcal disease, which is one of many causes of meningitis (inflammation of the brain lining), but one of the most deadly, even with treatment

Streptococcal pneumoniae disease; the vaccine is often referred to as the “pneumonia vaccine”, but the bacteria can also cause ear infections, sinusitis, meningitis and sepsis (bloodstream infection)

Haemophilus disease is similar to pneumococcal, but more of a concern in infants and children

 

Preventing viral infections

Virus vs Bacteria One major difference between bacterial and viral infections is the treatment. We have many more effective antibiotics (drugs which fight bacteria) than we do antiviral drugs. And antibiotics do not affect viruses. Despite that fact, patients often expect and even demand their physicians prescribe antibiotics for viral infections such as influenza, colds…

 

exploring the HEART of infection control

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

 

Dr Aletha

 

 

 

 

 

 

          

 

 

 

 

 

 

 

 

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