Problems Related to Antibiotic Use

Antibiotics can help our bodies to kill bacteria, mycoplasma, and other microorganisms that cause infection. They are not anti-inflammatory drugs. The words “inflammation” and “anti-inflammatory drugs” do not apply — the correct terms are “infection” and “antibiotics”. Antibiotics also do not have any effects on viruses, and should not be used to reduce fever. 70-80% of upper respiratory tract infections are caused by a virus, which do not call for the use of antibiotics. The principle of taking medication should be, if it is possible to take an oral medication, do not get an injection. If it is possible to get an injection, no intravenous infusion is necessary.

Antibiotics are medications that doctors prescribe to treat infections caused by bacteria, fungi, mycoplasma, chlamydia, or other microorganisms. They cannot kill viruses. Since Sir Alexander Fleming’s discovery of penicillin in 1928, antibiotics have saved the lives of millions of people. Unfortunately, the misuse of antibiotics has become a problem worldwide, especially in developing countries. On average the amount of antibiotics each person uses in China is 10 times the amount used in the United States, largely because antibiotics are often taken without a doctor’s prescription. Many people think they have an “inflammation” when they get a cold or develop a fever and take “anti-inflammatory drugs” right away. In their minds, antibiotics are the same as anti-inflammatory drugs. In reality, anti-inflammatory drugs and antibiotics are completely different. Inflammation is the response of the vascular tissues when our body’s immune system reacts to stimuli. In addition to bacteria, viruses, trauma, and allergies all cause inflammation. However, antibiotics are useful only when the cause is due to bacterial pathogens. If you bumped your leg on the corner of a table and have a bruise, are you going to take antibiotics due to inflammation on the leg? Of course not. Likewise, you do not need to take antibiotics when your cold or fever is caused by viruses.

Anti-inflammatory drugs refer to medications which have both anti-inflammatory and analgesic effects. These medications help alleviate the localized immune responses (inflammation). Some examples are ibuprofen (Fenbid for adults and Motrin for children) and diclofenac, though they do not have any antiseptic effect. When someone develops a fever, don’t assume there is inflammation and don’t take “anti-inflammatory drugs” right away. You have to find out if the fever is caused by a bacterial infection or something else. Your doctor will make a diagnosis after taking medical history, a physical examination, and other necessary diagnostic exams. You should take antibiotics only if there is a bacterial infection.

Viruses are responsible for about 70-80% of all upper respiratory tract infections, so most don’t require antibiotics. If you are taking antibiotics, please comply with your doctor’s order and finish the cycle, regardless of if you are feeling better after only a few days. Antibiotics abuse and misuse can lead to the bacteria in our bodies gaining resistance to the drug, and later, when you are taking the same antibiotics, the bacteria will not be killed. At this time, doctors need to replace it with broader spectrum and more powerful antibiotics, which will eventually lead to the emergence of “superbugs” that are resistant to multiple antibiotics. If we will run out of antibiotic choices, a lack of effective medication will compromise our ability to cure certain disease.

In China, on average eight bottles of intravenous fluids are used per person every year. Many people request to be put on intravenous fluids when they are sick, thinking that will make them getting better quicker. In fact, for most general bacterial infections, the use of oral antibiotics achieves the same effect as intravenous or intramuscular injection. Excessive treatment also increases the chance of severe allergic reactions. Normally, when the infection is quite severe or the patient cannot tolerant oral medications due to vomiting, doctors will consider prescribing the antibiotics intravenously. The reason why many patients feel more comfortable after IV fluids is due to the effects of fluid replenishment. Fluid replenishment in a fever patient will promote blood circulation and is good for fever reduction. In fact, fluid replenishment can be accomplished orally by drinking more water. It takes time to recover from an illness. Some people think taking antibiotics early can help put the fever down faster. In reality, antibiotics are not fever reducers. Tylenol and ibuprofen can help bring a fever down, but they can only lower the body temperature temporarily, and the body temperature will go back up after a few hours. If it is a common viral infection, as long as the patient takes fever-reducing medication regularly and drinks more water and fluids, they will feel better in 2-3 days after the body’s immune system fights off the viruses. If it is a bacterial infection, it also takes time for the antibiotics to have an effect. Generally the body temperature will get better within 48 hours.

To stop the spread of antibiotic resistant superbugs, we must standardize the use of antibiotics.  We have to hold everyone responsible. This includes not only ourselves, but also our family and friends.

References:

1. Xiao Yonghong, Wang jin, Li Yun. Bacterial resistance surveillance in China: A report from Mohnarin. 2004–2005. Eur J Clin Microbiol Infect Dis. 2008, 27: 697-709.
2. Xiao Yonghong. Total reaction to the public crisis of bacterial resistance [J]. Clinical Medication Journal, 2010 (3): 01-04.