Your Illness and Antibiotics: What Everyone Needs to Know

• What’s the difference between bacteria and viruses?
While both can cause sickness, bacteria and viruses are very different. Bacteria are single-celled organisms that live alongside our body cells. Although some bacteria cause disease, the majority of these organisms are harmless or even essential to humans, helping us digest our food, for example.

Much smaller than bacteria, viruses are relatively short segments of genetic material covered in a protective protein. Rather than live alongside cells, viruses invade cells and use those cells to reproduce themselves. Antibiotics cannot effectively treat viruses. Also, extensive research has shown that antibiotics do not prevent a bacterial infection from developing after a viral infection.

• What is antibiotic resistance?
Antibiotic resistance is the power that bacteria develop against antibiotics. Bacteria are constantly undergoing random change, or mutation, in their genetic material. Simply by chance, some bacteria are going to develop the mechanism needed to resist a particular antibiotic. Bacteria can also pass this resistance on to other bacteria. Antibiotics do not cause resistance directly, but they create resistant bacteria. In other words, the drugs inhibit vulnerable, or susceptible bacteria, allowing the resistant ones to reproduce and thrive. The most important thing to realize is that bacteria, not individual people, develop resistance. To have a resistant infection, all you need is to catch bacteria that are resistant to an antibiotic. Resistance is everyone’s problem.

• Why is antibiotic resistance such a big deal?
According to the U.S. Centers for Disease Control and Prevention (CDC), already more than 12,000 Americans die of antibiotic-resistant bacterial infections each year. As the use of antibiotics has increased, so has the incidence of resistance. Many bacterial strains have developed resistance to numerous antibiotics, with some deadly strains managing to resist every known antibiotic. Although researchers are attempting to develop new antibiotics to fight the bacteria, the results of these efforts are uncertain. Many "new" antibiotics are nothing more than rehashed versions of old drugs. And even if totally new antibiotics are developed, it is only a matter of time before bacteria develop resistance to these drugs as well. We must conserve the antibiotics that we already have.

• Do I always need antibiotics when I’m sick?
When you are sick you do not always need a prescription antibiotic. Antibiotics are great for most bacterial infections, but they do absolutely nothing for viral infections. Most common infections like colds, sinus congestion, and bronchitis are caused by viruses. If your doctor diagnoses you with a viral infection, plenty of fluids and rest rather than a prescription may be the answer. Most infections caused by viruses clear up on their own within a few days. Getting an antibiotic prescription for a viral infection only contributes to resistance, wastes money, and opens you up to several potential undesirable side effects of the drugs (like diarrhea or vaginal yeast infection). Don’t make a free visit to Student Health into something more costly.

• Once I start feeling better, should I stop taking my antibiotic?
No. As bothersome as it might be to take several pills a day for multiple days, it is extremely important that you take your pills when you are supposed to and that you take all of them. There is a reason why antibiotic prescriptions are as extensive as they are. When you begin taking an antibiotic, the drug starts by inhibiting the most vulnerable, or susceptible bacteria of the infection. As you take more of the prescription, the more resistant bacteria are also inhibited. Stopping the drug when you start to feel better might leave behind the most resistant bacteria, which can reproduce and cause the infection to recur – this time more (if not totally) resistant to the antibiotic previously used. This is why it is essential that you take your entire antibiotic prescription. This is also why you should never take a leftover prescription rather than going to your doctor. Not only will you wind up taking too little of the drug, but the infection might be viral (in which case antibiotics are useless), or the antibiotic may be the wrong kind for that particular infection. The moral of the story is, finish your antibiotic prescription, even after you start feeling better, and never take a leftover prescription. Otherwise, you might contribute to the development of antibiotic resistance.

• When should I ask my physician for an antibiotic?
In general, it is best not to ask your doctor for an antibiotic. As with any other treatment, physicians are not supposed to give you an antibiotic unless it is needed. But physicians are only human. If you pressure your doctor to give you the drugs, then he/she may cave into that pressure. Some doctors do not take resistance seriously though, and may see little harm in giving the individual patient an antibiotic for a viral infection if that is what the patient wants. Let your physician decide when you need an antibiotic. There is nothing wrong with asking questions, but listen to what your physician has to say. By all means, if your doctor says you have a bacterial infection and gives you an antibiotic, take the drug as prescribed. The whole point of the drug is to fight bacterial infections. Some bacterial infections are extremely dangerous, and may become life-threatening if you do not take an antibiotic.

• Which illnesses require an antibiotic and which do not?
The first thing to realize is just because an illness has a fancy-sounding name does not mean that it is bacterial and requires antibiotics. According to the CDC, many cases of sinusitis (sinus inflammation or congestion), pharyngitis (sore throat), nasopharyngitis (the common cold), bronchitis (airway infection), and otitis media with effusion (middle ear fluid) are caused by viruses, not bacteria, and therefore are unaffected by antibiotics. Both bacteria and viruses can cause a fever. Bacterial infections tend to last longer than viral infections. Your best bet is to see your doctor. Your doctor is trained to tell the difference between a bacterial and a viral infection, and can take a culture of the infection for testing if he/she is unsure. It is important to understand that just because you received an antibiotic for a particular set of symptoms in the past does not mean that you need an antibiotic prescription for the same symptoms now.

• What can I do to combat antibiotic resistance?
Never pressure your physician for an antibiotic. If your physician wants to give you an antibiotic, ask him/her if there are any alternative treatments. If there are not, then make sure that you complete the entire antibiotic prescription, even if you begin to feel better before you finish it. Never take a leftover antibiotic prescription rather than go to the doctor for a new one. By following these simple guidelines you can help fight antibiotic resistance.

Maintained by: studenthealth@virginia.edu Last Modified: Tuesday, 01-Nov-2005 11:15:13 EST © 2002 by the Rector and Visitors of the University of Virginia