Despite their widespread use all over the world, antibiotics still remain the most misunderstood medicines. Some parents always look worriedly at all antibiotics as if they are some dreaded monsters! The others take antibiotics to be some miracle drugs and expect them to be prescribed for every possible illness.
Both these extremes are wrong and what is needed is a sensible ‘middle path’ where antibiotics are used when necessary and avoided when unnecessary.
Let’s try and tackle some widespread myths about antibiotics.
- Myth 1: “Who needs Antibiotics? They are useless.”
Well, it is not at all true.
Since the time when Alexander Fleming discovered penicillin –the first ever antibiotic- way back in 1928, antibiotics have occupied a pride of place in modern medicine. Thanks to them, millions of lives have been saved from deadly infections.
Like any other important medicines, antibiotics are indispensable when they are actually needed!
- Myth 2: “Antibiotics can cure any infection.”
Antibiotics are useful only in bacterial infections. Common infections of various body organ systems are caused mostly either by viruses or by bacteria.
In children, as well as in adults, almost 90-95% of infections are viral in origin. Antibiotics are unnecessary in viral infections as they don’t have any effect on viruses.
Sometimes even in a viral infection, antibiotics are given to prevent secondary bacterial infection. Severe suggestive symptoms at very young ages, urinary infections, pneumonias, middle ear infections and CNS infections often need antibiotics.
- Myth 3: “All antibiotics are one and the same!”
No, it is not true! There are many different groups of antibiotics like Penicillins, Cephalosporins, Macrolides, Aminoglycosides, Tetracyclines and Fluoroquinolones. Each group is effective against particular types of bacteria and is used according to the suspected type of infection.
In some severe or different types of infections, multiple antibiotics are used to launch a multi-pronged attack on bacteria. By aiding each other’s action, by working on the bacteria through different routes and by broadening the treatment spectrum these combinations eradicate infections.
- Myth 4: “The latest antibiotics are always superior.”
The main aim in development of any new antibiotic is to improve its activity, broaden its spectrum and lessen its side-effects. But beware that not all new antibiotics are better than their age-old predecessors and in terms of money they are usually costlier.
- Myth 5: “Antibiotics are needed for every severe medical symptom.”
Every case with severe fever, cough, loose motions or vomiting doesn’t really need antibiotics. As explained earlier, if these symptoms are caused by a viral infection, then antibiotics have no role to play. Even otherwise, these symptoms may be caused by other medical conditions different from an infection and may need a totally different treatment.
- Myth 6: “If I don’t start antibiotic early, then I am risking worsening of the illness.”
Most of the unwanted, unwarranted use of antibiotics happens because the parents or patients assume that by starting the antibiotic immediately, they are avoiding further complications. Of course, this assumption is most of the times wrong!
- Myth 7: “Antibiotics can easily be started on our own. Just ask the pharmacist!”
Worst mistake of all!
Antibiotic should never be started without a doctor’s advice. Through a clinical examination and sometimes through laboratory tests, the doctors first try and ascertain the medical condition causing the symptoms. They try and differentiate viral from bacterial infections. They try and deduce the type of bacteria most likely in that particular case and then, decide the best possible antibiotic accordingly. They will also decide the correct dosage and duration according the need of the patient.
- Myth 8: “I had a previous antibiotic prescription. I just use it whenever similar symptoms recur.”
Many people keep repeating the same prescription over and over again if they encounter similar symptoms for which their doctor had earlier prescribed an antibiotic. This is a dangerous practice as the similar looking symptoms may be caused by different medical conditions and also, by using the same antibiotic again and again, we are reducing its efficacy in the long run, because the bacteria then get used to the antibiotic and become resistant to its effect.
- Myth 9: “Antibiotics can be stopped once the patient starts feeling better.”
Another common trait in patients!
Every antibiotic has a prescribed course, which is to be completed for certain number of days (3, 5, 7, 10, 14 etc.) according to the type of medicine and the type of infection. Unless that course is completed, the infection is not completely eradicated and can recur. Incomplete course also leads to development of antibiotic resistance in bacteria.
- Myth 10: “Antibiotic dosage can be modified on our own.”
Antibiotic doses are decided according to clinical studies. In children, these doses are calculated as per body-weight. The doses for various antibiotics are different and so are their strengths. There is little sense in comparing ’10 mg of this’ with ‘100 mg of that’ antibiotic.
Modifying the dose on your own for any reason is useless. If you are worried or unsure about the dosage, always consult your doctor.
- Myth 11: “Antibiotics are full of side-effects.”
Like any other important medicine, an antibiotic is chosen by the doctor after making sure that its benefits are far more than its risks. Yes, there are side-effects of antibiotics but with correct choice, dosage and duration of antibiotic treatment we can avoid or minimize most of them.
- Gastro-intestinal disturbances (nausea, vomiting and diarrhea) and skin rashes are the commonest side-effects and can be seen to a more or less degree with almost any antibiotic.
- Penicillin injection and occasionally oral penicillin can cause severe anaphylactic allergic reactions.
- Aminoglycosides can cause adverse effects on kidney and hearing.
- Tetracyclines cause a permanent yellow staining of teeth.
- Chloramphenicol can cause bone marrow depression and a drop in blood counts.
- Sulfa drugs can lead to a severe reaction called Steven-Johnson syndrome.
- Quinolone group of antibiotics can cause joint affection.
- Long term antibiotic therapy can cause pseudomembranous colitis – an inflammation of colon.
Many of these ‘risky’ antibiotics like sulfa drugs, quinolones, tetracyclines, chloramphenicol and penicillin are usually avoided in children.
Most of the commonly used contemporary antibiotics are quite safe and are well-tolerated by the patients if they are prescribed and taken in the correct manner.
Take-home wisdom:
The most important problem associated with repeated use of antibiotics is the development of bacterial resistance. Because of the rampant antibiotic use, bacteria are fast getting ‘used to’ and developing resistance to most commonly used antibiotics.
Major cause for bacterial resistance is the tendency of people to use incomplete, inadequate antibiotic courses. The day is not far when we won’t have any more effective antibiotics to tackle serious bacterial infections!
To avoid this, follow these simple rules.
Never start antibiotic on your own.
Never demand an antibiotic prescription from your doctor.
Ask the doctor ‘Why’ and ‘Which’ about the antibiotic prescription.
Discuss about side-effects and any relevant queries.
Costlier, newer antibiotics are not always the best choices. Ask the doctor if another alternative is possible.
Follow the dosage/ duration of antibiotic schedule as advised.
Don’t keep repeating the same antibiotic over and over again.
Remember antibiotics are not ‘monsters’. They really are ‘miracle medicines’ but only to be used in situations where they are absolutely necessary!
