We must preserve our last line of defense.
When patients visit us and their doctor doesn’t prescribe an antibiotic, I tell them it’s likely a well thought-out decision.
It might not be the one they want to hear, but we’re not doing it to push the patient’s care under the rug. We know what we’re doing.
I’ve been an ER doctor for the past four years at Stoughton Hospital and in just the past several years, both here and at previous hospitals I’ve worked at, I’ve seen many changes with how antibiotics are prescribed and how doctors look at them.
A ‘Critical Mission’
Because antibiotic resistance is a growing problem here in Stoughton and across the world, medical providers are becoming far more cautious about prescribing antibiotics.
The Centers of Disease Control and Prevention (CDC) call it a “critical mission” to prevent this resistance from becoming even worse.
The main reason it’s a problem is the overuse and misuse of antibiotics. Put simply, many patients expect to get antibiotics whenever they visit their doctor, and all too often, they get them when they’re not needed.
When You Do – and Don’t – Need Antibiotics
Here in Stoughton, we’ve had many patients come in requesting antibiotics when they don’t really need them.
The most important reason to give antibiotics is to fight a bacterial infection. That’s where they are effective.
Antibiotics are not effective against viruses and other infections. That is the big problem we have in the emergency room – using antibiotics to treat people suffering from what are likely viral infections.
Antibiotics are needed for a bacterial pneumonia or a bacterial strep pharyngitis (strep throat infection) which is confirmed by X-ray or test.
The ‘Green Mucus’ Myth
But the vast majority of upper respiratory infections – colds, sinus infections, even ear infections – are caused by viruses. They will get better on their own, and they will not respond to antibiotics.
These conditions require symptomatic treatment only; ibuprofen and Tylenol for fevers and decongestants or steroid nasal sprays for sinus congestion. Getting vaccinations that will prevent infections is also incredibly important.
Many people believe mistakenly that having green mucus means they have a bacterial infection and therefore need antibiotics. But while it certainly can be startling to see this in your tissue, it does not mean you have a bacterial infection.
Taking antibiotics when you don’t need them only lowers their effectiveness when you do.
Bacteria are Evolving to Resist Antibiotics
What we’ve seeing now is that bacteria are evolving, and they have essentially developed ways of resisting our normal antibiotics. As such, the methods we have traditionally used to treat these infections no longer work.
When we’re just talking about a basic sinus infection, it’s not the end of the world. But, if antibiotic treatments for more severe, life-threatening infections like sepsis stop working, that’s extremely difficult to control.
We think about this a lot and see it a lot. So don’t be surprised if we don’t prescribe an antibiotic the next time you come in feeling miserable.
By reserving our antibiotics for true, documented bacterial infections, the hope is they will remain effective against the more serious infections.
Getting vaccinations that will prevent infections is also important.
Have a ‘Comprehensive Conversation’
My best advice is to be sure to discuss all your symptoms and history with your doctor and have a comprehensive conversation. At the end of that conversation, if your doctor does not think that antibiotics are warranted, trust your doctor and go along with that recommendation, realizing that the vast majority of infections are viral.
They will resolve on their own with symptomatic control and time.
© 2017 Stoughton Hospital. This article originally appeared in the Stoughton Courier Hub. Reprinted with permission.