Why Antibiotics Aren’t Always the Answer

By Max Pitlosh, MD

Unfortunately, in America we have gotten in the habit of giving antibiotics for ear infections, and for the vast majority of patients, they expect antibiotics to be prescribed.

There has been evidence for over a decade in Europe and Canada that supports pain relief over antibiotics for children with ear infections, and that has been their practice. There is a difference between what society and tradition say we should do — which is to prescribe the antibiotics — versus what the latest scientific information tells us to do: ease the symptoms.

For sinus infections, the evidence is very similar to ear infections. The treatments of choice for a sinus infection are decongestants, pain relievers and using a humidifier along with a nasal rinse. Antibiotics may be used if the infection doesn’t respond. But it can be difficult to determine whether a sinus or ear infection is due to a virus that won’t respond to antibiotics or a bacterial infection that might.

With throat infections, however, strep tests and throat cultures give us the luxury of being able to definitively distinguish between a bacterial or viral infection. When I know it’s a virus, I use treatments that are specific to symptoms: For example, a humidifier can relieve hoarseness and gargling with warm salt water can reduce inflammation.

Overusing antibiotics certainly has serious repercussions — most notably bacterial resistance to antibiotics. For example, my wife is a schoolteacher who had multiple infections and was treated multiple times with antibiotics early in her career. Now, she is resistant to three of the four major classes of antibiotics, so when she gets a simple bacterial infection, it is much harder to treat.

Also, the overuse of antibiotics has contributed to a number of antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA). I’ve seen a few patients who have had MRSA infections even though they were never treated with an antibiotic. So, certainly, we should be careful in regard to our use of antibiotics.

Max Pitlosh, MD, is a family physician with Rush University Physicians at Lincoln Park. View his introductory video.

One thought on “Why Antibiotics Aren’t Always the Answer

  1. I couldn’t agree more Max!

    It’s nice to finally see a Doctor who doesn’t think that the only cure is to dose someone up with antibiotics.

    My wife has had similar instances where she has been given three different antibiotic treatments trying to clear up a sinus infection. Come to find out that it was a problem inside of her nose that was the issue. Once she had surgery to fix the problem she has not had a major sinus infection since.

    Also, there are good bacteria that our bodies need to work correctly that are being destroyed by these same antibiotics.

    Most of the time there seems to be a knee jerk reaction in medicine anymore to try and just mask the problem rather than actually trying to find out the root cause.

    I suppose we owe that to all the drug commercials that everyone is bombarded with these days.

    Thanks again and sorry for the rant 😉

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