There is hardly a week or in fact a day even, which does not have a health awareness message attached to it. Last week was antibiotic awareness week. To be honest, I am over “awareness”. In most of these cases we all know or are “aware” of the situation. Lack of awareness is never the problem. The problem is the inability or more often refusal to make the changes needed.
The discovery of penicillin was a great boost for human health. It became possible to treat bacterial infections such as pneumonia and rheumatic fever which were previously often fatal. Over the next 40 years further antibiotics were discovered and their use exploded.
The notion was that if you had any sort of infection, then an antibiotic was required to make you better. Doctors and the public all believed this. But our knowledge does not stand still. We have subsequently found that viruses and not bacteria cause the vast majority of infections.
Viruses do NOT respond to antibiotics. Cold and flu like illnesses do not need treatment with an antibiotic. It will not do anything to make you better.
Yet old habits die hard. An international survey found that 64% of people thought that you could treat a cold with an antibiotic. A survey by the Journal of the American Medical Association found 71% of doctors treat bronchitis with an antibiotic generally at the patient’s request despite knowing that it is generally viral.
Returning to awareness. We all know that too many of us take too many antibiotics. This is even worse when it comes to children.
In Australia we sit above the OECD average for use of antibiotics being eighth highest overall. Australians take twice as many as the Dutch. Are we to believe that we really get bacterial infections twice as often as people in the Netherlands? In the USA the average child will receive 15 courses of antibiotics before reaching adulthood!
There are multiple drivers of this. Often people feel that unless they get a prescription the trip to the doctor was a waste of time. Doctors often feel the need to do “something” and that something is writing a script. Fear of litigation (especially in the USA) is another factor as you are less likely to be sued for prescribing than not prescribing.
But there is one other driver, which I don’t think, gets enough attention. That is the belief that there is no harm in taking a course of antibiotic when it is not needed. I hear this often from patients. Well I would rather be safe than sorry and there is no harm in taking them.
This is wrong on both counts. Firstly there is no safety in taking something, which will not make you better. In particular with children there is still the view that a temperature means an antibiotic is needed. A fever comes with a virus too. And it is the body’s way of dealing with infection so signifies a working immune system.
More importantly antibiotics can do harm. There is much talk about superbugs and antibiotic resistance. This is a problem but to most people it is something obscure.
Antibiotics affect the good bacteria in our body. Many will have experienced diarrhoea with antibiotics and women will have had thrush (candida) as a consequence too.
More subtly it is being shown that children who have multiple and early courses are more prone to asthma and other allergy problems. And they contribute to obesity in children. Remember that antibiotics are fed to livestock and poultry (a practice that needs to stop) to “fatten them up”. It should not come as a surprise to find that a similar effect occurs in humans.
This is through the effect on bacteria in our gut. These bacteria influence the absorption of nutrients and also effect metabolism. Considering there are ten times as many bacteria in the human gut as there are human cells in the body, we ought not be surprised that disturbing them disturbs us.
Because this is unseen and not felt immediately the link is not made and we assume that there is no harm from the tablets we have taken.
The bottom line is that there is harm to you or your child from taking antibiotics, which you do not need.
Remember this next time you have a cold or other viral illness.
This article first appeared on www.drjoetoday.com