Your Health: Antibiotics explained

In a recent column, I said that antibiotics are usually not necessary to treat most upper-respiratory infections. I have been asked to discuss antibiotics in more detail.
An antibiotic is a type of medication that kills bacteria, or at least inhibits growth, thus curing an infectious disease.
The first antibiotic to be discovered was penicillin, which was produced from a common mold and was discovered accidentally by Alexander Fleming in 1928. It wasn’t used to treat disease until 1941, but it became extremely helpful when it was found to cure the myriad infections of the soldiers in World War II.
Today, there are more than 100 different antibiotics on the market, treating bacterial infections ranging from the minor, such as strep throat, to the life-threatening, such as meningitis.
As of yet, we have very few antibiotics that can treat viral infections. There are none to treat the common cold and only a few that can help treat influenza. However, bacterial infections — the cause of such common diseases as strep throat, bladder infections, skin infections and many ear infections, for example — can be cured by the use of antibiotics.
If an antibiotic is used, your physician will choose the one most likely to be effective against the type of germ causing your infection. Other factors in the choice of an antibiotic include medication cost, dosing schedule and potential side effects.
Antibiotics have been over-prescribed for a number of reasons, including patients’ expectations or insistence on use of antibiotics; physicians prescribing them because they don’t have the time or willingness to explain why they are not necessary; and medical legal reasons.
The consequences of over-prescribing antibiotics are twofold.
First is the possibility of a bad reaction to the antibiotic. This might span from minor conditions — a bothersome rash, diarrhea or a yeast infection — to a life-threatening allergic reaction called anaphylactic shock.
The bigger problem, as I see it, is the emergence of resistant germs. This happens when the overuse of antibiotics allows the development of germs that are no longer killed by most of the common antibiotics.
As opposed to the post-World War II decades, when drug companies were pumping out new antibiotics faster than germs could become resistant, we are now in a situation in which, for various reasons, drug companies are not putting in the resources to develop new antibiotics. This will become a serious crisis when we reach a time when many infections will not be treatable with existing antibiotics.
As I have emphasized previously, when seeing your physician for an illness, it is best not to have expectations of being treated with antibiotics. Rather, let your physician decide whether antibiotics are needed, and expect an explanation from him or her as to the reasoning behind that decision. You should also be given suggestions as to what you can do to make yourself feel better during the course of your illness.
– Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or email him at [email protected]. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.