Monday, January 7, 2013

To take antibiotics or not?

Happy New Year, folks!  

It has been a busy past few weeks with extended family visiting.  Plus, I've been sick with a nasty upper respiratory infection which started out like a regular cold with sore throat and congestion.  I actually thought I beat it after a few days and was getting better, but then I came down with a cough that worsened and kept me up all night.  Finally, after a week of symptoms that did not seem to be resolving, I took antiobiotics.  Even then my cough lingered and only two nights ago did I finally sleep through the night without waking from coughing!

I was pretty miserable and probably took so long to recover because my immune system is stressed from the hustle and bustle of this season. Since I've been with my kids all week 24/7 I really worry that I transmitted my germs to them.  It is probably inevitable and I'm dreading the sleepless nights ahead.

So how do you know if your sickness is viral or bacterial requiring an antibiotic?  This is a busy time of year for our practice and we get a lot of requests for antibiotics.  Unfortunately, most upper respiratory infections are viral and antibiotics would not help at all.  It may just be coincidence that someone starts to feel better after they start taking the antibiotics prescribed.

Usually antibiotics are prescribed if there is clinical evidence of an ear infection or strep throat.  It would be indicated for sinus infection if there is significant facial swelling/pain or has lasted for more than 10 days.  Otherwise, most sinus infections will resolve on its own with supportive care.  However, most people cannot wait that long and come to the office after only a day or two of symptoms.  Most claim they fear a worsening of symptoms if they do not "nip it at the butt".  Therefore, most doctor offices will give in and prescribe more antibiotics than really necessary.  This in turn can lead to resistance where antibiotics will become less effective.

My rule of thumb is to at least give it a good week to see if there is improvement.  If no improvement after one week or if symptoms are worsening, then perhaps antibiotics is warranted.

The most important rule of thumb is to wash hands frequently and adequately!



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