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Volume CXXXII, Number 14 |
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Viruses and antibiotics
JEFF BENSON, M.D.
Dear Dr. Jeff: "Last year when I had the flu, my physician at home gave me a "Z-Pack." Last week, when I went to the Health Center with the same type of illness, I was told I had a viral infection and didn't need an antibiotic. What's the deal?" M.W.
Dear M.W.: I can't comment about your illness last year, but I assume that this year you were told your illness was likely viral, not bacterial. The vast majority of upper respiratory infections are viral in origin, and antibiotics don't kill viruses.
Unnecessary antibiotics can be harmful. They can have side effects (allergic reactions, nausea, diarrhea, and yeast infections, to name a few). They kill off helpful bacteria in your body (bacteria which help you digest food and offer protection against viral pathogens). And they promote the development of antibiotic-resistant bacteria (so that diseases that used to be easy to treat become very difficult to cure). According to many experts, nearly half of the antibiotic prescriptions written each year are inappropriate.
Even when antibiotics are indicated, choosing the wrong one, or choosing an excessively broad spectrum antibiotic, may give organisms in your body a chance to develop resistance. Zithromax, prescribed in your "Z-Pack," is certainly easy to take, and it's very effective for certain kinds of infections. It is also aggressively marketed, fairly expensive, and moderately broad spectrum. Two years ago, it was specifically targeted in Consumer Reports as a leading culprit in "antibiotic misuse and overuse."
As you're all probably too well aware, it's Cold and Flu Season now. We officially diagnosed our first case of Influenza last week, and our numbers are rapidly growing. This year, the most common symptoms include sore throat, cough, headache, fever, chills, marked fatigue, and muscle aches. Influenza, like most viral illnesses, needs to "run its course," and treatment aims to relieve symptoms. Most people turn to some combination of decongestants, gargles, cough syrup, Tylenol or Ibuprofen, steam, extra fluids, and rest. Come into our Self-Care Room, and pick up a "Cold Care Packet". If you have access to a stove or microwave, you can also cook up some chicken soup, a favorite home remedy nearly world-wide. My personal preference is to load it with lots of fresh garlic and ginger. If you're vegetarian, try the garlic and ginger in vegetable broth.
Sometimes viral illnesses take longer than you think they should to resolve. If you're concerned, please come into the Health Center to be checked out. Sometimes these illnesses progress into other problems, such as ear infections or bronchitis. Warning signs might include severe ear pain, fever greater than 101.5 for more than three days, prolonged or severe sinus pain, shortness of breath, deep cough productive of green or bloody phlegm, or swollen red tonsils with white spots. If you develop any of these signs or symptoms, please come in to see us.
We may not always prescribe you a "Z-Pack," but we promise to evaluate you thoroughly and thoughtfully.
Jeff Benson, M.D.
Dudley Coe Health Center
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