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Volume CXXXIII, Number 2 |
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Caring for upper respiratory disease
JEFF BENSON, M.D.
DUDLEY COE HEALTH CENTER
Dear Dr. Jeff: Last winter when I had a cough, my physician at home gave me a "z-pack." This week when I went to the Health Center with the same type of cough, I was told I had a "cold" and didn't need an antibiotic. What's up with that? -L. F.
Dear L. F.: I can't comment about your cough last year, but I'd guess that this year you were told your illness was likely viral, not bacterial. You've probably come down with the "Bowdoin Crud," which is already starting to reach near-epidemic proportions.
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 (which may offer protection against viral pathogens), and they increase the development of antibiotic-resistant bacteria (so diseases that used to be easy to treat become very difficult to cure). According to some researchers, nearly half of the antibiotic prescriptions written each year are inappropriate.
Even when antibiotics are indicated, choosing the wrong one or choosing an especially broad-spectrum antibiotic may give many organisms in the body a chance to develop resistance. Zithromax, prescribed in your "z-pack," is certainly easy to take and very effective for specific types of infections. It has also been aggressively marketed, is fairly expensive, and is moderately broad-spectrum. It was recently targeted in Consumer Reports as a leading culprit in "antibiotic misuse and overuse."
Common symptoms of viral upper respiratory illnesses are runny or congested noses, sore throats, cough, headache, fever, fatigue, and muscle aches. These illnesses generally need to "run their course," and treatment aims to relieve symptoms: decongestants, gargles, cough syrup, Tylenol or Ibuprofen, steam, extra fluids, and rest. All of these treatments have been packaged up in our Cold Care Packets, which you can pick up in our Self-Care Room at the Health Center. You'll also find lots of information there about other common ailments, as well as the diagnostic and treatment options you can manage yourself
There are some things you can do to avoid falling prey to the Crud. Eat well, exercise moderately, don't smoke, and above all, get plenty of rest. And, in October, be sure to get your flu shot!
Given the realities of student life, however, upper respiratory illnesses are pretty much unavoidable, especially for first year students. Sometimes these illnesses take longer to clear up than you think they should. If you're concerned, come into the Health Center to be checked. Sometimes these illnesses progress into other problems, such as ear infections or bronchitis. Warning signs of more likely bacterial illness include severe ear pain, fever greater than 101.5 for more than 3 days, prolonged or severe sinus pain, shortness of breath, deep cough productive of green or bloody phlegm, and swollen red tonsils with white spots. If any of these develop, please come into the Health Center for evaluation.
We may not prescribe you a "z-pack," but we promise to check you over thoroughly and thoughtfully.
Be well!
Jeff Benson, M.D.
Dudley Coe Health Center
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