Antibiotics represent an incredible resource when it comes to treating certain types of infectious diseases — but they’re not appropriate for every situation, and they can actually have serious side effects. That’s why it’s so important to know when antibiotics should be used and when you can skip them.
“There are some patients who ask for antibiotics because they believe that that class of drugs can be taken ‘just in case’ they will provide a cure or symptom benefit,” says Allison Baroco, MD, infectious diseases specialist at Augusta Health. “But they’re not right for every situation. And also, the risk of taking antibiotics can be more complex than people might realize.”
Dos and don’ts
Antibiotics are best used for issues like pneumonia, some types of ear infections, urinary tract infections and other problems caused by bacteria.
Although some people might request antibiotics for a cold or bronchitis (over 90 percent of bronchitis infections are caused by viruses), those type of viral conditions are not improved or cured through antibiotic use. In fact, you could also be putting yourself at risk for side effects like diarrhea or even clostridium difficile — often shortened to “C. diff” — a serious condition that can be highly contagious.
That’s because antibiotics not only kill illness-causing bacteria, they also kill the type of normal, beneficial bacteria that keeps your gut healthy. If you’re suffering from the bad bacteria, then it’s often worth the trade-off of also eliminating good bacteria. But when you’re taking antibiotics unnecessarily, it means you’re putting your gut health at risk for no reason.
Some people have C. diff colonized in their digestive system, Dr. Baroco says, but it’s often hibernating or suppressed by beneficial bacteria. When antibiotics remove that control mechanism, C. diff can grow and spread, colonizing large parts of the gut. That can result in abdominal cramping, fever, nausea and dehydration, among other symptoms. “Over time, especially if you have multiple courses of antibiotics, your risk for C. diff may increase,” says Dr. Baroco.
But even one course of antibiotics could be an issue, she adds. Additionally, people can develop allergic reactions to the drug — even if they’ve taken it in the past.
Though less than 5 percent of healthy individuals are likely colonized with C. diff, certain people are at a much higher risk (15–25 percent) of contracting it. They are: people older than 65 who reside or recently have been in a nursing home, or who have health problems that suppress the immune system.
To minimize the risk of infection and side effects, talk with your doctor about the most appropriate course of treatment for your condition. Sometimes, there are other treatments to try first before turning to antibiotics — rather than thinking of antibiotics as the default solution that’s a first line of defense. “A good discussion with your physician is very helpful when deciding whether or not an antibiotic is the treatment for you,” says Dr. Baroco.