Dr. Roger Hicks
When you or a loved one has been feeling ill with a sore throat or some sort of respiratory infection and decide to see a doctor – hoping for antibiotics – it can be frustrating to hear “I think it’s a virus and it needs to run its course.”
We all know how helpful antibiotics can be in certain situations. But the reality is, the overuse of antibiotics has become a global issue that has compromised the effectiveness of these life-saving drugs and is threatening their future usefulness.
Antibiotics are compounds capable of killing or inhibiting the growth of bacteria. They do nothing to other types of disease-causing microorganisms, such as viruses and fungi. The first antibiotic was discovered in London in1928 by Scottish bacteriologist Alexander Fleming, who realized that bacteria in one of his petri dishes were being killed by an itinerant colony of penicillium mold. This may be why ancient Egyptians had a practice of applying a poultice of moldy bread to an infected wound. Penicillin did not become widely available until 1943 when it was produced by U.S. drug companies for the battlefields of World War II.
Antibiotics have revolutionized medicine and saved millions of lives. They are now widely used in humans and in agriculture – approximately 80% of the antibiotics used in the U.S. are given to farm animals. But in the 75 years since they have been in use, we have learned a thing or two about them.
For one, unnecessary prescribing and overuse of antibiotics has caused a resistance crisis. Bacteria are living organisms that quickly evolve into strains resistant to the antibiotics used against them. Treating those resistant infections can require higher doses or stronger antibiotics, but some bacteria have become “super bugs” unaffected by even the most powerful antibiotics available today.
According to the CDC, antibiotic resistance caused an estimated 23,000 deaths annually in the U.S. alone. Many medical experts agree that most antibiotics we count on now will be useless 25 years from now, the 100th birthday of this type of medicine. The situation is made more concerning by the fact that the major drug companies – Pfizer in 2011, then Sanofi, Eli Lilly, AstraZeneca, and most recently, Novartis – have all stopped doing research on the development of new kinds of antibiotics.
We’ve also learned that antibiotics can have a downside. Antibiotics are one of the most common causes of reactions to medicines resulting in emergency department visits, especially for children. These include allergic reactions ranging from an annoying rash to a life-threatening condition like anaphylaxis. Antibiotics also kill the beneficial bacteria that normally live in our bodies. For example, they upset normal vaginal bacteria that prevent yeast infections. And they can cause an imbalance in the intestinal biome, the gut bacteria that help with digestion, resulting in diarrhea, or in worst cases, Clostridia difficile or C. diff. Killing beneficial bacteria is similar to me to tearing out a lawn – weeds can come in and take over.
As a physician, I strive to use antibiotics only when necessary. This can be a challenge early in the course of an illness, especially with people who come in to our urgent care clinic knowing exactly what they have, want and need. Over the years, countless patients have told me “Whenever I get a cold, my doctor gives me antibiotics and I always get better.” That reminds me of the truism known round the world, “If you beat a drum during an eclipse, the sun will always come out.” Yes, you always got better from your cold, but it wasn’t because of the antibiotics.
Of course, it’s much better to not get sick, so the best thing you can do is to safeguard against contagious illnesses by taking precautions to prevent them in them first place. Be vigilant about washing your hands, avoid contact with or wear a mask when you’re around people coughing or sneezing, stay home when you are ill and make sure you are up to date on all immunizations.
Other things that may help are a healthy diet, certain medicinal herbs such as echinacea, and supplements like vitamin C and zinc that may help boost your immune system. If you do end up taking antibiotics, be sure to complete the course and then replenish your system with probiotics.
A director of the Urgent Care Association of America from 2011 to 2017, Dr. Roger Hicks served as the Association’s treasurer and then secretary. He is founder and current board member of the Urgent Care Assurance Company, a malpractice company specializing in urgent care. He is the founding President of the California Urgent Care Association. He is also the founding president of the South Yuba River Citizens League and served on SYRCL’s Board of Directors for 30 years.