Why More Is Not Always Better with Antibiotics

By Eric Matheson, M.D., MSCR

Antibiotics can be a powerful weapon defending us against infections from a broad range of germs that could make us extremely ill. However, inappropriate use of antibiotics for mild infections such as colds can result in germs learning to resist these powerful medications. With careful use, antibiotics will be around to defend us when we need it the most, but overuse of antibiotics could leave us defenseless against severe infections.

What are antibiotics?

Antibiotics are medications, such as penicillin, that help the body destroy germs like bacteria and fungi. Antibiotics work by interfering with the ability of germs to divide and multiply.

What is antibiotic resistance?

Antibiotics are designed to kill germs. When the germs learn to resist the antibiotics that are intended to kill them - and thus continue to grow - that's antibiotic resistance. The CDC reports that more than 2.8 million antibiotic-resistant infections occur in the U.S. each year, killing over 35,000 people. While many factors contribute to antibiotic resistance, one of the most important is the use of antibiotics to treat mild viral infections such as colds or bronchitis.

What can be done to turn this around?

The key to stopping antibiotic resistance is to improve how we take them and how health care professionals, like me, prescribe them. We, at MUSC Health, are committed to improving how antibiotics are prescribed so that these lifesaving drugs can benefit us all for a long time to come.

When do we need antibiotics?

Only certain infections need antibiotics. The following are some examples of times when antibiotics are necessary.

• For severe, life-threatening conditions, like sepsis or pneumonia
• For people at high risk for severe infection such as patients undergoing surgery, patients with end-stage kidney disease, or patients receiving chemotherapy.

When are antibiotics not needed?

Contrary to popular belief, most viruses don't respond to antibiotics, so you won't need them for symptoms like a cold, a runny nose, or bronchitis.

While antibiotics are generally safe and well tolerated, serious and potentially life-threatening side effects can occur. Some common side effects of antibiotics include:

• Rash
• Dizziness
• Diarrhea
• Nausea
• Vomiting
• Yeast infections

So, are we too dependent on antibiotics?

According to the U.S. Centers for Disease Control and Prevention (CDC), Americans are taking unnecessary and potentially harmful antibiotics. It warns that antibiotic resistance is "one of the most urgent threats to the public's health." But don't lose heart. Providers, like MUSC Health, are prioritizing patients and working to fight antibiotic resistance.

What can I do to ensure I'm taking antibiotics safely?

• Have an honest and open dialogue with your health care provider about your treatment.
• If prescribed, take antibiotics exactly as prescribed. Failing to complete your antibiotic may increase the risk of developing an antibiotic resistance
• If you experience any side effects, talk to your doctor immediately.

How to stay healthy - and keep others healthy

• Keep your hands clean. Use soap and water for a 20-second count, or use a hand sanitizer with a minimum of 60-percent alcohol. The 20-second rule goes a long way to keep us safe from infection!
• Cover your mouth and nose when you sneeze or cough.
• When you're sick, stay home.
• Get recommended vaccines, including the flu shot.

---

Eric M Matheson, M.D., MSCR, is an MUSC Health associate professor and family medicine physician. To make an appointment with Dr. Matheson or another MUSC provider, call 843-792-7000 or schedule with your MyChart account.