Thursday, November 27, 2014
   
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Unnecessary antibiotics can be harmful

By Trudy Lieberman

Rural Health News Service

How many times have you walked away from the doctor’s office with a prescription for an antibiotic to treat a cold? Probably many. Over the decades we’ve been conditioned to believe that antibiotics are sort of an insurance policy against some malady that might be worse than a cold or that they will make the nasty symptoms magically disappear.

In recent years, study after study has shown that this “just-in-case” medicine comes with oodles of side effects and serious consequences that might make patients think twice before dashing off to the pharmacy. And yes, it might mean questioning your doctor’s judgment—something most patients are reluctant to do.

While antibiotics can cure a strep throat that’s caused by bacteria, they aren’t going to do much to get rid of a sore throat caused by a virus—the culprit causing most sore throats. And while they are helpful in clearing up bladder infections, says the Mayo Clinic, antibiotics aren’t much use when it comes to curing the flu or most coughs.

Still, doctors prescribe them anyway. Warnings surfaced more than 20 years ago that taking antibiotics when they are not helpful could make patients resistant to them years later when a serious infection develops. Such resistance may make it tough or even impossible to cure these patients.

Yet last fall a study showed that between 1997 and 2010 primary care and emergency room doctors prescribed antibiotics about 60 percent of the time for sore throats. The lead researcher, a primary care doc from Brigham and Women’s Hospital in Boston, noted that “the right antibiotic prescribing rate for adults with sore throat is probably around 10 percent.” So it seems many of us are taking way too many of these drugs.

The fact that American doctors are all too willing to prescribe antibiotics hit home a couple of weeks ago when I was traveling in Europe. I had what seemed like a garden-variety cold several days before I left. Since it was lingering, I decided to check it out the day after I arrived in London and made my way to what the British call the A and E Department (for accidents and emergencies) at a nearby hospital.

The doctor who examined me saw no indications that would warrant antibiotics—no red ears, no red throat, no congestion in the lungs. She warned this viral infection might turn into a bacterial illness, but for the time being, the doctor explained antibiotics were unnecessary and possibly harmful.

Another week passed, and the symptoms got worse. It was clear I needed to visit the National Health Service again. Sure enough this time a doctor spotted signs indicating an antibiotic might be in order. But she didn’t prescribe a Z-Pack, Cipro, or any other high-powered drug, which is what I have seen doctors do at urgent care centers in New York City. One time a physician give me Zithromax which he said would help the lungs, the ears, the sinuses and throat in case I had something in those areas that needed treatment.

In England I got a computer-generated prescription for old-fashioned amoxicillin, which a pharmacy filled in less than five minutes. No one asked about coinsurance, copayments or whether the drug was on the formulary—barriers patients face here. In fact, I paid nothing for the medicine. Medicines are free in the UK to those over age 60. Nor did I pay anything for the two visits to the health service. Initial treatment at A and E departments and walk-in clinics is free to all overseas visitors.

My point is not to tout the ease of getting treated as a foreigner in the U.K. but to note the proper care that I received. It made me think about all those times U.S. doctors sent me out with a prescription for the latest and greatest wonder drug, a treatment that might come back to hurt me some day.

The antibiotic worked, and the whole experience underscored that questioning your physician when you show up with a cold may be the best medicine of all.

Editor’s note: The Rural Health News Service is funded by a grant from The Commonwealth Fund and distributed through the Nebraska Press Association Foundation, the Colorado Press Association and the South Dakota Newspaper Association.

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