A cough, a sore throat, a runny nose, feeling under the weather; these symptoms are almost ALWAYS caused by a virus. A virus does not respond to an antibiotic.
According to the World Health Organisation, antibiotic resistance is one of the biggest threats to global health, food security, and development today. A growing number of infections – such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis – are becoming harder to treat as the antibiotics used to treat them become less effective.
Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality.
In general practice medicine, it is common for a patient to walk through the door with very typical features of a viral illness and demand an antibiotic. "it worked last time" they will say. But unfortunately, last time was likely a virus, which last for a few days only, so by the time you saw the doctor and they gave you a script (because not arguing and complying is far easier and quicker), your virus was already starting to turn a corner, and your healthy immune system was starting to defend you from the virus.
When I was at medical school, it was common practice for doctor's to give an antibiotic for every sore ear, for every sore throat- because the nuance of virus vs bacteria was maybe less important, especially given antibiotic resistance felt like this far away thing that was talked about but not really seen in day to day practice. But in a relatively short time (I was at uni in 2008), there has been emerging evidence, that probably most ear aches do not require an antibiotic, as well as most sore throat's. Why? Well, lots of reasons, but mainly this is because of research. Studies, which grouped children treated with an anitibiotic for a sore ear vs those treated with pain relief only, and what they found was the speed of improvement in symptoms was at best around 12 hours in the antibiotic group. But when weighing up the cons of exposure to antibiotic, such as allergy, diarrhoea, serious side effects, not withstanding the long term implications on our microbiome, suffice to say, not all ear aches need an antibiotic.
Now, please note that there are some nuances to this, for example, children under two, children with recurrent ear infection, ATSI children, or a perforated ear drum- these situations often will require an antibiotic, as research indicates the benefit outweighs the harm in such circumstances (Please note that this advice refers to Australian based guidelines and does not translate to other countries).
Other, more concerning trends since I complete medical school, is the shifting guidelines of what we prescribe. This is because antibiotic resistance continues to emerge. For instance, in Australia, recent guidelines have changed regarding antibiotic management of chlamydia and gonorrhoea.
I once met a medical student from Denmark, and he explained that Denmark has some of the best antibiotic stewardship programs in the world. He, along with all of his colleagues who travelled abroad to work in a hospital system, would need to undergo decontamination with antibacterial wash prior to re-entry into the Danish hospitals. The Danish healthcare system doesn't want to risk naughty resistant bacteria hitching a ride on these student's from our hospital's.
As always, I believe that there needs to be a healthy balance. We are so lucky to live in an era where antibiotics are freely available to cure illness that our ancestors would have succumbed to, however widespread willy nilly use, and more concerning, use on livestock in the food production industry needs to be fine-tuned.
DISCLAIMER: All information discussed is for health information and education only. This does not replace individual advice. For any health related concern, please speak with your doctor.
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