Antibiotics: The Case for Over-Prescription

Published: January 02, 2018

Ruby Desai, MD


We live in a world of immediate gratification. Resources such as Amazon, Netflix, and Uber provide quick and easy services, so why shouldn’t this extend to our health? With the arrival of winter and flu season, people are looking for quick fixes for their stuffy noses, coughs, and sore throats – assuming that antibiotics are the answer. The problem? While antibiotics are great at killing bacteria, more than 90% of respiratory infections are viruses, against which antibiotics are essentially useless. However, more than 70% of the time, patients are incorrectly prescribed antibiotics for common variety colds and viral infections.  

This trend of overprescribing can be overcome by educating patients on: the causes of symptoms, how antibiotics work, and the difference between viral and bacterial illnesses.  Here are some key points: 

  • Fever: Both bacteria and viruses can cause fevers, but bacterial fevers are generally higher (> 101.4) and tend to be persistent.
  • Duration of illness: Viral symptoms usually last 7-10 days but can last longer up to 2-3 weeks. In contrast, bacterial infections are more likely when symptoms start to improve but then gradually worsen again after 7-10 days. 
  • Mucous color: Any color on the mucous is due to cells that have died fighting the infection in your body. Color is generally meaningless, however, when accompanied by fever it can be correlated with bacterial infection. 
  • Sore throat: Most viral colds start with a sore throat, but a sore throat without cold symptoms (cough) can be bacterial strep throat, which would require antibiotics.
  • Antibiotics: They might help, but they certainly cannot hurt, right? Wrong! Antibiotics are not only dangerous from a public health standpoint (they breed drug-resistant bacteria), but they are also personally harmful by killing off healthy bacteria in your body and causing serious side effects. 
  • Testing: Lab testing through throat or nasal swab, collecting bodily fluid, or obtaining a chest x-ray is the only guaranteed way to determine if you need an antibiotic.

What does this mean for you? Always seek medical care if you are uncertain about your symptoms, and remember: the next time you do go to a doctor’s office for a sick visit, don’t ask for antibiotics. Ask the doctor to rule out a bacterial infection! 

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