The Appropriate Use of Antibiotics: When and When Not to Use Them
Dr. Gina Lynem-Walker
| 4 min read
Dr. Gina Lynem-Walker, MD, is a quality medical director for utilization management at Blue Cross Blue Shield of Michigan. She is an internal medicine physician with experience in utilization management, care management and disease management, and is a volunteer faculty member at Wayne State University Medical School. She is married with two children, and enjoys gardening, reading, crafts, music, community service and travel.
Each year, more than 230,000 antibiotics are prescribed in outpatient settings in the United States. Between 80-90% of antibiotic prescriptions are in outpatient settings and up to 28% of these prescriptions are not needed. Overprescription of antibiotics can lead to antimicrobial resistance.
Antibiotics aren’t always needed for many common bacterial infections
Antibiotics are used to fight certain bacterial infections and bacteria-caused illnesses. Many common bacterial infections can be resolved without the use of antibiotics, including common sinus infections and ear infections.
Antibiotics do not work against viruses and viral infections. For example, antibiotics are not appropriate treatment for the common cold, most sore throats and the flu. These illnesses are caused by viruses. Inappropriate use of antibiotics may even cause the development of “superbugs” or drug-resistant bacteria.
Not only do antibiotics not work to treat viral infections, they won’t prevent the virus from spreading. Washing hands properly and regularly, using tissues when coughing or sneezing and getting immunizations, especially the flu shot, are the best ways to try to avoid common viral infections.
When are antibiotics most effective?
Antibiotics are effective against certain bacterial infections. In these cases, antibiotics treat the bacterial infection and can prevent spreading of the bacteria or prevent complications stemming from the infection. Antibiotics are appropriate and effective for treatment of some soft tissue infections, respiratory infections and eye infections caused by bacteria, including, but not limited to:
- Staph infections
- Infections from animal bites
- Necrotizing fasciitis
- Bacterial pneumonia
- Strep throat
- Whooping cough
- Urinary tract infections (UTIs)
- Pink eye
- Lyme disease
In some cases, antibiotics may be prescribed before surgery. These are called prophylactic antibiotics and are used to reduce the risk of post-operative infections.
The harms of misusing antibiotics
Antibiotics are powerful medications when used properly, but also carry risks when misused. Do not pressure doctors to prescribe antibiotics even if one feels unwell. Misuse of antibiotics includes:
- Improper prescription of antibiotics
- Taking the wrong antibiotic
- Taking someone else’s prescribed antibiotic
- Letting someone else use an antibiotic not prescribed to them
- Taking the wrong dosage of antibiotic
- Taking antibiotics for the wrong length of time
Side effects of antibiotics are usually minor inconveniences when they are properly prescribed, but if taking antibiotics when not needed or misusing antibiotics, they can be worse. Reactions from antibiotics are the leading cause of medication-related emergency room visits for children. Side effects can include:
- Diarrhea
- Nausea and vomiting
- Dizziness
- Rashes
- Yeast infections
- C. diff infection
- Allergic reactions up to and including anaphylaxis
Research also shows that overuse of antibiotics in childhood may increase the risk of developing certain chronic diseases later in life. This does not mean antibiotics cause chronic disease, but overuse of antibiotics is correlated with higher rates of chronic disease. Misuse of antibiotics also contributes to antimicrobial resistance.
What is antimicrobial resistance?
Antimicrobial resistance refers to bacteria, viruses, fungi and parasites that no longer respond to the medication designed to treat them. These microbial threats to human health can become more drug-resistant over time through genetic changes, but this process is sped up by overuse or misuse of medication designed to treat them, including antibiotics.
Drug-resistant infections are harder to treat, carry greater risks and lower the efficacy of medical care. Globally, more than 40% of reported cases of E. coli, more than 30% of Staphylococcus aureus cases and up to 20% of UTIs were drug-resistant in 2020.
How to prevent antibiotic misuse
Everyone can do their part to reduce the misuse of antibiotics. Do not seek antibiotics out when receiving medical care. If the condition calls for antibiotic use, doctors will prescribe it. Do not pressure a doctor for an antibiotic prescription. Take antibiotics as directed, taking the proper dose for the prescribed length of time. Do not share antibiotics with anyone who they are not prescribed to.
To avoid the spread of disease, wash hands regularly, as well as after handling raw food, touching animals including pets, using public transportation, using the restroom or changing diapers. Stay home if possible when sick and cover the mouth and nose with a tissue when coughing or sneezing. Stay current on the flu shot and other vaccines.
Gina Lynem-Walker, M.D., associate medical director at Blue Cross Blue Shield of Michigan. For more health information and tips, visit MIBlueDaily.com.
