Do You Need An Antibiotic? – By Dr. Alan Christianson
Hey, there! Dr. Alan Christianson here. Do you need to take an antibiotic? I am going to give you some easy ways to answer that question confidently. Of course, antibiotics are terribly overused. They’re getting less and less effective, and we are seeing more germs resistant to them. There are times when you are sick and feel desperate because you cannot afford to be down for a few days. You may be traveling, have a big presentation or are going on vacation. What do you do in those moments? How do you make the decision to take antibiotics or not?
You want to think about four areas: your ears, throat, lungs and sinuses. When you have symptoms in more than one area, you usually have a virus. Let’s say you have painful, congested ears (maybe things sound a little funny or sounds come and go), a runny nose, some pressure, a sore throat, tickling cough or a heavier cough and chest pressure. When you mix all that up, you have a virus. If you mix two or more of those up, you almost certainly have a virus.
Let’s talk about an optical illusion with a lot of viral infections. You have symptoms that will last from seven to ten days. The first few days, they are not too bad. Maybe you notice them, as you’re not feeling quite right. Then you get in the thick of it, and you are feeling really awful for a bit. Now, when you first start feeling awful, you will start questioning if you need an antibiotic. So, a few days into feeling awful (probably on day seven or eight out of ten), is when people usually seek out medical care. They say, “Hey, I am done with this. This has gone on for too long, and I just need this gone!” Again, they are on about day seven or eight out of ten, and that is when they get the antibiotic. Then, in the next two days, they magically get better. Remember, it is typically a ten-day issue. Often, to the doctor and to the participant, it seems like the antibiotic fixed the problem. Really, it did not, as the symptoms would have gone away in that time frame anyway.
Here is the time when antibiotics are really indicated: If you have strongly localized symptoms in your throat, ears or lungs, these could be caused by bacteria and could need antibiotic treatment. Let’s look at each area individually:
If you are listening closely, you might notice I didn’t address one area: the sinuses. There was a large study done by otolaryngologists (ear, nose and throat experts), with people suffering from full-blown sinus infections. These sinus infections were confirmed with a CAT scan, so there was no debate they had them. They put the patients in a couple of groups. One group received antibiotics, and one did not. The otolaryngologists not only tracked how long the symptoms lasted (which was important), but also tracked the patients afterwards to see how many times they got sick per year. The results of the study were contrary to an old way of thinking about sinus infections. In many levels of my training, I was taught sinus infections take a long time to get rid of, so patients probably need two courses of antibiotics. We now know that sinus infections take about three weeks to go away. If you take an antibiotic, it will take about three weeks. If you do not take an antibiotic, it will take about three weeks. There is no difference in how long the symptoms last. Here is something to consider: If you do take an antibiotic, your odds of having more sinuses infections that year are 50% higher than if you did not. So, if you do take an antibiotic for a sinus infection, it won’t go away faster, but you have a good chance of getting sick sooner than you would otherwise.
I am not against antibiotics, but by very conventional guidelines, they are not all that helpful when you are seeing a mixture of symptoms, such as with bronchitis, common colds or flu. One note about the flu: There is a treatment, called Tamiflu, which is kind of like an antibiotic against influenza. The data is really strong that it is not helpful. If you were to treat someone within the first twelve hours of being sick, their illness might go away five to ten hours sooner. That is it, and that is at the cost of some potential, substantial side effects! There are also types of flu that are resistant to it.
Let me share with you one of my favorite, fun tricks. Viruses shed themselves by sweating more than anything. When kids get sick, they get a miserable, crazy-high fever, and then, they are done. Their body gets rid of the virus fast because they can mount a stronger fever response. As adults, we do not have that kind of vitality to mount that kind of fever, but here is a recipe for you to shed a virus in a short period of time: At bedtime, prepare some ginger tea. Fill the bathtub with water that is as hot as tolerable. Put extra blankets on your bed and a lot of warm, sweat clothes. Get socks, sweat pants, sweat shirts and maybe even a wool hat. Just get a silly amount of clothes. Jump in the tub for about fifteen minutes, while drinking some warm to hot ginger tea. Ginger is a diaphoretic (it helps you sweat things out faster), so it will warm you up internally. Once you have cooked yourself pretty good in the tub, put on all the sweat clothes, jump in bed, pull the extra blankets on and go to sleep. Typically, after a few hours, you sweat really hard and are pretty warm. Throw off the extra clothes, and go back to sleep. In many cases, you will awaken and will have kicked the virus! You will be feeling better and have broken the cycle of it. So, that is a stronger antibiotic for most, common, respiratory infections and has no side effects!
Thanks for hanging out with me, and we will be back real soon.