Fight the overuse of antibiotics with these 4 questions
The irresponsible use of antibiotics can lead to antibiotic-resistant superbugs — not to mention unnecessary side effects. Here’s what to ask before you fill your prescription.
If you’ve ever gone to the doctor with a bacterial infection, you’ve probably experienced the rapid relief that antibiotics can provide. But there’s also a good chance that you’ve taken antibiotics at a time when the medication couldn’t actually help you.
For years, industry experts have been sounding the alarm about the overuse of antibiotics. But the problem hasn’t gone away. According to a 2019 study in The BMJ, a quarter of antibiotics are still prescribed unnecessarily.
Why is that a problem? Because it gives bacteria an opportunity to evolve. It leads to a rise in antibiotic-resistant “superbugs” that medications can’t kill.
According to the U.S. Food and Drug Administration, we now have multiple infections that can no longer be treated with antibiotics. Among them are new strains of bacteria that infect the skin, urinary tract and lungs. We’ve also seen antibiotic-resistant meningitis and sexually transmitted diseases. For these infections, there’s no longer an easy cure.
“The general public is used to getting an antibiotic for everything since they were a child,” says Alicia Shelly, MD. She’s a physician in Douglasville, Georgia, and an adviser at testing.com. “So there is an expectation that when patients go to the doctor, they will get an antibiotic.”
Of course, if you truly need an antibiotic, you should take it. And Optum Perks can help you save money on your prescription. You can search for antibiotics such as amoxicillin and doxycycline on our website or mobile app. And we may be able to find you a discount.
But if you don’t need an antibiotic, you should avoid taking one. That’s why the World Health Organization and the Centers for Disease Control and Prevention (CDC) sponsor an antibiotics and antimicrobial awareness week from Nov. 18 to 24 to educate the public about this issue. So this is a good time to reflect on how we use these powerful medications.
The responsible use of antibiotics is something we should be doing year-round, and it starts with you. Before you take antibiotics, ask these questions.
Question #1: Is this a bacterial infection?
Here’s the basic fact about antibiotics: They only kill bacteria. For illnesses that aren’t caused by bacteria, antibiotics are no help. But often, doctors prescribe them anyway. They’re used for existing infections and in situations where infection is likely.
“Antibiotics are critical in preventing and treating infections in people on chemotherapy and in those with complex chronic diseases, organ transplants or joint replacements,” says Gwen Murphy, PhD. She’s an epidemiologist in Dublin, Ireland, and an executive director at LetsGetChecked.
But many conditions aren’t caused by bacteria. For instance, colds, the flu and COVID-19 are all caused by viruses.
“That means that antibiotics will not help,” says Kelly Pillinger, PharmD. She’s an infectious disease clinical pharmacy specialist at the University of Rochester Medical Center in Rochester, New York. “If you also have a cough, runny nose or a raspy voice, you probably do not need antibiotics.”
Unfortunately, these conditions are often treated with antibiotics. When the Pew Charitable Trust looked at data from 5,000 COVID-19 patients, it discovered that more than half received an antibiotic. And more than a third received multiple antibiotics.
For many viral infections, the challenge is that there is no cure. In many cases, the only thing you can do is rest and hydrate, says the CDC. But people often want medication, so they end up with antibiotics. This is a bad idea. If your infection is viral, skip the antibiotics.
(From amoxicillin to Z-paks: Here’s how doctors choose the right antibiotic for you.)
Question #2: Is my bacterial infection a type known to have an alternative treatment?
Even if your doctor has confirmed that you’re dealing with a bacterial infection, you still might not need antibiotics. Some bacterial infections are known to resolve just as well on their own.
Many bacterial ear infections, for example, will get better without antibiotics, according to the CDC. Rather than prescribe antibiotics immediately, many pediatricians will recommend waiting 2 or 3 days to see if the body’s immune system deals with the infection. Alternately, the doctor may write you a prescription but recommend that you wait 2 or 3 days before filling it to see if the antibiotic is truly necessary.
The CDC also mentions sinus infections as an example of an illness that may not need antibiotics. These, too, will often get better without medication, since most are caused by viruses. In these cases, antibiotics do no good, and they may lead to side effects such as rashes or diarrhea. That could make your suffering worse rather than better.
“Your doctor can help determine whether antibiotics will be effective in treating your infection,” says Murphy. Just be prepared to question whether there are other options.
Question #3: Do I really have strep throat?
Strep throat is caused by a bacteria called Streptococcus pyogenes. If you have it, you will probably need antibiotics. But a study published by the College of Family Physicians of Canada found that 85% to 95% of sore throats and throat infections aren’t actually strep. Most of the time, your suffering is caused by a virus.
“If it is viral, you can avoid antibiotics,” says Dr. Shelly. Instead, stick to rest and hydration.
The best way to determine whether your sore throat is bacterial is with a rapid strep test. You should have one before deciding whether to take antibiotics, says Murphy.
Question #4: What are the side effects?
If you need antibiotics, you should take them. But it’s useful to know the downsides.
“Antibiotics, like all medications, have a risk of side effects,” says Pillinger. “Some antibiotics can cause things like upset stomach and diarrhea. Rarely, patients may have even more serious side effects of antibiotics, such as allergic reactions.” (Side effects are just one of the many things you should ask your pharmacist about.)
Taking antibiotics unnecessarily gives you risk with no reward. “So if you can avoid antibiotics, you should,” says Dr. Shelly.
Another downside of antibiotic use is that the medication could kill off the good bacteria in your stomach and intestines, says Murphy. These bacteria help your body extract nutrients from food. They also keep your immune system strong and produce vitamins that your body needs, according to the Harvard School of Public Health.
A large review of studies published in 2020 found that people who took antibiotics had a rapid decline in the diversity of bacteria in their digestive tracts. In some cases, it took 2 to 6 months for the gut to return to normal.
Of course, there are things you can do to lower your odds of needing an antibiotic. You can wash your hands often, clean surfaces that you use throughout the day, and avoid contact with sick people.
“The pandemic has taught us how effective basic hygiene measures can be at helping us avoid infection in the first place,” says Murphy.
That’s good for you, but it’s also good for us all. The less we use antibiotics, the less likely we are to find new bacteria that can’t be killed.
When you do need medication, consider using the Optum Perks mobile app to help you save money. It provides access to coupons that work at more than 64,000 U.S. pharmacies.
Nearly a quarter of antibiotics prescribed unnecessarily: The BMJ (2019). “Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study”
The rise of antibiotic-resistant bacteria: U.S. Food and Drug Administration
World Antimicrobial Awareness Week: World Health Organization
U.S. Antibiotics Awareness Week: Centers for Disease Control and Prevention
More than half of COVID-19 patients receive antibiotics: PEW (2021). “Could Efforts to Fight the Coronavirus Lead to Overuse of Antibiotics?”
There’s no cure for the common cold: Centers for Disease Control and Prevention
Bacterial sinus infections don’t usually respond to antibiotics: Centers for Disease Control and Prevention
Sore throats are usually viral: College of Family Physicians of Canada (2011). “Acute sore throat”
What gut bacteria does: Harvard School of Public Health
Antibiotics harm the microbiome: BMJ Open (2020). “Antibiotic-induced changes in the human gut microbiota for the most commonly prescribed antibiotics in primary care in the UK: a systematic review”