Montgomery Medicine #793

Are Antibiotics Necessary?

When we get sick with an infection, many people assume that antibiotics are the best and fastest way to recover. However, this is not always the case. Antibiotics are powerful medications designed to fight bacterial infections, but not all infections are caused by bacteria. Many are due to viruses, fungi, or other microorganisms that antibiotics simply do not affect. Taking antibiotics unnecessarily can lead to more harm than good, including side effects and the growing problem of antibiotic resistance.

One of the most common reasons antibiotics are overprescribed is for viral infections like the common cold, flu, or most cases of bronchitis. Viruses and bacteria are very different in how they invade the body and multiply. Viruses enter human cells and use them to reproduce, while bacteria multiply on their own and can sometimes cause harm. Because antibiotics work by targeting bacteria-specific processes – like cell wall formation or protein production – they do not interfere with viral replication. This means that taking an antibiotic for a viral infection will not help you recover faster and may even cause unnecessary side effects, such as diarrhea, nausea, or allergic reactions.

Another key issue with unnecessary antibiotic use is antibiotic resistance. Bacteria are constantly evolving, and when exposed to antibiotics repeatedly or inappropriately, they can develop ways to survive these drugs. This leads to the rise of “superbugs,” or antibiotic-resistant bacteria, which can cause infections that are difficult, or sometimes impossible, to treat. The Centers for Disease Control and Prevention (CDC) has identified antibiotic resistance as one of the biggest threats to public health. In the United States alone, at least 2.8 million antibiotic-resistant infections occur each year, leading to over 35,000 deaths. When bacteria become resistant, stronger and sometimes more toxic antibiotics are needed, and in some cases, no effective treatment exists.

Doctors carefully decide when to prescribe antibiotics by determining whether an infection is bacterial and whether antibiotics are truly necessary. Many bacterial infections, such as ear infections and some sinus infections, actually clear up on their own without antibiotics, thanks to the body’s immune system. Clinicians use guidelines based on symptoms, physical examination, and sometimes lab tests to confirm a bacterial infection before prescribing antibiotics. If an infection is mild or likely to resolve without treatment, doctors may recommend supportive care like rest, fluids, and over-the-counter medications instead.

There are also risks involved with taking antibiotics when they are not needed. Beyond contributing to resistance, antibiotics can disrupt the balance of good bacteria in our bodies. Our gut, for example, is home to trillions of helpful bacteria that aid digestion and immune function. When antibiotics kill both harmful and beneficial bacteria, it can lead to complications like antibiotic-associated diarrhea or infections with Clostridioides difficile (C. diff), a bacterium that can cause severe intestinal illness.

So how can we protect ourselves from infections and reduce the need for antibiotics? One of the best strategies is prevention. Vaccinations help protect against bacterial infections such as pneumonia, whooping cough, and meningitis. Good hygiene practices, like regular handwashing and covering coughs, can help reduce the spread of bacteria and viruses. Staying up to date on recommended vaccines, practicing safe food handling, and avoiding close contact with sick individuals are all ways to reduce the likelihood of needing antibiotics.

If you do get sick, it’s important to follow your health care provider’s advice about whether antibiotics are necessary. If prescribed, take them exactly as directed, completing the full course even if you start feeling better. Never use leftover antibiotics or take someone else’s prescription, as this can contribute to resistance and may not be the right treatment for your condition.