Perhaps this has happened to you: Your recent cough kept you up for another night, so you went to the doctor. The nurse took your vitals, the doctor asked you some questions, listened to your lungs, maybe looked at your ears and your throat, and recommended rest, fluids, over the counter treatments, and time. It all seemed fine until you got home and realized the doctor did not “do anything” for you.
Why didn’t the doctor prescribe an antibiotic? What could it hurt?
The use of antibiotics has been a blessing and a lifesaver. On the flip side, antibiotic resistance and opportunistic infections have been on the rise.
Our bodies naturally produce good, beneficial bacteria in our gut and on our skin. Antibiotics can kill off some of those good bacteria, causing diarrhea or a yeast infection. Other problems triggered by antibiotics are not immediately apparent. For example, normal bacteria on your skin may become resistant, causing methicillin-resistant Staph aureus or MRSA, which can cause a stubborn infection the next time you get a cut or scratch.
With less competition from normal bacteria in your gut, the bad bug Clostridioides difficile or C. diff can take hold causing severe diarrhea and inflammation of the colon which is hard to treat and even harder to eliminate. Or perhaps you may have an allergic reaction to an antibiotic, or worse, a severe sloughing of the skin called Stevens-Johnson syndrome and toxic epidermal necrolysis. All the above may cause hospitalizations and even death.
Most cold symptoms like a sore throat or cough are caused by viruses. Antibiotics are not effective against viruses, and early antibiotic use, often in the first week of symptoms, has not been shown to decrease the risk of a bacterial infection taking hold. In fact, if one does take hold, it may become even more resistant.
Your doctor wants to help you feel better. It would be quick and easy to immediately prescribe an antibiotic, but that may not be what is best for you and your health. After listening to you, reviewing your medical history, your medications, your vitals, and doing an examination, and after further conversation with you, I trust that if a test, an x-ray, or antibiotics are warranted, the doctor will likely recommend it.
If you feel like the doctor didn’t “do anything” for you, please consider the risks of antibiotics. Of course, if your condition does not improve, and you start to feel worse, notify the doctor. But, if you do get better without additional tests and antibiotics, consider being grateful. The human body is a marvel.
Andrew Ellsworth, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show celebrating its twentieth season of truthful, tested, and timely medical information, streaming live on Facebook most Thursdays at 7 p.m. central.
