When Do You Need an Antibiotic?

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April 8, 2022

Chances are you have taken an antibiotic in your lifetime. These medicines are commonly used to treat ear infections in children and sinus infections in adults, among other uses. But antibiotics can be overused or taken incorrectly. It is important to be informed about these medications before taking them. 

Antibiotics are medicines that fight infections from bacteria. They are only used to treat certain bacterial infections according to the Centers for Disease Control and Prevention. Doctors prescribe antibiotics to treat conditions such as sinus infections, urinary tract infections, ear infections in children and skin infections. 

“Physicians and people who prescribe medicine are adequate judges of how frequently people should take antibiotics. But people should be aware of the medications they are taking and ask questions if a doctor prescribes treatments,” says Dr. Lloyd Kapp, medical director with BlueCross BlueShield of South Carolina.  

It is important to take antibiotics as directed, Kapp says. This means people need to finish the full course of antibiotics for the medication to be the most effective. Completing the full course of antibiotics helps prevent bacteria from building immunity against the treatment. Be sure to take medications as prescribed

“Bacteria are smart in the sense that, when exposed to antibiotics in higher concentrations over prolonged periods of time, they can naturally select out resistant strains,” Kapp says. “You don't want to increase the chances of creating resistant organisms.”

This is the same reason it is important to limit how frequently a person takes antibiotics. If a person takes antibiotics too frequently, he or she can risk developing resistance to the medication. 

“You want to make sure you’re taking an antibiotic to treat a bacterial infection as opposed to taking it when you have a virus or something that is not bacterial,” Kapp says. 

For example, the American Academy of Family Physicians recommends not using antibiotics to treat sinusitis or sinus infections unless symptoms last longer than 10 days. Antibiotics do not help with allergies. You may not need an antibiotic for colds, the flu or other respiratory illnesses. Antibiotics are recommended for whooping cough, strep throat and bacterial pneumonia. 

Another reason to limit use of antibiotics is that these medications kill all bacteria, not just the bad bacteria that make you sick. People have bacteria in their intestines that help digest food. Antibiotics wipe out these bacteria, which can cause digestive issues such as diarrhea or nausea. 

Other organisms can develop in the absence of good bacteria after several exposures to antibiotics, says Dr. James Ables, pharmacist and director of pharmacy services at BlueCross. This can be particularly true for hospital patients who receive large doses of antibiotics. 

Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation, aims to educate patients about physician recommendations for common treatments and offers suggestions to reduce antibiotic use in hospitals. Patients are encouraged to ask questions for any treatment or procedure. 

“You want to try and limit your body's exposure to antibiotics in general. Take as few as possible,” Ables says. 

It is also important to take medications as directed by taking the correct number of pills per day, says Ables. Follow your pharmacist’s instructions. 

“As a pharmacist, we often get asked what you should do if you forget to take a dose in the morning. We usually tell people to make sure and take it as soon as you remember it and make sure to complete the number of doses to be taken in a day,” he says. 

For anyone with recurring health concerns, such as sinus issues or frequent infections, it can be important to seek specialty medical help to determine underlying conditions, Ables says. 

“If you feel like you’re having too many infections, there may be specialists who can assist you in determining why you have systemic illnesses,” he says. 

You can find more physician-led recommendations for antibiotic use on the Choosing Wisely website

The Centers for Disease Control and Prevention, the American Academy of Family Physicians and the American Board of Internal Medicine are independent organizations that offer health information you may find helpful.

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