Responsible Use of Antibiotics

"I'm all congested and have green mucus from my nose"…

"I've been coughing for a week"…

"My doctor at home always gives me amoxicillin when I have a sore
throat"…

"My sinuses are clogged-I think I have an infection"…

"I always feel better once I'm on penicillin"…

These are phrases frequently heard in the Health Center, often followed by a request for antibiotic treatment. The fact is, the overwhelming majority of coughs, head colds, sinus infections and sore throats are caused by viruses, not bacteria. Even if the mucus is green. Even if the symptoms last for 1-2 weeks. Antibiotics do not work on viral infections; they are designed to work only on bacterial infections. Treating viral infections with antibiotics does not prevent them from occurring, speed up their resolution, or prevent complications. What it does do is contribute to antibiotic resistance.

Antibiotic resistance is the ability developed by certain bacteria to survive the antibiotics that would normally kill them. These bacteria go on to reproduce and can even pass on their resistance to other bacteria. It is important to note that it is the bacteria that develop resistance, not individual people. Students sometimes say: "I had that medicine a lot when I was a kid and now it doesn't work for me any more." If amoxicillin doesn't cure your ear infection any more, it is because the bacteria causing your ear infection is resistant to amoxicillin. It is not because your body is resistant to that specific antibiotic.

It is estimated that about 40% of the antibiotics prescribed by medical providers in this country are prescribed (inappropriately) for viral infections. The more antibiotics are used, the greater the risk of developing resistant strains of bacteria. The higher the prevalence of resistant strains of bacteria in your community, the greater your risk of catching one. This has become an increasingly serious problem. Bacteria exist now for which there are no effective antibiotic treatments-they have developed resistance to even the most powerful antibiotics. Many people die each year due to resistant infections. Resistance affects all of us.

The good news is that when antibiotics are used appropriately, levels of resistance go down. The Centers for Disease Control (CDC), along with physician groups, has developed guidelines for the responsible use of antibiotics. The providers in the SHC strive to follow these guidelines and use antibiotics only when appropriate for bacterial infections. This may be difficult for some students to accept if they are accustomed to a different approach to antibiotic use. We all want to be well as soon as possible and sometimes think that antibiotic treatment offers a "quick fix". If you have questions or concerns about your treatment, please feel free to ask the provider for reasons why antibiotics may or may not be appropriate for your condition. SHC providers understand your frustration with feeling miserable and your need to be functional for classes and will make every effort to point out effective medicines, self treatment and comfort measures to get you back to normal as soon as possible.

Here are some ways you can help combat antibiotic resistance:

• If you are not sure if your illness is viral or bacterial in nature, see your provider for an evaluation.
• Don't assume you will be treated with an antibiotic, even if you have been treated with one in the past for a similar problem.
• If your provider diagnoses a viral infection, follow the symptomatic treatment guidelines suggested and try to be patient while your body heals itself.
• If you don't feel better or symptoms worsen, return for further evaluation. Some illnesses may start with a viral infection but later develop a secondary bacterial infection.
• If an antibiotic is prescribed for you, take all the pills as directed even if you feel better after just a few pills. If you stop after a couple of days you have killed off only the weaker bacteria, encouraging the remaining bacteria to develop resistance.
• Never take antibiotics "left-over" from a previous illness (you should never have any remaining-see above).
• Never take anyone else's medication, including antibiotics.
• Remember: antibiotics can cause side effects (diarrhea, vaginal yeast infections, sun sensitivity) or interact with other medications (birth control pills)--they are really best used only when the potential benefits outweigh the potential risks.

For further information, talk with a SHC provider. Web resources include:

Centers for Disease Control www.cdc.gov/drugresistance/community www.cdc.gov/drugresistance/general/prevention_tips.htm www.cdc.gov/ncidod/op/index.htm