March 2016
America advises using antibiotics
only when strep throat is confirmed by a throat swab.
Many “sinus infections” are not
infections at all, but are caused by
allergies and may respond to allergy medication. When an infection
is present, it is more likely to be
viral than bacterial. However, there
is no easy test to distinguish viral
from bacterial sinusitis. Even the
presence of colored mucus from
the sinuses does not reliably predict a bacterial infection. Since 80
percent of sinus infections resolve
within two weeks without treatment, current guidelines advise
against using antibiotics in the first
week of symptoms, unless they
worsen after initial improvement,
suggesting a bacterial infection.
Although coughing can be
caused by many different conditions, the majority of coughs that
accompany respiratory illnesses
are not caused by bacteria and do
not respond to antibiotics. The
CDC recommends health care
providers use the term “chest
cold” in their effort to explain that
“bronchitis” is usually caused by
a virus and typically resolves on
its own.
Safety is a common goal of
consumers and their health care
providers, as we all try to avoid
causing harm. Many consumers, including many parents, are
unaware of the potential harm
from antibiotics, even when they
are prescribed appropriately.
Antibiotics are the most common
cause of allergic drug reactions.
These reactions can be serious and
even fatal. Antibiotic-associated
colitis can cause a bacterial diarrheal illness (Clostridium difficile, aka C. diff ) that can be
life-threatening, especially in the
elderly. Women who take antibiotics during pregnancy increase the
risk that their babies will develop
asthma as young children. Many
women develop vaginal yeast
infections from antibiotics, requiring an anti-fungal medication to
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