Why An Antibiotic Isn't the Silver Bullet You Think It Is.
I’ll be the first to admit doctors are not perfect people. A lot of bedside manner, and time for discussion is seriously lacking (but not at apios!). When you’re sick with cold symptoms, and sinus pressure, we know you feel horrible and want to do anything to get better faster. BUT, in the ER, clinic, and at apios we often hear the same sentiment from patients over and over, “well last time I got an antibiotic and it's the only thing that helped”. It's important to talk about why you might think that, and why you were most likely tricked. The amazing thing about apios membership is that we have that kind of time. So let’s get into it…
Every year in the US alone almost 3 million people contract an antibiotic-resistant infection, and more than 35,000 die from it. Yes, you read that right. You might wonder how in the world this is happening in 2024 when medicine is so advanced. Keep on reading…
When you take an antibiotic three things happen:
You may kill the bacteria causing your symptoms (if there is an actual bacteria causing them)
You will kill the good bacteria in your gut
You will leave bacteria behind that were able to stay alive because of adaptations that allow them to resist being killed by the antibiotic. These stronger bugs will stick around, and next time there’ll be more of them. This starts the cycle of antibiotic resistance.
Don’t get me wrong, antibiotics are an amazing feat of modern medicine and save lives every single day. They’re absolutely essential in many cases. However, due to overprescribing practices, pressure from patients, full schedules for providers, and wanting to meet patient satisfaction scores —antibiotics are still being written all the time unnecessarily, even though we as physicians know better. It's hurting patients and creating drug-resistant super bugs that anyone can get.
Here are the most common unnecessary antibiotics I see prescribed in both the ED and urgent care settings:
antibiotics for sinus infections
antibiotics for viral upper respiratory infections (also known as colds)
antibiotics for “bronchitis"
antibiotic for ear infections/pain in adults or older children
So back to that infamous statement “last time I took and antibiotic and it's the only reason I got better.” Not true. We have high quality research over many years that tell us taking antibiotics in these scenarios DOES NOT make you get better faster. In fact, patients would have gotten better in the same amount of time, they just attribute their improvement to antibiotics.
On the topic of research: We also know that green or yellow mucous does not equal bacterial infection, in fact the most common reason for this color is your body’s own cells fighting off infection! Additionally, we know that even IF that sinus infection has some bacteria in it, there is new research that it will STILL clear up in the same amount of time without antibiotics (and with the over-the-counter regimen we recommend here at apios).
It has been very clearly demonstrated time and time again in studies that these patients taking even something as simple as amoxicillin or azithromycin are at risk for serious overgrowth of dangerous gut bacteria called c.difficile, painful diarrhea, and future drug resistant infections, to name a few problems.
At apios, we focus on the evidence. It's the basis for all our recommendations. We do the work so that you don’t have to. We are happy to have the time and the ability to directly communicate with our members and share this kind of research, because we know you have better things to do. We want you to know that we hear your frustration, and we want you to get better as fast as possible! When a doctor tries to talk you out of an antibiotic, it's for a reason—to protect you and protect our society from the scary numbers above.
So next time you feel a cold coming on, have an annoying cough, are sure you have a sinus infection, chat with your apios doctor about how to best manage it before jumping to antibiotics. Always give yourself a full week when you’re able to hydrate and don’t have a persistent fever.
We owe it to ourselves and future generations to be good stewards of antibiotic use, and we absolutely love having these conversations with our members and watching them improve without a trip to the pharmacy.
We’re here for you! As always, please reach out to your apios provider for any questions!
