An­ti­bio­tics no cu­re for colds or flu

La Jornada (Canada) - - PORTADA -

CThis can mean days off work or school dea­ling with so­re th­roats, na­sal con­ges­tion and fe­ver. For pa­rents, it can be cha­llen­ging to com­fort young kids with fe­ver, coug­hing or ear pain.

As doc­tors, we know that both phy­si­cians and pa­tients would love a quick fix - a ma­gic bu­llet to deal with the­se sym­ptoms. Pa­tients want to get their li­ves back to nor­mal as quickly as pos­si­ble.

Un­for­tu­na­tely, an­ti­bio­tics are not usually the ans­wer.

An­ti­bio­tics are com­monly mi­su­sed be­cau­se peo­ple mis­ta­kenly be­lie­ve they will treat the sym­ptoms of colds and flus. In fact, fe­ver, cough and ear pain are usually due to a vi­rus - and vi­ru­ses aren’t af­fec­ted by an­ti­bio­tics.

Mo­re than half of all an­ti­bio­tic pres­crip­tions in Ca­na­da are es­ti­ma­ted to be un­ne­ces­sary - and inef­fec­ti­ve.

Com­mon con­di­tions that are usually vi­ral in nature but that are of­ten pres­cri­bed an­ti­bio­tics un­ne­ces­sa­rily in­clu­de si­nus in­fec­tions, ear in­fec­tions and chest colds (or bron­chi­tis). An­ti­bio­tics don’t ty­pi­cally help for any of the­se con­di­tions and the sym­ptoms will get bet­ter with sim­ple rest and ti­me.

It’s hard for us as phy­si­cians not to be able to of­fer a cu­re, and dif­fi­cult so­me­ti­mes for our pa­tients to ac­cept that the­re isn’t much to be do­ne asi­de from ma­na­ging their sym­ptoms and wai­ting it out.

A good first step is for doc­tors and pa­tients to have a con­ver­sa- old and flu season for many Ca­na­dians means get­ting ready to have their li­ves and rou­ti­nes th­rown off by pain­ful and an­no­ying sym­ptoms.

tion about the down­si­des of un­ne­ces­sary an­ti­bio­tics.

What harm can ta­king un­ne­ces­sary an­ti­bio­tics do?

Plenty.

When trying to treat sym­ptoms that are cau­sed by vi­ral in­fec­tions, an­ti­bio­tics don’t help and can ac­tually ma­ke pa­tients feel wor­se. An­ti­bio­tics work by stop­ping ill­ness-cau­sing bac­te­ria from gro­wing and mul­tiplying. When di­sea­ses are vi­ral in ori­gin rat­her than bac­te­rial, an­ti­bio­tics have no im­pact.

Using an an­ti­bio­tic when not nee­ded al­so pro­mo­tes the growth of bac­te­ria that are re­sis­tant to com­monly-used an­ti­bio­tics. This ma­kes pa­tients, es­pe­cially the el­derly, mo­re vul­ne­ra­ble to an­ti­bio­tic-re­sis­tant in­fec­tions and un­der­mi­nes the good that an­ti­bio­tics can do when they’re truly nee­ded.

The­re are al­so si­de ef­fects to ta­king an­ti­bio­tics; about one in four peo­ple who ta­ke an­ti­bio­tics ex­pe­rien­ce sto­mach up­set, diz­zi­ness or skin ras­hes.

The­re’s a new tool that you may no­ti­ce in your doc­tor’s of­fi­ce to help have con­ver­sa­tions about when an­ti­bio­tics aren’t ne­ces­sary - it’s ca­lled a vi­ral pres­crip­tion pad. This is a tear-off sheet si­mi­lar to what you might re­cei­ve for a pres­crip­tion, ex­cept it con­tains in­for­ma­tion about sym­ptom-re­lie­ving stra­te­gies for fe­vers, aches and pains. It al­so ex­plains the risks of un­ne­ces­sary an­ti­bio­tics and of­fers exam­ples of when you should go back to the doc­tor should your sym­ptoms wor­sen.

Re­cei­ving no an­ti­bio­tics for a cold or flu doesn’t mean no treat­ment. It just means a dif­fe­rent ap­proach.

One way to start the con­ver­sa­tion about whet­her an an­ti­bio­tic is really ne­ces­sary is to use the­se th­ree ques­tions de­ve­lo­ped by Choo­sing Wi­sely Ca­na­da when tal­king with your doc­tor:

Do I really need an­ti­bio­tics? What are the risks?

Are the­re sim­pler, sa­fer op­tions? Dr. Guy­lè­ne Thé­riault is a fa­mily phy­si­cian who prac­ti­ses fa­mily me­di­ci­ne in Ga­ti­neau, Qué. She is the as­sis­tant dean of Dis­tri­bu­ted Me­di­cal Edu­ca­tion, in the De­part­ment of Fa­mily Me­di­ci­ne at McGill Uni­ver­sity. Dr. Wendy Le­vin­son is the chair of Choo­sing Wi­sely Ca­na­da, a con­tri­bu­tor with Evi­den­ceNet­work.ca, which is ba­sed at the Uni­ver­sity of Win­ni­peg, and a pro­fes­sor of Me­di­ci­ne at the Uni­ver­sity of To­ron­to.

And using an an­ti­bio­tic when not nee­ded ma­kes pa­tients mo­re vul­ne­ra­ble to an­ti­bio­ti­cre­sis­tant in­fec­tions

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