If you develop the flu, a cold or a sinus infection this winter, you might be tempted to ask your doctor for an antibiotic.
But pressuring your doctor for antibiotics can backfire. For one thing, colds and the flu are caused by viruses, and antibiotics don’t work against viral infections. So the prescription not only won’t help you feel better but also can be a waste of money. Worse, it can lead to dangerous, even deadly allergic reactions and side effects, and make the drugs less likely to work when you really need them.
That’s because inappropriate use of antibiotics breeds superbugs — bacteria that often can’t be controlled even with multiple drugs. The Centers for Disease Control and Prevention estimates that more than half of all antibiotics used in this country are prescribed inappropriately.
That has tragic consequences. At least 2 million Americans are sickened each year by resistant bacteria, and 23,000 die as a result.
Here’s how to avoid using antibiotics when you don’t need them and the steps that will enable you to use them safely.
Prevent infections. The best way to avoid antibiotics is to sidestep infections in the first place. One key step: washing your hands often, using plain soap and water. That’s especially important before preparing or eating food, before and after treating a cut or wound, and after using the bathroom, sneezing, coughing or handling garbage. Steer clear of antibacterial hand soaps and cleaners: There’s no evidence that they work any better than regular soap, and they may promote antibiotic resistance. Also, get recommended vaccines, such as those that protect against the flu and pneumonia.
Skip antibiotics for cold and flu. Instead, ask your doctor about treatments that can help you feel better, such as an over-the-counter pain reliever, throat soother, antihistamine or decongestant. If you’re at high risk of flu complications — because you’re older than 65, pregnant or have a chronic condition such as asthma, diabetes or heart disease — ask your doctor about the antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza).
Don’t rush to antibiotics. Even if your infection is caused by bacteria, that doesn’t necessarily mean you need an antibiotic. If your symptoms are mild and complications are unlikely, ask your doctor whether you can delay treatment for a few days. Then call or visit your health-care provider again to see whether you really do need medication. In some cases, you might be able to fight off the infection without it.
Be wary of broad-spectrum antibiotics. These antibiotics — which include cephalexin (Keflex and generic), ciprofloxacin (Cipro, Proquin and generic), levofloxacin (Levaquin and generic) and tetracycline — kill multiple types of bacteria. That might sound like a good idea, but that shotgun approach is more likely to breed resistance and wipe out good, protective bacteria in your body. That opens the door for the bacterial infection Clostridium difficile. At least 250,000 Americans people develop C. diff infections linked to antibiotic use each year, and 14,000 die as a result. If possible, opt for a narrow-spectrum antibiotic that targets the bug causing your infection. That means your doctor should try to order tests to identify the specific bacteria.
Ask for the shortest course necessary. Longer isn’t necessarily better. In some cases — such as for certain urinary-tract, ear and sinus infections — a shorter duration works equally well, which can reduce your risk of complications. Also, ask your doctor for the lowest dose of antibiotics necessary to treat your infection.
Follow directions carefully. When antibiotics are necessary, it’s important to not skip doses or stop the medication early, even if you feel better. And don’t use leftover antibiotics from a previous prescription to treat a new infection. That drug might not be the right one for your current problem.
Use creams sparingly. Even antibiotics applied to the skin can lead to resistant bacteria. So use over-the-counter ointments containing bacitracin and neomycin (such as Neosporin and generic) only if dirt remains in a wound after cleaning with soap and water.
Watch for side effects. Antibiotics can save lives, but they can also have dangerous consequences. Contact your doctor if you have severe or lingering diarrhea, stomach pain or vomiting after taking antibiotics. And get immediate medical care if you experience any of these less common but potentially more serious side effects:
● Severe skin rash
● Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles or lower legs
● Difficulty breathing or swallowing
● Yellowing of the skin or eyes
● Unusual bleeding or bruising
● Dark-colored urine
● Blisters or peeling of the skin
● Unusual muscle weakness
Be especially alert if you’re on fluoroquinolone antibiotics such as ciprofloxacin (Cipro, Proquin and generic), levofloxacin (Levaquin and generic), and moxifloxacin (Avelox and generic). They increase the risk of ruptured tendons, depression, hallucinations, suicidal thoughts and aortic aneurysms. Contact a doctor if you suffer tendon pain or swelling, or emotional disturbances.
For more information about the use of antibiotics and the rise of antibiotic-resistant bacteria, visit consumerreports.org/ superbugs.
For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.