Are Antibiotics the Cure-All?

Nowadays, when people get sick, the question is: “To see or not to see a doctor?” Unfortunately, most of the population chooses not to see a doctor. The money they save from not seeking consult means more budget for basic necessities. So, what do they do? They either go to an albularyo or self-medicate. ^4,3 For those who choose the latter, the story is the same. First, they assume that all illnesses can be cured by antibiotics. The flu, a sore throat, a stomachache, you name it. Then, they use an antibiotic which was previously prescribed to them, or to a relative, or to a friend of a friend of a friend. Never mind the fact that the antibiotic was used for a totally different illness or for just remotely similar symptoms. Lastly, the moment they feel better, they stop the antibiotic.

To make things worse, drug stores dispense antibiotics even without doctors’ prescriptions. In studies by Lansang, et al, antibiotics were dispensed without prescriptions 66.3% and 56.6% of the time in Metro Manila and Laguna, respectively.

According to Dr. Cybele Abad-Alvaran, an Infectious Disease specialist from the The Medical City and Philippine General Hospital, “In the US, where I practiced for a few years, the commonly misused and abused antimicrobials, both in the outpatient and hospital setting, include quinolones (e.g. Levofloxacin, Ciprofloxacin), macrolides (e.g Azithromycin), and cephalosporins (e.g. Ceftriaxone). In the hospital where I worked, we jokingly referred to Levofloxacin as Vitamin L, just because it was used almost on a daily basis, like a vitamin! I have not been back in the Philippines for very long, but from my limited experience, and based on some research, I think the most frequently abused antimicrobial in the Philippines belong to the Penicillin class. Examples of this would be Amoxicillin and Amoxicillin-Clavulanate (e.g. Augmentin/ Co Amox- Clav).”

Clearly, antibiotics have been doctors’ allies since the discovery of penicillin in 1928 by a Scottish scientist, Alexander Fleming. But contrary to popular belief, antibiotics are not cure-alls. Yes, they are used to treat microbial infections but antibiotics are specifically designed to treat BACTERIAL infections. However, not all illnesses are caused by bacteria. Some are caused by viruses and fungi, for which antivirals and antifungals are used. See the difference? Sometimes, a virus doesn’t even need any medication. It is self-limiting. This means that it goes away on its own after taking its course. The perfect example of which is the common cold. Fruits, lots of water or juice, and bed rest do the trick just fine.

So, what happens if the antibiotics are not used properly?

Drug Allergy/Drug Reaction – This can range from a simple, itchy rash to a severe, life-threatening allergic reaction called anaphylaxis with map-like rashes, swelling of the eyelids and lips, difficulty of breathing, and low blood pressure. Another scary reaction is Stevens Johnson Syndrome wherein the full-blown condition involves sheets of skin, clumps of hair, and whole nails falling off ever so easily.

Kidney and/or liver problems – Drugs in general are transformed into their active compounds in the kidneys and liver. Naturally, when antibiotics are used too frequently, these vital organs take a beating.

Imbalance of intestinal flora – In our intestines, there are good bacteria, bad bacteria and fungi. When we take antibiotics longer than we are supposed to, the bad bacteria tend to overpower the good bacteria and fungi. This leads to bowel problems like cancer of the colon and ulcerative colitis (large intestine ulcers).

But most importantly, Dr. Abad-Alvaran added that, “The main effect of the indiscriminate use of antimicrobials is drug resistance. This means that the ‘germs’ we are trying to get rid of develops immunity against the antibiotic, and renders it ineffective. An example of this is the rise of Methicillin Resistant Staphylococcus aureus or MRSA in the community, which developed in large part because of the indiscriminate use of penicillins such as amoxicillin.” A MRSA infection starts out as an ordinary boil but instead of getting better after a week-long course of penicillin, it later becomes a deep abscess in the skin which can dig even deeper into the bones, blood, heart and lungs.

In conclusion, Dr. Abad-Alvaran had this to say about antibiotics, “Doctors should all practice antimicrobial stewardship or the proper use of antibiotics — the right antibiotic for the right disease, at the right dose, for the right length of time. Patients should listen to their doctors and follow their doctors’ instructions. Forcing your doctor to prescribe antibiotics may be harmful in the long run. But the reverse is also true — once given an antibiotic prescription, skipping antibiotic doses, or not completing the antibiotic course, leads to development of drug resistance.”

Now, you think your cold might not be as common as you originally thought? Go, see a doctor!

Source: DOH