Antibiotics - The Good, Bad & Ugly 💊🦠🌎
The antibiotic drugs people have depended on for decades are losing their superpowers, thanks to strains of bacteria that have adapted to resist them.
Antibiotics often are seen as wonder drugs. And, in many ways they are. Antibiotics revolutionized medicine and have saved countless lives over the past century. Unfortunately, many health care providers now rely too heavily on antibiotics and prescribe them when they aren’t necessary. Patients also have come to expect – and even demand – antibiotics every time they get sick.
Nearly 50% of the antibiotics prescribed in the United States aren’t appropriate for the conditions being treated. Why?
Today, I’d like to talk about the very real world challenge with antibiotic use, and consequences that go along with taking them(especially if not needed). 💊🌎🦠
Before we get started, I hope you learned some interesting tidbits from last week’s newsletter on ”Are you feeling “Taxed?”, stress and how it ultimately affects your health”, if you missed it, you can click this link, Here.
OK, let’s talk “Antibiotics” - the Good, Bad and Ugly!
💊 🌎 ☠️ 🦠 💊 🦠 ☠️ 🌎 💊
WHEN YOU NEED THEM, WHEN YOU DON’T
Antibiotics are a type of medication that are prescribed to patients in order to kill bacterial infections. They are given more than 154 million times a year and many reports state that close to 50% of the time it is unnecessary. That is a scary statistic that should make us all take pause, since there are many very serious consequences that go along with taking antibiotics, especially if they are unneeded.
For example, an overuse of antibiotics in our society has caused a rapid rise of antibiotic-resistant infections such as MRSA. Not to mention the many direct side effects of antibiotic use. About 14,000 Americans die every year from diarrhea caused by antibiotics and many others have to live with permanent damage to their nerves, tendons, and skin. These shocking facts should have us questioning: what are these antibiotics doing to our immune systems?
A large part – close to 75 percent – of your immune system resides in your microbiome. Antibiotics are known to damage this collection of bacteria in your gut which is vital in maintaining optimal immunity and health. The antibiotic ciprofloxacin, for example, has been shown to reduce (3) the bacterial diversity of your microbiome by about one-third. Even though most of the bacterial diversity recovered after the round of antibiotics ended, some bacterial strains still hadn’t recovered six months later. You can read more details, HERE.
The average child in the United States and other developed countries has received 10–20 courses of antibiotics by the time he or she is 18 years old. Long-term changes to the beneficial bacteria within people's bodies may even increase our susceptibility to infections and disease.
Why is this a problem? Because it’s led to a surge in antibiotic-resistant bacteria that are becoming increasingly difficult to treat. In fact, the first bacteria resistant to last-resort antibiotic treatment was identified in the United States in May 2016.
It’s important to learn which conditions antibiotics can treat, why antibiotic resistant infections are so scary, and how doctors and patients need to be smarter about antibiotic use.
WHAT DO ANTIBIOTICS DO?
I often see patients who come in complaining about a cough, sinus pressure, or earache and leave disappointed because I didn’t prescribe an antibiotic. But antibiotics can’t cure everything.
Antibiotics treat bacterial infections. They do not work against infections caused by viruses (viral infections). So which illnesses are bacterial and which are viral?
Examples of BACTERIAL infections:
Strep throat
Pneumonia
Urinary tract infections (UTIs)
Skin infections
Examples of VIRAL infections:
Cold
Flu
Bronchitis
Most coughs
Most sore throats
There are instances in which an illness could be bacterial or viral, such as an ear or sinus infection. The JAMA study found that of the 17 million prescriptions written for sinus infections – the most common reason to prescribe antibiotics – 6 million were unnecessary.
For antibiotics prescribed for acute respiratory conditions (like coughs or congestion), only half were deemed appropriate. This is because the vast majority of upper respiratory infections are viral, not bacterial.
Viral infections, for the most part, just have to run their course. Symptoms can last two to four weeks. I know you want them to clear up in a few days, but we never want to give you a medication that you don’t need – especially one that won’t help you get better.
While antibiotics are prescribed often, they are not without risks.
In fact, one out of five visits to the emergency room for an adverse drug event is due to an antibiotic. One common antibiotic, Azithromycin (more commonly known as a Z-Pak), can cause a potentially fatal arrhythmia in people with pre-existing heart conditions. Even amoxicillin carries a risk of serious side effects. Read more, HERE.
Besides the risk of side effects, there is another reason to avoid prescribing antibiotics when they are not needed: antibiotic-resistant infections.
THE RISE OF ANTIBIOTIC-RESISTANT INFECTIONS
When antibiotics were first discovered, there was a boom in developing new ones. However, that has slowed dramatically since the 1950s. In fact, a new class of antibiotics hasn’t been discovered in the past 30 years. We’ve been prescribing the same drugs for years because they’ve worked – until now!
Bacteria are smart. They evolve in order to survive future antibiotic attacks. The more often an antibiotic is used, the more bacteria develop antibiotic resistance, rendering the drug less effective. This is true even when an antibiotic is used to treat a viral infection. As we learned above, antibiotics don’t cure viral infections, but if taken unnecessarily, it will attack bacteria that weren’t even causing you harm – and the bacteria will adapt to avoid being targeted next time.
As bacteria become resistant to antibiotics, patients may need stronger antibiotics or may need to take them longer. Oral antibiotics may even stop working, and patients will need to switch to IV medications. Or, there may come a point where no antibiotic will work on a particular strain of bacteria.
The Centers for Disease Control and Prevention said 2 million people were infected by and 23,000 died from antibiotic-resistant infections back in 2013. Here is a link to an interesting article written way back in 2011 when “Stopping the killing of beneficial bacteria” research started surfacing; click HERE.
One report predicts that by 2050, antibiotic-resistant infections will kill more people than cancer!
By working together, we can help ward off this public health threat.
HOW FUNCTIONAL DOCTORS ARE CURBING ANTIBIOTIC OVERUSE
As the people prescribing antibiotics, providers need to be at the center of this effort. Every time we go to write a prescription for an antibiotic, we should ask ourselves if it’s truly needed. We also can’t give in to pressure from patients who demand an antibiotic when we know it won’t help them.
TIPS FOR PATIENTS
We need your help as well. There are three ways you can help fight antibiotic resistance:
We also often field calls from patients who want an antibiotic prescription but don’t want to come in for an exam. It’s important we evaluate you in person because so often these illnesses are viral, not bacterial. We may not be able to tell the difference on the phone.
It’s not unusual for patients to tell me, “Well, last time I had this, antibiotics cleared it right up.” I explain to them that every infection is different. They may have had a bacterial infection last time, in which case the antibiotics would have been effective. It’s also possible that it was a viral infection and their symptoms disappeared after a couple days not because of the antibiotic, but because that’s how viral infections work. The symptoms subside on their own.
As a patient, follow these guidelines:
Do not pressure a doctor to prescribe an antibiotic: You want to feel better fast. We want that, too. However, antibiotics won’t help in every case. Sometimes all we can do is give the illness time to pass. We often get calls from patients a day or two after visiting use who say they still don’t feel better and want an antibiotic. That just isn’t enough time for most viral infections to clear up. You still need a few more days – try to be patient.
When prescribed an antibiotic, ask, “Do I really need this?”:Asking, forces the doctor to stop and think, “Am I prescribing this properly?”
Don’t use old antibiotics for a new infection.
Don’t share antibiotics with family or friends.
HOW TO RELIEVE COLD OR UPPER RESPIRATORY SYMPTOMS
As I said earlier, viral infections can linger for two weeks or more. You may feel terrible for three or four days, but then the symptoms tend to fade away. During this time, you can use home remedies to help relieve your symptoms:
Cough: Honey, hot drinks, ginger, water, steam, neti pot, elderberry, menthol, humidifier and herbs (see detailed instructions, HERE)
Nasal congestion, allergies, and sinus pressure: fluids, humidifier, avoid cold, dry air, steamy showers, hot tea or soup (see detailed instructions, HERE)
Sore throat: Drink fluids, humidifier, warm teas with honey and lemon, warm water with salt gargles (see detailed instructions, HERE)
Fever: Call me, and I will assist you in whether you should reduce your fever, or not
The basics: Stay Hydrated and Get Rest. I know you want to get back to work and your daily life, but your body needs time to heal – plus you want to avoid giving the virus to someone else.
If you have a fever that lasts more than two or three days, call or come see me. If your symptoms last more than 10 days, or if you start to get better and then get sick again, call or come see me.
Antibiotics are not evil, and we shouldn’t fear them. But we need to use them responsibly to ensure they continue working when we need them for years to come.
THE BOTTOM LINE
“Each generation could be beginning life with a smaller endowment of ancient microbes than the last..”
A question I get asked all the time is whether functional medicine doctors can prescribe medication. The short answer is yes! Functional medicine doctors are real doctors, and they can prescribe medication when it’s necessary. However, we take a different approach to traditional doctors, in that we treat each individual holistically with the goal of restoring their overall well-being. This means that instead of treating the symptoms of a disease (like prescribing antibiotics), we treat the root cause.
Antibiotics are not evil, and we shouldn’t fear them. But we need to use them responsibly to ensure they continue working when we need them for years to come.
Bacteria are smart. They evolve in order to survive future antibiotic attacks. The more often an antibiotic is used, the more bacteria develop antibiotic resistance, rendering the drug less effective.
The CDC reported that 2 million people were infected by and 23,000 died from antibiotic-resistant infections over ten years ago.
Concerns about antibiotics focus on bacterial resistance — but permanent changes to our protective flora could have much more serious consequences.
One report predicts that by 2050, antibiotic-resistant infections will kill more people than cancer!
By working together, we can help ward off this public health threat.
If the tools that I shared today don’t offer any relief, or you are feeling that you may need an antibiotic, come in and see me. We will talk about your unique body and physical situation. You can make an appointment with me using this link: HERE.
Or, you can always give me a call at (973) 210-3838
I want to hear from you! What concerns do you have about antibiotics, when and how to use them? Did you find this newsletter helpful?
Share your thoughts in the comments on our
We bring tools such as these to you, our patients, by using proven cutting-edge therapies to extend the health-span, life-span and years of health for everyone (no matter their age)!
* * * * * *