Unfortunately, we as a country are one of the causative factors for increasing antibiotic resistance both here in New Zealand and globally. This needs to change.
There are two major aspects of this – doctor education and patient education. In this article I will be focusing on patient education.
Often I hear from my patients, “My ears hurt, I need antibiotics… My cold has gone to my chest, I’m coughing up gunk, I need antibiotics… I have a wound, I need to apply antibiotic ointment.” But is that correct?
Let’s focus on these three in particular.
- Ear “infections” – These are very common, especially in small children. More often than not, the middle ear gets blocked by the tube that connects the middle ear to the nose during a cold/flu/virus, which then begins to cause pain as pressure builds. The problem is not bacteria, but the viral effects causing a blockage, increasing pressure and thus pain. In recent years, advice from Starship Children’s Hospital reports no more than 4-5% of all inner ear pain would even have a chance of benefiting from antibiotics. Children under the age of six months especially require close inspection, but it is interesting food for thought! Ibuprofen will often be your best friend to help settle ear pain, taken regularly for 48 – 72 hours.
- Chest “infections” – A common side effect of a cold/flu/virus is mucus production down the back of the throat and a runny nose. Often after a few days to a week with a virus, this can then accumulate at the top of the chest, which you then begin to cough up, spit out or swallow. Because this is a natural body response to fighting the virus, this is expected. The latest reports from respiratory specialists have found colour change of the sputum (as a general rule of thumb) is no indicator for antibiotics/bacteria in the chest (pneumonia). If pain increases, shortness of breath occurs or you develop other symptoms outlying that of a normal virus/cold/flu, please get checked.
- Wound management – Often something done without thought, but our use of topical antibiotic creams is in the same boat – too much. Our skin is a living organ, the largest in the body, and applying topical antibiotics unnecessarily can also result in antibiotic resistance. A clean wound, rash or irritation does not need antibiotics. Skin specialists are recommending antiseptic wash or cream. This is the best approach, unless a wound has grown a bacteria on wound swab testing etc.
None of us enjoy being sick, we all want to do the best we can to fight it off as soon as possible. More often than not, antibiotics are not the answer, and can actually be causing you more harm than good.
As a doctor, daily I am put under pressure from patients adamant on antibiotics. Our goal is the health of you, our patients, but we also want to make you happy and comfortable coming to see us, so we want to try and meet your concerns and expectations! So together we need to change our expectations on what antibiotics are for and their appropriate use.