Antibiotics: Cure or Curse?

Antibiotics: just say no!

First some background. Sinusitis is a huge problem that typically goes unnoticed. Over 30 million Americans are affected by sinusitis annually. In addition to the daily pain and suffering of those afflicted, additional  costs to society include 73 million days of restricted activity or lost work per year, and an estimated yearly financial burden of $5.8 billion.

Moreover, the vast majority of doctors themselves tell us they are dissatisfied with their ability to treat the disease. In a 2007 study published in The Journal of Allergy and Clinical Immunology, 202 doctors were surveyed from the US, UK, France, and Germany and  86% of them said they were generally unhappy with current treatment methods.

So here’s our issue – recent research gives us new insight into a major reason for our inability to treat sinusitis: the ill-advised use of antibiotics to treat a disease that’s typically viral-based.

Bacteria causes sinusitis in only 2% to 10% of cases, yet a national survey showed that 81% of adults presenting with acute sinusitis were prescribed antibiotics.

That’s like using a fishing rod to hunt deer, as bacteria and viruses are entirely different “animals.”

In fact antibiotics are so over-prescribed that sinusitis is now the fifth leading indication for antimicrobial prescriptions by primary care physicians.

The reason for wrongly prescribing antibiotics is that distinguishing between  bacterial and viral-bases sinusitis is difficult to do. Normally, the difference can’t be differentiated in the first 10 days of the onset of the illness.

So in 2012 the Infectious Disease Society of America issued guidelines to help doctors and their patients distinguish between the two.  Generally speaking the longer the symptoms last and the more severe they are the more likely it is that the problem is bacterial-based. IDSA defines severe symptoms as those that last for ≥10 days without improvement, high fever, i.e. ≥ 39°C  or  102°F, or a pussy nasal discharge or facial pain lasting for at least 3 to 4 consecutive days. 

Here’s one more thing to consider. What happens when you take an antibiotic when you shouldn’t? To begin with it won’t help you with your illness – you might as well have taken a sugar pill. But something else happens too: it kills off your “good” bacteria and what’s left over is the “bad” bacteria – those that are resistant to antibiotics (that’s why they’re still there). The resistant bacteria then go on to “multiply” taking over the space formerly occupied by the “good” bacteria.

So here’s the rub: say you eventually contract a bacterial-based ailment like pneumonia for which you require antibiotics – what happens when you take them? Nothing, the pneumonia will continue unchecked. And that’s because your bacteria are now resistant to antibiotics – remember, that’s what’s left after taking that first ill-advised batch of antibiotics. And that can put you in a very difficult spot when  you can’t treat something serious like a pneumonia – it can eventually heal on its own – or not.

The lesson? Before you ask for antibiotics or before your doctor decides prescribes them for you – for sinusitis or otherwise – be sure to ask this question: Doctor, how do you know my illness is caused by bacteria and not by a virus or some other pathogen?

The answer can be the difference between restored health and continued suffering – or between life and death.











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