Why Your Doctor Might Not Prescribe An Antibiotic
Since the 1940s, when penicillin was discovered, antibiotics have revolutionised medicine and saved many lives. Antibiotics can help clear up infections caused by bacteria, but not by viruses, worms or fungi. Being able to distinguish which illnesses result from bacterial infections is the key to using them successfully and will help you understand why your GP will not always give you a prescription for an antibiotic.
How Antibiotic Resistance Forms
Antibiotics can be very helpful when used appropriately. However, not every infection needs an antibiotic. Some illnesses do not respond to them and some germs can be become resistant if antibiotics are overused. Even worse, antibiotics can sometimes do us harm by killing the helpful bacteria which live naturally in our bodies and help in the digestive process. Sometimes it is simply better to let nature take its course, uncomfortable though that might be.
When Is An Antibiotic Needed?
Antibiotics kill bacteria - one of the types of germs which cause infections. They have no affect on many other germs, including viruses, or on worms and fungi. So if you want to know whether an antibiotic will help, you have to be able to tell which infections are caused by bacteria. This, of course, is where the difficulty arises because the symptoms of many sorts of infection are the same, whatever their cause. These symptoms can be a fever, aching muscles and a particularly sore spot at the seat of the infection. Bacteria can infect almost every part of the body but they favour particular places. The most common places that bacteria infect are:
• the throat, the sinuses and the tonsils
• the ear
• the chest
Sometimes doctors can take samples to tell what sort of germ is causing your infection. But this is not always helpful because it often takes several days before the results are known. More often than not, doctors have to rely on common sense. Your doctor will have a lot of knowledge and experience of the different types of germs which commonly cause infections. If there is doubt, he or she is best placed to know when and how to intervene.
The Main Uses Of Antibiotics
In general the following are useful in deciding whether or not an antibiotic will be useful.
• Sore throat and tonsillitis. Antibiotics may be useful if the symptoms have persisted for longer than 3 or 4 days; if the tonsils are big and swollen and exuding pus; or if the glands in the neck have become enlarged. However, glandular fever often looks like this, too, but it does not respond to antibiotics.
• Sinusitis. There are sinuses on both sides of your forehead, and behind your eyes. Antibiotics will be helpful if the skin over the sinus has become red and swollen or if you have a temperature and severe pain over the sinus.
• Chest infections. These often produce wheezing with phlegm and pains in the chest. The phlegm may be coloured (yellow or green) and sometimes contains blood. Because chest infections are among the more serious infections, most doctors use antibiotics for all cases.
• Cystitis (pain when urinating). This is usually treated with antibiotics. However, for women, it has to be distinguished from vaginitis which is not treatable with antibiotics. Cystitis (which is an infection in the urinary bladder) makes you want to pass urine frequently and is usually painful. Sometimes, there will be blood in the urine and a pain which passes up into your side.
In comparison, vaginitis is an infection in the vagina, commonly caused by thrush and can treated with pessaries (a 'plug' placed in the vagina).
Which Germs Don't Respond To Antibiotics?
Diarrhoea and vomiting are usually caused by viruses. Antibiotics have no effect on viruses and because antibiotics can cause diarrhoea as a side effect, often do more harm than good. However, if the diarrhoea has blood in it, antibiotics may be useful. Two of the most common infections, the common cold and flu, do not respond to antibiotics. Both are caused by viruses and both should have gone within a week. If the symptoms persist after this time you may have caught a bacterial infection and you should see your doctor.
What To Expect From Your GP
When you visit the doctor with an infection, don't always expect to be given an antibiotic. You may have a virus infection. You may get better just as fast without one. Keep an open mind. If you expect to receive an antibiotic, then the doctor may feel pressured to prescribe one. If you are given antibiotics then always take the whole course. Bacteria are less likely to develop resistance with a full course of treatment.
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