“There’s an antibiotic for that”
Have you ever taken, or been advised to take, an antibiotic for something “just incase”? Apparently, lots of us have or do, as 1 in 5 people expect antibiotics when they visit their doctor (1). But it takes two to tango and doctors also share a huge responsibility as 1 or 2 in 10 antibiotic prescriptions issued by GP’s may be inappropriate (2). Most of these inappropriate prescriptions are for sore throats, coughs, colds and ear infections (2).
Today (23rd October 2018) Public Health England (PHE) launch their national campaign ‘Keep Antibiotics Working’ to help reduce the number of inappropriate prescriptions for antibiotics by raising awareness of the issue of antibiotic resistance (3).
What are antibiotics and when should they be used?
Antibiotics are a group of medicines that are used to treat infections caused by bacteria and certain parasites. They do not work against infections that are caused by viruses – for example, the common cold or flu. Even with mild bacterial infections, such as sore throats or ear infections, the immune system can usually clear it on its own and antibiotics do very little to speed up recovery. So in some cases your doctor may not recommend an antibiotic based on their clinical judgement. Of course there are instances where antibiotics are essential, and often life saving, for example in the cases of sepsis, meningitis, or pneumonia. This is why it is absolutely essential that we keep them working by stopping the rise of antibiotic resistance.
How does antibiotic resistance happen?
The more we use antibiotics, the more opportunities there are for bacteria to develop resistance. That means that if the time comes when you really need them, the antibiotics may not actually work.
Antibiotics work by inhibiting the growth and survival of the bacteria through various mechanisms (such as destroying the cell wall). However bacteria can change in response to these antibiotics and develop protective mechanisms to survive, and as they grow and multiply, they can transfer the gene for resistance to another bacteria. This leads to the development of superbugs that are resistant to the antibiotics which makes infections much harder to treat. As a result it is estimated that at least 5,000 deaths are caused every year in England because antibiotics no longer work for some infections and this figure is set to rise with experts predicting that in just over 30 years antibiotic resistance will kill more people than cancer and diabetes combined (1).
Furthermore, antibiotics like any medication have side effects. While every antibiotic is different, the most common side-effects include; diarrhoea, or mild stomach upset (nausea), thrush, rashes, and in rare cases people may have a severe allergic reaction (4). Antibiotic use can also disrupt the balance of the good bacteria in the gut.
What can we do?
In order to combat resistance, it’s not a matter of never using antibiotics, it’s just about using them appropriately – and that responsibility lies both with healthcare professionals who prescribe them and the patient/general public.
Colds, most coughs, sinusitis, ear infections and other infections usually get better without antibiotics (5).
Sore throat 7-8 days
Sinusitis 14-21 days
Common cold 14 days
Cough or bronchitis 21 days
Middle ear infection 8 days
Most of these conditions are self limiting and can be treated with self-care :
- Rest
- Drink enough fluids
- Ask your local pharmacist to recommend any over-the-counter medications to help your symptoms.
- Check out the Treat Your Infection prescription pads at the bottom of this post.
If concerned seek medical advice urgently from NHS 111 or your GP.
When to seek help:
- you’ve had a cough for more than 3 weeks (persistent cough)
- your cough is very bad or quickly gets worse, for example – you have a hacking cough or can’t stop coughing
- you have chest pain
- you’re losing weight for no reason
- the side of your neck feels swollen and painful (swollen glands)
- you find it hard to breathe
- you have a weakened immune system, for example because of chemotherapy or diabetes
See a GP urgently if you’re coughing up blood.
Find out more about how you can make better use of antibiotics and help this vital treatment effective by visiting www.nhs.uk/keepantibioticsworking
Resources
(1) https://www.gov.uk/government/publications/health-matters-antimicrobial-resistance/health-matters-antimicrobial-resistance
(2) https://academic.oup.com/jac/article/73/suppl_2/ii36/4841818
(3) https://campaignresources.phe.gov.uk/resources/campaigns/58-keep-antibiotics-working/Overview
(4) https://www.nhs.uk/conditions/antibiotics/side-effects/
(5) https://campaignresources.phe.gov.uk/resources/campaigns/58/resources/2133
