Want to Help? Just Say 'Whoa'
Bring up "antibiotic resistance" at the office lunch table and watch the eyes glaze over. But what if your elderly parent were desperately ill with pneumonia that wouldn't respond to antibiotics? Or you had a diabetic friend with painful skin ulcerations? Or your son, back from Iraq, had a raging blood infection? Is that personal enough?
The increasing demand and misuse of antibiotics aren't the only reasons hospitals are awash in bacteria that can fend off the drugs. The influence of low-dose antibiotics used as growth stimulants in food animals is almost certainly far greater. But if enough people changed their behavior, the onslaught of resistant bugs might be slowed, buying time to develop better drugs. Consider this expert advice:
Hold off. Viruses, not bacteria, are responsible for colds, flu, and most bouts of bronchitis and other upper respiratory illnesses. Antibiotics won't touch a virus. No matter how rotten your cold makes you feel or how often you blow vile gunk from your nose or cough it up, it is very unlikely that an anti-biotic will help.
Get a little culture. If your child has a sore throat, the physician should test for a particular germ--group A beta-hemolytic strepto-cocci--before starting an antibiotic. It is the main cause of the small percentage of sore throats caused by bacteria, found only 15 percent to 36 percent of the time.
Narrow is better. Many physicians take a shotgun approach, prescribing a broad-spectrum antibiotic like azithromycin rather than one that targets the offending bug. That can stimulate resistance in more than one type of bacterium. Ask whether a culture to identify the bacterium, followed by a narrow-spectrum drug, would be advisable.
Easy on the ears. Otitis media, a common condition in children in which fluid builds up in the middle ear, is not always painful, is rarely helped with antibiotics, and usually goes away on its own.
Take as directed. If an antibiotic is prescribed, don't stop taking it because you're feeling better. Bacteria that haven't been killed off are the tough ones. Those must die, too.
Wise up. The Centers for Disease Control and Prevention's "Get Smart" campaign has more advice concerning antibiotic use (www.cdc.gov/drugresistance/community/snortsnifflesneezespot/index.htm). Also check out the Alliance for the Prudent Use of Antibiotics, based at Tufts University School of Medicine (www.tufts.edu/med/apua) . And if you'd like to understand how resistant bacteria get that way, call up a color-ful animated video (www.fda.gov/cvm/antiresistvideo.htm) .
This story appears in the January 9, 2006 print edition of U.S. News & World Report.
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