ANTIBIOTICS AND LOWER RESPIRATORY ILLNESS
Today is the first official day of summer, and so talking about bronchitis might not seem to go with the seasons. But there’s new important research out that looks at the treatment of the typically-winter illness, and whether certain medicines can cut short what is often a long, drawn out and annoying illness.
Antibiotics may not be helping those with respiratory illness, says new evidence. There’s a good chance that when you go to the doctor and expect an antibiotic you’re asking for something completely unnecessary.
Research in the Journal of the American Medical Association suggests that many reparatory infections can be resolved without the use of antibiotics as many of them last as long in spite of antibiotics.
Upper respiratory infections refer to infections of the nose, the sinuses, the ears, the throat, and laryx, like sinusitis, strep throat, and laryngitis.
Bronchitis and pneumonia, infections of the airways and lungs, are examples of lower respiratory infections.
Infections can be caused by bacteria, which do respond to antibiotics, or they are often caused by viruses, which do not. And even bacterial infections can resolve without an antibiotic treatment.
Still, patients are often determined to get an antibiotic. “Patients when they call a physician think they need an antibiotic. They expect that prescription is going to be filled because they believe as lay people they’ll feel better much more quickly with the antibiotics,” says Dr. Gregory Tino, an pulmonary specialist with the University of Pennsylvania Health System.
This is a huge issue: cough is the third most common reason for seeing the doctor, in New York and other places. In 2002, that meant 30 million visits to the physician; most of the patients get an antibiotic, often an expensive one can cost between 50 and 100 dollars per prescription. “The other thing we’re concerned about is antibiotic resistance which makes subsequent infections more difficult to treat. I can’t tell you how many times they say I got better because you treated with antibiotics when in fact they might have gotten better without the antibiotics,” says Dr. Tino.
This latest study shows that prescribing an antibiotic gives a person with a three week illness maybe a day less of phlegm, sleep problems and overall feeling lousy. But the cough didn’t go away faster, and can still last as long as a month!
So if you can accept the fact that coughs and bad symptoms won’t necessarily go away in a week, and may last much longer, and antibiotics won’t make a difference, then perhaps holding off on antibiotic prescriptions can affect the problem of antibiotic resistance, and help protect the effectiveness of these medicines for infections that truly warrant them.
Know that if you do get a bronchitis, the study shows you’re going to have around 12 days, on average of cough overall, but a quarter of individuals will have a cough for as long as 17 days. A quarter will have a bad cough for at least eight days, and these will typically go away without any antibiotic.
Reasons to definitely go to the doctor are high fever, difficulty breathing, wheezing, or any symptoms of bronchitis if you have significant conditions like heart or lung disease. But if you’re young and healthy, often you’ll do just fine without any antibiotic prescription.
For more information, go to www.jama.com
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