When you're feeling miserable with a cough, fever, stuffy nose or stomach bug, it’s natural to want something that will help you feel better fast.
For many people, that means wondering whether an antibiotic is the answer. But antibiotics often are the wrong treatment, and taking them when they’re not needed can cause more harm than good.
Knowing when antibiotics help – and when they don’t – can protect your health now and help keep these lifesaving medicines working for the future.
When you need an antibiotic, and when you don’t
Antibiotics are powerful medicines that kill the bacteria that cause a number of infections in our bodies.
However, they don’t fight viruses, and many of the colds, flus, coughs and stomach issues we regularly face are caused by viruses. In these cases, antibiotics won’t help and could make bacteria harder to kill in the future.
This is why it’s important to stop thinking of antibiotics as the first thing to grab when you’re sick. It should be the last thing you grab, if all else fails. Most people are healthy enough overall that it’s safe to try other things first in hopes you’ll start feeling better without an antibiotic.
In the U.S., as many as 70% of antibiotics prescribed are unnecessary.
What are “superbugs”?
Overuse of antibiotics can lead to “superbugs.”
Superbugs are bacteria that have become resistant to many antibiotics – meaning they can’t be treated by those antibiotics. This gives us fewer treatment options and can lead to longer healing times or serious illness.
We refer to superbugs as “antibiotic-resistant” or “multidrug-resistant” bacteria.
These types of resistant bacteria can develop in individual people and spread through communities, healthcare facilities, food systems and the environment.
Why antibiotics can stop working
When we take an antibiotic for a certain illness, that antibiotic tends to go throughout most of the body, killing the targeted bacteria as well as good bacteria.
Bacteria that make it through the assault come out a little stronger, with the ability to survive treatment by that antibiotic. Over time, more and more bacteria become resistant to a variety of antibiotics.
Because bacteria reproduce and evolve very quickly, they’re becoming resistant to drugs faster than we can develop new antibiotics to treat them. As this happens, we may encounter infections that are difficult or impossible to treat.
The concern has become so great that both the World Health Organization and the U.S. Centers for Disease Control and Prevention have deemed antibiotic resistance an urgent threat.
What types of infections are caused by antibiotic-resistant bacteria?
Antibiotic-resistant bacteria can lead to infections anywhere in the body.
Some infections that have become more difficult to treat include bloodstream infections, pneumonia, urinary tract infections, abdomen infections, wound infections and after-surgery infections in incisions.
As bacteria become more resistant, the standard drugs used to treat these issues may no longer work.
Who’s at risk for antibiotic-resistant infections?
Every time you take an antibiotic, you’re taking a risk that can lead to antibiotic resistance and make future infections very difficult to treat.
Some groups are at even higher risk:
- People with weakened immune systems, including some cancer patients and organ transplant recipients
- People who need surgery or who have medical devices, such as dialysis lines, catheters or joint replacements
- People with chronic conditions that increase infection risk, such as diabetes-related foot wounds
When the usual antibiotics don’t work
When an antibiotic is not killing bacteria, doctors may have a lab perform cultures to determine the specific bacteria causing the illness. The lab then runs tests to determine which antibiotics will work against that bacteria.
In certain situations, an IV antibiotic may be needed.
Protecting against antibiotic-resistant bacteria
In the doctor’s office
- Understand that antibiotics won’t work against the many coughs, fevers, sinus symptoms and respiratory illnesses caused by viruses.
- Ask whether the illness is likely viral or bacterial and if treating symptoms and waiting is an option.
- If an antibiotic is not prescribed, ask about the signs to watch for that would mean an antibiotic is needed.
- If an antibiotic is needed, ask why the one being prescribed is the best choice, how long you need to take it and what side effects to watch for.
- Discuss any old records about penicillin allergies with a doctor, especially if the reaction was mild or happened in childhood. Removing an inaccurate allergy label may allow use of more appropriate antibiotics.
In the hospital
Antibiotic use is closely monitored in hospitals through antibiotic stewardship to help ensure that only patients who need antibiotics receive them – and that they receive the right drug at the right dose for the right amount of time. Further, care teams are required to obtain special approval to prescribe certain antibiotics to help prevent them from becoming obsolete.
There are also ways that you can help:
- Speak up. When prescribed an antibiotic ask: “Do I really need this?” “What is it treating?” “How long do I need it?” “What side effects should I watch for?”
- If your care team limits your antibiotic, understand that hospitals monitor antibiotic choice, dose and duration to protect patients and help preserve the effectiveness of the drugs.
- If recommended, follow isolation precautions regarding the use of gowns and gloves, and ensure that any visitors do the same.
- Follow rules about handwashing and sanitizing, and speak up to ask everyone entering and leaving the room to wash and sanitize their hands.
- Consider recommended daily skin treatments with antiseptic chlorhexidine gluconate (CHG). The germ-killing soap helps lower the risk of infection and may be recommended for patients in the hospital, especially those who have an IV line or other medical device.
When an antibiotic is prescribed
- Make sure dosing instructions are clear, and ask questions if there’s any confusion.
- Ask whether the antibiotic should be taken with food, on an empty stomach or at different times than other medications or supplements.
- Take the antibiotic exactly as prescribed and for the full recommended duration unless a doctor tells you to stop.
- Don’t save leftover antibiotics for a future illness.
- Don’t share antibiotics with family members or friends.
- If symptoms do not improve, return to the doctor rather than automatically asking for another round of antibiotics.
At home
The majority of infections come from our own bodies, when good bacteria goes where it shouldn’t. For example, good bacteria in the gut can cause infections if they get into a wound or into the bloodstream.
Certain habits that prevent viral spread won’t prevent these types of infections. However, there are steps you can take to stay safe.
- Avoid overreliance on products marketed as “antibacterial” for routine handwashing; regular soap is generally enough.
- Prevent infections based on personal health risks: Follow wound care instructions after surgery, manage chronic conditions and seek care promptly for concerning symptoms.
- Stay up to date on vaccines that prevent certain bacterial illnesses, such as pneumonia, meningitis and tetanus.
- Practice good hand hygiene with regular soap and water or alcohol-based sanitizer.
- To prevent viruses, use alcohol-based wipes or common disinfecting wipes when cleaning shared surfaces.
- Be aware of antibiotics in meat products, which can contribute to resistant bacteria that may affect humans. It’s not always possible or practical to avoid these foods, but be sure to handle all meat safely: Take steps to avoid cross-contamination and cook to safe temperatures.
- Reinforce education about antibiotic resistance by paying attention to public service announcements and materials, especially during “International Antibiotic Awareness Week” in November.
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