Why You Should Think Twice Before Taking An Antibiotic For Your Sore Throat: A Microbiologist Explains

Medical Microbiologist By Douglas Toal, Ph.D.
Medical Microbiologist
Douglas Toal, Ph.D., DABMM, is the Vice President of Clinical Laboratory Operations at Metabolon, Inc. He obtained his Ph.D. in Microbiology from the University of Oklahoma and completed a fellowship in Clinical Microbiology at the Mayo Clinic in Rochester, MN.

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As winter approaches and our tendency to catch colds and influenza increases, it's good to be aware that the CDC estimates approximately 46 million of us will be prescribed antibiotics that we do not need.

This shocking estimate comes from a recent CDC study published in the Journal of the American Medical Association (JAMA) showing that out of the estimated 154 million antibiotic prescriptions made in outpatient settings during 2010 to 2011, 30 percent were unnecessary. That's an astonishing statistic especially when we consider how the overuse of antibiotics results in deeply concerning increases in antibiotic resistance.

More antibiotic use means more antibiotic resistance.

Research tell us that global antibiotic consumption grew by 36 percent between 2000 and 2010, and at the same time, our ability to treat sick people with antibiotics has become more and more compromised. In some countries, resistance of deadly pathogens to our most powerful antibiotics had already reached 57 percent by 2014.

Recently the CDC announced the discovery of an E. coli bacterium in a UTI patient that is resistant to a powerful antibiotic called colistina—a real eye-opener since colistin is often a last resort drug used to treat patients with infections that are already resistant to other medications.

In simple terms: Our overuse of antibiotics has resulted in the emergence of bacterial pathogens that are no longer treatable. And while this is scary stuff, don't despair. There are some simple rules to live by that will make you part of the antibiotic solution, not the problem.

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This is how to use antibiotics responsibly.

One of the most important things to remember is that antibiotics are incredible drugs that can save lives—if used appropriately. And we all have a responsibility to ensure that these powerful drugs are reserved for the sick patients who need them the most, especially those with compromised immune systems, cancer, organ transplants, and trauma patients.

To help accomplish this, here are a few helpful facts that every patient should know when prescribed an antibiotic:

1. Antibiotics are effective against bacterial infections, but they do NOT treat viruses.

Many respiratory infections (like the common cold, sore throat, bronchitis, influenza, viral pneumonia, and sinus and ear infections) are actually caused by viruses. And this means that an antibiotic simply will not work. The best defense against viral infections is our highly capable and efficient immune system. Eating healthy and staying active is a great way to ensure that your immune system is firing on all cylinders.

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2. Sore throat does not equal strep throat.

Approximately 37 percent of children and 18 percent of adults who go to the doctor for a sore throat actually test positive for the group A Streptococcus bacterial pathogen. And for these patients, an antibiotic prescription is advised. Unfortunately, approximately 56 percent of children and a whopping 72 percent of adults with sore throats received antibiotics from their doctors in 2010 to 2011. That mean we—as a society—are consuming (and in some cases demanding) antibiotics that we do not need.

3. National guidelines are available.

Guidelines for whether or not antibiotics should be prescribed have been published for a long list of ailments including sinusitis, ear infections, sore throat, pharyngitis, and bronchitis. Doctors should be aware of the guidelines and as patients, we should know that they exist and that they have been established using good science and many years of experience. The next time you are prescribed antibiotics, have these guidelines handy to review with your doctor.

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4. Antibiotics should not be taken lightly.

Antibiotics are powerful pharmacological drugs that destroy massive amounts of good and bad bacteria in our bodies. Recent scientific findings have shown that our gut flora—the complex community of microbes that live in our digestive tract—plays an essential role in immunity, digestion, and overall health. Antibiotics do not target specific pathogens; they kill indiscriminately.

And despite being widely prescribed, the oral consumption of antibiotics exposes our gut flora to chemicals that can cause microbial imbalances and lead to unhealthy consequences. For some individuals, antibiotic usage can result in serious allergic responses, and in others, antibiotic use can cause the emergence of a harmful pathogen known as Clostridium difficile. It's important to remember that antibiotics have their own side effects and should not be taken unless they are truly needed.

5. We have a national goal to reduce inappropriate antibiotic use.

In March of 2015, the White House announced the National Action Plan for Combating Antibiotic-Resistant Bacteria, which established the goal of reducing inappropriate antibiotic use in the outpatient setting by 50 percent in 2020. In order to reach that goal, 15 percent of the antibiotic prescriptions (or about half of the 30 percent of unnecessary prescriptions that are currently made) should be eliminated by 2020.

The goal is aggressive, and we all have an important role to play in educating ourselves and making sure we are using these drugs responsibly. By ensuring that antibiotics are prescribed and taken only when needed, it will protect the health of communities all over the world and preserve the power of lifesaving antibiotics for those who truly need them.

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