How To Tell If You (Really) Need An Antibiotic + What To Do If The Answer Is Yes

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Antibiotics—or medications given to patients to kill bacterial infections—are prescribed more than 154 million times every year. And of those many millions of prescriptions, a staggering 30 percent are unnecessary, according to the CDC. Some reports even say that number is more accurately 50 percent, which is a statistic that should make us all take pause.

Why? Because there are many consequences to taking antibiotics—especially when you don't really need them.

For starters, using too many antibiotics has caused an epidemic of antibiotic-resistant infections. Bugs like MRSA—a bacteria that resists many common antibiotics—are spreading like never before, in part, because of our overuse of antibiotics. There are also many direct side effects to antibiotic use. Astonishingly, 14,000 Americans die each year from severe diarrhea caused by these drugs, and many more have irreversible damage of their skin, nerves, and tendons from antibiotic use. In addition, there's an important question that remains largely unanswered: What are antibiotics really doing to our immune systems?

We know that antibiotics disrupt the microbiome—the trillions of good bacteria in our gut—which is also conveniently where 75 percent of our immune system resides. Just a single use of antibiotics can cause changes in the microbiome, especially in the diversity of gut bacteria, and this is bad news because bacterial diversity is essential for our optimal health. The antibiotic ciprofloxacin, for example, has been shown to reduce the bacterial diversity by around one-third. While a majority of bacterial diversity eventually recovered after the round of antibiotics, some species still hadn't recovered six months later.

This is when antibiotics are actually useful (if not lifesaving).

So now that we've covered some of the dangers of overprescribing antibiotics, it's important to also recognize that there are many cases in which antibiotics are useful, and these drugs have saved many, many lives. It's all about distinguishing between when they're actually needed and when they're not. So when are antibiotics appropriate, exactly? If you're concerned you have an infection it's important to see a doctor to determine the nature of your illness, as some can be threatening. Here's what you should know about the two major categories of infection:

Viral infections.

Upper respiratory infections such as the common cold and the flu (influenza) are caused by a viral infection—not bacteria. Sinus infections and eye infections (pinkeye) are also almost always caused by viruses instead of bacteria. Remember, antibiotics kill only bacteria, so it's important to know what type of infection you're dealing with because they won't be effective against anything viral.

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Bacterial Infections.

Now that we know that antibiotics should be used only for bacterial infections, we still have to remember that there are a ton of different kinds of bacterial infections, so it's really a case-by-case basis. (And should be evaluated with the help of your doctor.) In general, most ear infections resolve on their own after a few days. Urinary tract infections can cause painful and difficult urination, and while many cases also resolve on their own, antibiotics can be helpful. Some skin infections—especially those that are red and inflamed—will benefit from antibiotics.

A word on natural antibiotics.

There are many natural antiobiotics that can work effectivey on their own for some infections or amplify the effect of pharmaceutical options. One of my favorites is oregano oil. Oregano oil has been shown to be effective against staph infections in conjunction with monolaurin (a by-product of coconut oil, another source with antibacterial properties).

How to support your body if you have to take antibiotics.

If you've gone through the necessary channels and you—and your doctor—have determined that you do have a bacterial infection, there's no reason to panic. In fact, there's a lot you can do to give your body a little extra TLC while you're on antibiotics. Here's where to start:

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1. Antioxidants.

Antioxidants are essential for optimal immune function, eating up free radical compounds that make us sick. And while our meals should be our primary source of antioxidants, there are some key players that I often add to an immune-balancing regimen:

  • N-acetylcysteine (NAC): NAC is a powerful antioxidant and a precursor to glutathione, one of our body's most potent natural antioxidants. In addition, NAC has been proved to be an effective natural antibiotic, beneficially regulating biofilms. Biofilms are basically bacterial protective slime and the cause of persistent bacterial infections.
  • Pterostilbene: This antioxidant is found in foods like blueberries, almonds, and grape leaves. This compound is chemically similar to resveratrol, but researchers are finding that pterostilbene is even more potent. Some studies show that pterostilbene is four times more bioavailable than resveratrol, and it has also been shown to increase the NAD (nicotinamide adenine dinucleotide) molecule, which produces anti-aging effects.
  • Curcumin and Turmerone: I could not talk about antioxidant sources without covering the active ingredients in turmeric, curcuminoids and turmerones, which are great for reducing the negative effects of antibiotics.
  • Andrographis: This herb is another one of my favorite natural antibacterial viral agents, and I frequently recommend it when a patient has to take antibiotics.

2. Probiotics.

For most people, I suggest taking quality probiotics, but this becomes especially important if you have to go on an antibiotic. This may seem contradictory, but studies have shown that they are effective during a round of antibiotics and also can reduce some of the antibiotic side effects.

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3. Bone broth.

Bone broth is one my favorite food medicines to nourish the primary home of your immune system—the gut. If you don't want to make your own, Bonafide Provisions is my favorite brand because it's handcrafted the same way it has been for centuries: in small batches. It's also in the frozen section in the health food store, meaning all that real food goodness is preserved. None of that shelf-stable broth in a carton!

When I am feeling under the weather, here's exactly what I do.

William Cole, D.C.

Functional Medicine Practitioner
Dr. Will Cole, leading functional medicine expert, graduated from Southern California University of Health Sciences as a doctor of chiropractic. His extensive postdoctorate education and training is in functional medicine and clinical nutrition. Dr. Cole consults people around the world via webcam and locally in Pittsburgh. He specializes in clinically investigating underlying factors and customizing health programs for thyroid issues, autoimmune conditions, hormonal dysfunctions, digestive disorders and brain problems. Visit www.drwillcole.com for free e-books, recipes, and webcam evaluation.
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William Cole, D.C.

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