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Antibiotic Uses and Overuse

When are antibiotics good, and when are they harmful? How is overuse of them harmful? And what do mutant armies have to do with this? Dr. Rob answers all.

By
Rob Lamberts, MD,
July 15, 2009
Episode #005

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Hi gang! (Cough, cough) This is Dr. Rob, and this is The House Call (cough) Doctor’s Quick and Dirty Tips for Taking Charge of Your (cough) Health.

Sorry about that. I’ve been coughing like this for a few days. I’ve even had some fever. I wonder if I may need an antibiotic!

(Buzzer Noise)

Wrong answer! I get people coming into my office with many of the same thoughts. But they aren’t just wrong; they could actually be hurting themselves. The proper use of antibiotics is a very important subject for everyone to understand; so that is what I will cover in today’s podcast.

Let me warn you that this episode is longer than usual. This is a big subject that really requires more explanation than other subjects. It still qualifies as quick and dirty, but just less quick than usual.

Let me again remind you that this podcast is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.

What are Antibiotics For?

First let me explain what antibiotics do. Antibiotics treat infections. Infections are the invasion of your body by teeny-tiny bad guys called germs. The two main kinds of germs are bacteria and viruses (although fungi can be pretty bad dudes as well).

Bacteria and Viruses: the Good and the Bad

Some bacteria and even viruses aren’t bad. They wipe their feet and make sure they follow the local customs. Some bacteria even benefit us, and we become sick when they are not present. But other germs are pretty rude guests. They take food that is not theirs, leave their waste all over the place, and generally wreak havoc. They even sometimes release toxic pollution and sometimes multiply so quickly that they kill off the person whose place they crashed.

Sigh. Oh, how I wish instead that they’d join hands with us, share the food, and sing Kumbaya. It’s a hard world we live in, folks.

How Your Body Reacts to Infections

Fortunately, your immune system is really good at knowing which guests will follow the rules and which ones are bad news. It’s the job of certain white blood cells in your body to police the areas where germs hang out, making sure they regret their decision to make you their home. They either kill of the germ themselves, or they take a picture of it and circulate that picture around the rest of your body -- kind of like those pictures of people in the post office. No, they aren’t actual photographs; they are special proteins called antibodies which are made by the white blood cells  to carry the image of the bad guys around for all to see. So the next time the germs try to get in, antibodies grab them, which is a signal for the white blood cells to come kill the offending germ.

So what does this have to do with antibiotics? Well, remember those really bad germs I told you about that put out so much pollution that they kill their host? These germs are especially good at avoiding the post offices, sneaking around in shadows, and giving the white blood cells the slip. That is when infections like pneumonia and meningitis can cause problems. Antibiotics were made to help the body fight off these crafty little buggers so they can’t do their damage. Their invention prevented millions of deaths from infectious diseases.

So What’s the Downside?

Antibiotics of sorts have been around for thousands of years but only came into widespread use in the early 20th century. Prior to antibiotic therapy, simple infections like bladder, ear, and sinus infections could potentially become life threatening. So when antibiotics became available, they were used with abandon.

But something happened. Each infection contains a gazillion bacteria (they are really, really tiny) and while the antibiotic kills off almost all of them, some are mutants (kind of like the X-Men, only evil) and can resist the deadly antibiotic. Fortunately, the white blood cells arrive on the scene, clean things up, and send out antibodies to go up in the post offices and do their noble duty. Some of these mutants, however, hide in the shadows. They lurk in places where they can’t be seen, waiting to get their revenge. They don’t mutiply; they just lay low and bide their time.

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