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.

Rob Lamberts, MD
10-minute read
Episode #5

Tip 1: Wait

I have people coming in to see me who say: “The last time I got a cold, I got a sinus infection. I want to catch it now before it goes into one.”

While I appreciate their desire to avoid getting sicker, creating resistant bacteria is a much bigger risk. Even if there is a 50% chance it will turn into an infection needing an antibiotic, waiting until the illness declares itself is always the best policy. If I give antibiotics when you don’t need them, then they may not work when you do need them.

Tip 2: Wait Some More

I prefer waiting for a week before I treat cough or sinus symptoms. Studies show that people do just fine waiting. But don’t antibiotics make bacteria infections get better faster? The truth is, most bacterial ear infections and sinus infections will get better without antibiotics.

Don’t believe me? In one study of children with ear infections, parents were given pain-relief eardrops and a prescription for antibiotics and told to delay antibiotic use. Over half of these children didn’t end up needing an antibiotic, and they suffered fewer symptoms than the antibiotic-treated kids, many of whom had antibiotic side effects.[

Other studies have shown that real sinus infections got better just as fast without antibiotics as they did when antibiotics were given.[i To be honest, a lot of prescribing is still done more out of tradition than scientific fact. It’s hard to break old habits.

My point is this: if you don’t feel too bad, wait. Don’t see antibiotics as your only hope; see them as the last resort.

Tip 3: Use Other Treatments

Have you ever noticed that fast-moving streams are generally clear, while water that doesn’t circulate has stuff growing in it almost immediately? The same thing is true with mucous. One of the reasons your body puts out mucous is to flush out the respiratory tract and keep infection from coming. Using treatments that keep mucous flowing can prevent bacteria from moving in. Here are some ways to do this:

  • Drink lots of liquids. You have to stay hydrated to make mucous.

  • Humidify. Use of humidifiers, hot showers, and saline nose sprays can keep mucous flowing. 

  • Irrigate. Some people enjoy pouring large amounts of fluid in their nose, but most of us are a little squeamish about nasal irrigation. It really works, but I don’t blame you if you take a pass on this one.

  • Medicate. Expectorants like guiafenacin, which is found in Mucinex and Robitussin, can break up phlegm. Decongestants can open up the sinuses and allow flow.

  • These treatments aren’t foolproof, but they can prevent some infections and they can make you feel better.

Tip #4: See Your Doctor if You Are Not Sure

Tell your symptoms accurately and express your concerns. Most doctors will listen to their patients and give antibiotics when appropriate. Don’t get upset if you don’t get an antibiotic. Remember, it’s much easier for the doc to give in and prescribe than it is for them to wait. Ask lots of questions and make sure you know what to watch out for when you leave.

It’s not a waste to come in for this kind of thing. It’s better to come in and find out you have nothing serious than it is to stay home when you need to go in.

Tip #5: Know Warning Signs

There are some things that should alert you of danger, which means you need an immediate trip to the doctor. Here are some of them:

  • Fever and a stiff neck – this could mean meningitis

  • Cough, fever, and shortness of breath – this could be pneumonia.

  • Sore throat and a high fever – this could be strep. Strep’s not a terrible infection, but untreated it could lead to more serious complications.

  • Persistent or severe abdominal pain – this could be appendicitis, gall bladder infection, or other serious problems.

  • Finally, really young and really old people should be treated with caution. The “Wait” rule doesn’t apply to infants under 4 months or frail elderly people. Be very cautious with these and other frail people.

That’s it for today’s extended podcast (sorry it went long). I didn’t intend that it be the final say, but I hope you now understand why sometimes it is better to wait than to run to antibiotics. If you want to learn more about antibiotics in the meat you eat, check out Nutrition Diva's episode on just that topic.

The diagnostic process is fascinating, and anyone who watches "House" knows that. In episode 47 I'll start a series on mystery medical diagnoses.

If you have questions you want answered, send them to housecalldoctor@quickanddirtytips.com.

Catch you next time! Stay Healthy!


Antibiotics image courtesy of Shutterstock


Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.