Antibiotics - The cure becomes a problem

The discovery of antibiotics in the 1940s drastically improved health care in America, but they also could be creating a health-care crisis.

Antibiotics are powerful tools when used correctly, said Dr. Michael Kolda, emergency room medical director at Southeast Missouri Hospital. Yet the overuse of antibiotics can have a detrimental impact on society.

Antibiotics are used to treat bacterial infections. Viruses like the common cold aren't treatable with antibiotics.

Overuse of antibiotics makes them less effective in treating illnesses because greater strengths of the drug are needed to kill the bacteria.

"If you use an antibiotic too often, you get sensitized to it and it's not available to you when you really need it in the future," Kolda said.

Penicillin was a powerful tool when it was first introduced, but overuse caused some strains of bacteria to develop a resistance to it. A more powerful drug was needed.

Heavier doses

In many cases, doctors prescribe 750 milligrams of an antibiotic today when they would have prescribed only 200 milligrams 10 years ago, said Jeff Smith, manager at the Healing Arts Pharmacy.

Issuing unnecessary antibiotic prescriptions defeat the drug's purpose, he said. The frequency of patients requesting well-known antibiotics can lead to their ineffectiveness, he said.

Parents often call the family pediatrician asking for an antibiotic for a child with a sore throat or runny nose and temperature. Using antibiotics repeatedly make them less effective because the bacterial microorganism can adapt and become resistant to the drug, Smith said.

While most people realize that some medications can cause adverse side effects like rashes or diarrhea, people still expect to receive a prescription when they visit the doctor.

"Society expects a solution to every problem and a cure for every ill," Kolda said. Often, time is the best prescription a doctor can give.

"There is a lot of pressure on health-care workers to provide a definitive treatment for any illness," he said. And with plenty of consumerism in health care, people will continue to search for what they want.

Patients today are more informed about the drugs available, but that can be a double-edged sword, Smith says, if the patients start making requests before being treated by a doctor.

"Most physicians are very meticulous when prescribing antibiotics," Smith said. "It's important to diagnose the condition and find out what the organism is" before issuing any medications.

The U.S. Centers for Disease Control and Prevention has been working for almost five years to educate the public, physicians and patients about the problem of antibiotic resistance. The CDC continues to develop strategies to combat the problem.

Cipro concern

With the recent anthrax scares, health-care officials were concerned that Cipro would become overused and ultimately less effective for treating soft tissue infections and serious urinary tract infections.

The drug is extremely powerful and lists pages of possible side effects and warnings. With a threat of anthrax, the risk to an individual is greater from the side effects if taking the drug unnecessarily than contracting anthrax, Koldra said.

The biggest challenge doctors face is determining when it's best for a patient to receive an antibiotic prescription and when it is best just to let time pass for their body to heal, Kolda said.

If you have symptoms of a cold -- runny nose, aches and pains and low-grade fever -- clearly the risks outweigh the benefits of prescribing an antibiotic, he said.

With illnesses like colds and influenza, treating the virus with an antibiotic doesn't alleviate many of the symptoms any faster. Usually taking antiviral drugs for the flu only shortens the symptoms you'll feel by a day or two, Koldra said.

ljohnston@semissourian.com

335-6611, extension 126