Do you really need those antibiotics?

In 2007 there were two important studies published that should make all of us think twice about when we REALLY need to take antibiotics. In early December there was a study published in one of the premier medical journals, in which they found that routine antibiotics do not seem to speed the recovery from an uncomplicated sinus infection. Even though more than 90% of the doctors in the US will prescribe antibiotics for sinusitis, it is unclear whether they really help. This study confirmed earlier studies and found that about one-half of the people were better in one week and two out of three people were better in ten days, regardless of whether they took an antibiotic. Interestingly, nasal steroids sprays which are also often prescribed, did not seem to help much either.

Another important update came from the American Heart Association which updated its recommendations for when to give preventive (prophylactic) antibiotics to prevent heart infections. In the past, they recommended that hundreds of thousands of people with all sorts of fairly minor heart problems and heart murmurs should take a big dose of antibiotics before dental work, or certain urinary or gastrointestinal procedures, such as the use of scopes to look in the colon or the bladder. This was thought to be important in order to prevent serious infection of the heart valves (endocarditis). Earlier this year, these experts looked at all the scientific data and concluded that only a small portion of these people really needed the antibiotics. If you want to find out which groups of people need the antibiotics, go to http://www.americanheart.org/presenter.jhtml?identifier=11086 where you can also download a handy wallet card.

Unnecessary use of antibiotics clearly leads to increasing bacterial resistance as well as risks of allergies, potential side-effects, unneeded cost, etc. Many doctors will prescribe antibiotics even when they think that the clinical situation does not call for it because they think the patient really wants the medicines and will insist. Often antibiotics are essential and life-saving, but the next time your doctor recommends antibiotics, especially in cases of sinusitis or for prevention of heart valve infection, it may be reasonable to ask the doctor, “Do I really NEED that antibiotic?”.