Steamboat Springs During this time of year, many Steamboat Springs residents are dealing with sinus congestion and pain, sore throat, post-nasal drip, cough, chest tightness, fever, chills and/or body aches. In other words, they are just plain feeling lousy.
Because Steamboat is a busy tourist destination, most viral illnesses in the United States - and many from overseas - make their way here. Unfortunately, antibiotics will not help these illnesses and can even cause harm.
Colds, the flu and most coughs and sore throats are caused by viruses. Antibiotics do nothing against viruses. A large body of research and evidence-based guidelines emphasize that acute bronchitis and most acute sinusitis cases are not bacterial infections.
Acute bronchitis is a short-term (lasting about two weeks) inflammatory illness involving the large airways in your lungs causing cough without pneumonia. Acute bacterial sinusitis is often dramatic and involves only one side of the face.
Strep throat is the only common type of sore throat caused by bacteria, and most health care providers can rule it out quickly with a simple test.
Please consider the following when you think you may need antibiotics:
Every ear infection does not require antibiotics. According to a joint practice guideline by the American Academy of Family Physicians and the American Academy of Pediatrics, most ear infections in children older than 2 years old get better on their own and are not helped by antibiotics.
Colored sputum or nasal discharge usually does not mean a bacterial infection. Color is a poor predictor of a bacterial infection. Many viral illnesses will cause colored discharge. However, in some patients with chronic lung conditions, such as emphysema, a change in sputum color or production may indicate the need for antibiotics.
Chest tightness usually is not a sign of pneumonia. Many viral illnesses and reactive airway disease can cause chest tightness.
Antibiotics will not help most sinus pressure or pain. Most viral illnesses, and allergies, can cause inflammation and mucous accumulation in the sinuses (sinusitis).
A cough that lasts for more than a week does not mean you have pneumonia. The cough from a viral illness sometimes can last three or four weeks.
Just because a person got better with antibiotics last time, the antibiotics may not have helped. The natural course for any viral illness is to get better with time. Taking an antibiotic may not have sped up recovery any faster than taking a sugar pill.
Why not just take antibiotics in case they might help? In addition to causing allergic reactions, unnecessary antibiotic use can harm people in other ways. The over-use and incorrect use of antibiotics has fueled a bacterial arms race and the rise of antibiotic-resistant bacteria.
Of particular concern is the growing incidence of methicillin-resistant staph aureus. MRSA is resistant to almost every antibiotic and usually requires intravenous medication. We have begun to see resistance to even our most effective antibiotics, such as Levofloxacin (Levoquin).
Another reason to avoid the unnecessary use of antibiotics is they can kill the good bacteria that live in balance in our bodies and help us to digest our food. Sometimes an unwanted bacteria, such as Clostridium difficile, can then overgrow. The result can be diarrhea, cramps, food intolerances and other intestinal symptoms. Many women know antibiotic use can cause vaginal yeast infections.
Antibiotics will do nothing for most coughs, sore throats or sinus congestion. Most health care providers are following the rule "do no harm" when they tell a patient that antibiotics will not help their respiratory illness.
The unnecessary and incorrect use of antibiotics is putting all of us at risk. Some day you may have a serious infection that will not respond to antibiotics. Help yourself and fellow Yampa Valley residents by asking for and using antibiotics only when indicated.
Brian C. Harrington, MD, MPH is a board-certified family physician at Yampa Valley Medical Associates, P.C., and provides comprehensive health care to children and adults.