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By Ruchel Louis Coetzee
Posted On Sep 13, 2016

By Ruchel Louis Coetzee



The minute we feel a stuffy head or sore throat, our immediate instinct is to phone our doctor for an antibiotic or Z-pack to stop the so-called bug in its track. And when it comes to being a parent, we demand an antibiotic for our child’s flu symptoms before the pediatrician has even had the opportunity to render his diagnoses. This equation of cold = antibiotics has become so ubiquitous in recent years that alarm bells are starting to ring in the medical world. Why? Because studies are showing that some bacteria are now becoming resistant to antibiotics. According to the 2015 NTM Research Study conducted by HealthResearchFunding.org, 2 million people in the US acquire serious antibiotic-resistant infections each year and 23,000 people in the US die each year as a direct result of antibiotic resistant infections.


But are antibiotics even effective for all common colds?  The Centers for Disease Control and Prevention says that taking antibiotics for viral infections such as colds, flu, most sore throats, bronchitis, and many sinus or ear infections will not cure the infection. Antibiotics will also not keep other people from getting sick nor keep a child from feeling better. Antibiotics fight only bacterial infections, not viral infections, so to understand more about this rising dilemma, we turned to Lilian Abbo, M.D., Associate Professor of Clinical Medicine Division of Infectious Diseases at University of Miami Miller School of Medicine for further explanation and advice.


New You        Why should we exercise caution when it comes to taking an antibiotic every time we feel flu-like symptoms developing?


Dr. Lilian Abbo        The danger of using antibiotics when you don’t need them is that antibiotics kill certain bugs called bacteria. Many times we adults and kids end up catching respiratory infections that are not caused by bacteria like flu (the common cold), which are caused by a different type of bug called viruses. Antibiotics do not kill viruses, antibiotics kill bacteria and what happens when you take antibiotics for a cold or a sore throat, the antibiotics may not get rid of that cold but it will start killing the good bacteria that you have in your gut and other parts of your body. We need the good bacteria in the gut to digest the food and live healthy. When we start killing the good bacteria, those good bacteria become bad bacteria, which then become resistant to the antibiotics.


NY       What if those flu-like symptoms progress to more serious complications like bronchitis?


Dr. Abbo        It depends who you are, how healthy you are with your immune system, or if you are on chemotherapy. If the person has a bad immune system that does not protect them, then that can lead to complications. If we’re talking about a normal, healthy, young person, most of the time they will be able to overcome the bronchitis. If it’s viral, it will get cured.  However, there are some cases when antibiotics are necessary – for example, when you have a fever or when you’re coughing up phlegm that is dark or you see other signs and symptoms.


NY       On the one hand you kill the good bacteria with the frequent use of antibiotics and on the other hand you need the antibiotic to kill the bacteria causing dark or yellow phlegm. What are the dangers of choosing not to use an antibiotic when an antibiotic is the only solution for that symptom?


Dr. Abbo        Patients who are exposed to frequent viruses because of travel or who have young kids who go to day care or school and they choose not treat it with another round of antibiotics will experience other symptoms such as sinusitis occurring.


NY       When someone says, “oh, I’ll just get my doctor to prescribe a Z-Pak and I’m good to go,” how do you respond?


Dr. Abbo        That’s one of the biggest myths. A Z-Pak actually has Azithromycin and what we are seeing is an increase in resistance of some common bacteria. Bacteria causing meningitis or pneumonia are becoming resistant to Azithromycin and the same goes for Penicillin. We also see a lot of Penicillin kids – those kids treated frequently with Ampicillin or Amoxicillin. For example, a simple earache, is now becoming resistant to that treatment.  I’ll give another example. Gonorrhea, which is very prevalent in South Miami, was one disease back in the 1950’s or 60’s when Penicillin was first available, that you could kill with a single shot.  Today Gonorrhea has become one of those bacteria that have become very resistant to second and third generation Penicillin. Now you need a combination of treatments and in some cases there are no antibiotics available to treat this sexually transmitted disease.


NY       With such a stalemate, what happens next?


Dr. Abbo        Some patients are dying because they are becoming infected with resistant bacteria for which we don’t have any antibiotics available and this, unfortunately, is now a global problem. If we don’t use our antibiotics when we need them, the bacteria that are very smart become very strong and they have mechanisms of passing these resistant genes to one another. Then, when you really need an antibiotic, for say, a urinary tract infection, it is not going to work because you’ve been taking Z-Paks every time you experienced a common cold.


NY       What is the difference between a virus and bacteria?


Dr. Abbo        They are different organisms. It’s like comparing a snake with a mosquito – both can cause disease. Viruses are microorganisms. They replicate differently than bacteria and they cause disease in a different way. There are some viruses that can cause a lot of disease, but the common cold viruses are usually not treated with antibiotics and just go away because your immune system is able to fight that virus. Bacteria are different kinds of organisms and they also replicate differently than viruses. We have good bacteria that, for example, live in your gut, that help you digest your food. There are other bacteria we call bad bacteria, or pathogenic bacteria, that may cause diseases with the same intensity as viruses. We also, don’t have any viruses that are just part of our body and that just live with us. With bacteria we have good and bad bacteria and the way they replicate is different and the way we kill them is different.


NY       How do you recognize whether the bug is a virus or bacteria?


Dr. Abbo        Oh, that is tough – that is one of the most difficult questions in medicine. There are some blood tests nowadays that can help us identify if it is a bacteria or a virus. There are even some culture methods that can give you an answer within a couple of hours. The swab in the nose or a swab in the throat is now becoming available to doctors.


NY       At the start of flu season, do you recommend taking a flu shot?


Dr. Abbo        I get a flu shot every year. I do think if you have kids, get them immunized so they don’t get sick, then you don’t have to miss work and they don’t miss school days. Getting your annual flu shot can protect you from the flu. It may not protect you from the common cold because it’s a different bug, a different virus causing it, but a flu shot may protect you.  I also recommend high hygiene – washing your hands often and not coughing on your hands and then shaking hands with other people also helps prevent transmissions.


NY       Is there anything else you recommend?


Dr. Abbo        I recommend having a good immune system. Having a good immune system means avoiding stress because every time we’re stressed our immune system goes down. Anything to bring your immune system up such as yoga, meditation, thinking positively, and exercising will absolutely help you get strong and feel better – taking care of body and mind.