Antibiotics 101

With cold season comes a surge of patients asking providers for antibiotics, hoping the fabled Z-Pak will cure what ails them before they miss an upcoming holiday party. While this may seem harmless, taking an antibiotic when you don’t need one actually has many negative effects. In this blog, we will talk about antibiotic resistance, when you actually need an antibiotic, and what to do if you don’t.

Let’s first talk about when it is appropriate to take an antibiotic. Antibiotics work to fight bacteria and will not be effective against a virus. Below I have listed out some common bugs that fit into each category.

  • Viral: common cold, flu, COVID, bronchitis
  • Bacterial: Strep throat, impetigo, pertussis, bacterial pneumonia, urinary tract infections

Other illnesses, like sinus infections, ear infections, and pink eye, can be caused by either. In these situations, it is best to see a healthcare provider who is trained to determine if it is viral or bacterial in origin. If you have been under the weather for a couple of days it is likely viral in origin, whereas bacteria tend to rear their ugly heads around the 10-14 day mark. Sinus infections are a good example of this. Most sinus infections are caused by viruses and, although you may feel lousy, you will get better in about a week without an antibiotic. If you have had a sinus infection for about two weeks and are not showing signs of improvement it's likely a bacterial cause.

If you should need an antibiotic, keep in mind that:

  • Different antibiotics cover different bacteria. The medicine you would take for one bug may not work against another. Taking your mother’s leftover pills from a UTI she had six months ago may only give you unpleasant GI side effects.
  • You must take all of the antibiotics you are given, even if you are feeling better.
  • There are good bacteria that live in your gut that your body needs to function correctly. Antibiotics can’t tell the difference between these good bacteria and the bacteria making you sick, so it will wipe out both. This is why you might have unpleasant GI side effects when taking an antibiotic, not because you are allergic. Taking a probiotic two hours after the antibiotic can help reduce these symptoms.

Antibiotic resistance is the term used for when bacteria have adapted and evolved so that the medicines previously used to treat them no longer work. While this process does occur naturally, the misuse and overuse of antimicrobial medications is accelerating it. If this continues, eventually there will not be antibiotics available that work to treat bacterial infections when you actually need them, making illnesses like pneumonia even more threatening.

You can think of this like a fight between bacteria and an antibiotic. For the antibiotic to win the fight it has to be the right medicine to face a particular germ and it has to have enough time to win (i.e. you can’t stop taking the antibiotic early because you feel better). If the antibiotic were to lose, that bacteria can spread the information of how to take down that specific type of antibiotic to other bacteria so that those bacteria can also learn how to beat the antibiotic. If the bacteria knows how to beat the antibiotic, it is considered resistant to it. Taking an antibiotic when you have a viral illness can also contribute to this. The antibiotic will solely attack good bacteria working in your body as there are no illness-causing bacteria present. These bacteria may then become resistant to the antibiotic. The healthy bacteria that live in your body also aid the immune system. If the antibiotic is successful in removing these bacteria, this can also clear the way for disease-causing bacteria to take their place.

Antibiotic resistance doesn’t just affect the person who was taking this antibiotic. These resistant bacteria can spread to other people as well. For example, let's say I get sick and take an antibiotic that I do not need or the incorrect antibiotic. The disease-causing bacteria in my body may then become antibiotic-resistant. If I were to get other people sick, I would be passing an antibiotic-resistant bug to them. If this were to keep happening eventually all of that type of bacteria would be able to defeat that antibiotic, making it useless against that bacteria. If a bacteria becomes resistant to most types of antibiotics it becomes a “superbug” which can be incredibly difficult to treat leading to increased morbidity and mortality. Creating new antibiotics is a very time-consuming and expensive process and there have been fewer and fewer antibiotics created as time goes on.

Everyone can do their part in slowing this healthcare crisis. Don’t take an antibiotic unless you truly need it, and never take a medication that was not prescribed to you. If you are prescribed an antibiotic, take it as directed until you have taken all of it. If you are not sure if you need an antibiotic see your healthcare provider. In the meantime, get lots of rest and fluids. You can take over-the-counter medications as well to help with symptom relief. The general rule of thumb with exercise is that light to moderate exercise is likely safe if all of your symptoms are above the neck (sore throat, congestion, etc.). It may still be a good idea to take a day off to rest. It is better to rest and avoid getting others sick than to push yourself and end up with a longer recovery time!

Did you know you can strengthen your immune system through exercise and nutrition? Learn more about PUSH511's customized nutrition coaching, group CrossFit classes, and personal training sessions, and stay healthy during this cold & flu season!

About the Author

Cristen Headshot

I am a Licensed Registered Dietitian with experience in critical care, cardiology, weight loss, allergy services, and food service. I graduated from Penn State University with a BS in nutrition and finished my RD training at University of Maryland. I am currently in PA school and am looking forward to combining my love of nutrition with medicine. After moving to Baltimore in 2019, I did a trial class at PUSH511 Fitness as I was looking for accountability and to meet new people. When I walked into the gym for the first time, everyone was congregated on one side cheering on a member who was struggling with ring muscle-ups at the end of the workout. It was such an uplifting moment to witness. I left the gym that day in dire need of ginger ale, but also very excited about this amazing and supportive community I had stumbled upon. I am grateful for this opportunity to give back and share my love of nutrition!


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