EP.19 - To Antibiotic or not Antibiotic

We all know the names, penicillin, Z-pack, Amoxicillin, and Bactrim and we have been taking them for as long as we have been breathing, but do we really know what antibiotics are, how they work, and what they do to our bodies? Antibiotics, in a nutshell, kill bacteria, the bad ones and the good ones and if you have a viral infection no amount of antibiotic treatment will be any help and ultimately can be detrimental to your overall health. In this episode, Dr. Swain teaches Stacy all about antibiotics, how he prescribes the right one for a diagnosis, and why prescribing a patient an antibiotic (or not) is one of the hardest things he has to do every day. Plus, Dr. Swain explains common, and severe antibiotic side effects, allergies, resistance, and why there is not a one size fits all approach to prescribing these life-saving drugs.

Big Questions?

What is an antibiotic, and how do they work? How many types of antibiotics are available? What is an antibiotic allergy and what are typical reactions? What are the common and severe side effects for antibiotics Why it’s beneficial not to take an antibiotic on an empty stomach? How does a doctor know which specific antibiotic to prescribe What are the three most common type of bacteria? Are doctors prescribing too many antibiotics and why is this dangerous? What is antibiotic resistance?

 

Need an Appointment or Sinus Consultation?

Call Dr. Swain’s nursing staff at 251-470-8823 or schedule an appointment here.

Quotables & Tweetables?

I would name the show to antibiotic or not to antibiotic because that is the question that doctor's face all day long. - Dr. Swain

If I'm going to err, I'm going to err on giving this person an antibiotic because I don't want my patients to get sicker. - Dr. Swain

Viral illnesses will not respond to antibiotic treatment. - Dr. Swain

An antibiotic is a chemical that we use to kill bacteria. We use some antibiotics, they have different properties, obviously for killing different types of bacteria for different kinds of infections and some antibiotics actually have anti-inflammatory properties. - Dr. Swain

Sometimes we use antibiotics because they have a specific biochemical pathway that we use to decrease inflammation. - Dr. Swain

The easiest way to think about antibiotics is in terms of different categories. There are penicillin-based antibiotics. Then there are cephalosporin antibiotics, there are lots of those. And then there are fluoroquinolone antibiotics, and there are lots of those. And so we have antibiotics that are classified into what they do, and then in terms of those families. - Dr. Swain

The Food and Drug Administration is really vigilant about making sure that there's not an antibiotic that has side effects that need to be monitored or observed and they just need to make sure the drug is safe. - Dr. Swain

Sometimes people can get severe reactions where they even have their skin started peeling off or have trouble breathing or have the swelling of their throat or their mouth or their tongue. And so those are obviously the more severe reactions, but it can vary. - Dr. Swain

One of the common side effects of just taking antibiotics is to have your stomach upset sometimes, or you get a little bit of nauseated. That's just a side effect of taking the medication. - Dr. Swain

We tell people don't take an antibiotic on an empty stomach. You always want to take it with food to kind of buffer the GI side effects with it. - Dr. Swain

Basically, this chemical that you're taking goes and attacks the bacteria, and it does so in different ways. It can kill the bacteria. There are bacteriocidal antibiotics, where it kills the bacteria, and there are bacteriostatic antibiotics that kind of prevent the bacteria from growing. Depending on the situation, you would use a different kind of drug. - Dr. Swain

The three most common types of bacteria for those is usually strep pneumonia, Moraxella catarrhalis, and Haemophilus influenza. - Dr. Swain

Sometimes when people are really sick, you're not going to wait four or five days until you get a lab report back before you initiate antibiotic treatment. - Dr. Swain

If you have a viral illness like mononucleosis, you can use all the antibiotics and the world, it's not going to affect the mononucleosis. It's a viral illness, The hard part about all this is usually when you have a sinus infection, it doesn't start with bacteria just jumping in your sinus. It starts with a cold, it starts with a viral illness, and then you get swelling and mucosal thickening and stasis of the secretions, and the little sinus cavity in there closes off, and then you start getting the yellow discharge, and the pain in your teeth and you know, the purulent drainage and that's when you know you've got a sinus infection and that's when you need an antibiotic. - Dr. Swain

It's hard sometimes to look at somebody and go, okay. I know you feel terrible, but this is a cold. This is a viral illness. Take some Motrin and Tylenol and oh, by the way in a week, your either going to get over this or you're not, and then we're going to start antibiotics then. - Dr. Swain

A patient doesn’t want to get worse, and they think they want an antibiotic now. That's reasonable thinking, but sometimes that is not necessarily the best thing to do in terms of trying to use antibiotics appropriately and ultimately keep that person safe. You don't want to be on so many antibiotics that they don't work when you need them. - Dr. Swain

Generally, you do not want to start any antibiotics if you don't need them. - Dr. Swain

Communicating your medical and illness history is one of the most effective ways of getting the right diagnosis and proper treatments. - Dr. Swain

There are some situations where you would start an antibiotic early, but for the majority of people, if you've got a run of the mill upper respiratory tract infection we try to get those people to use the over the counter medicines initially for the first 24, 48, 72 hours and see what's going on with them. - Dr. Swain

Every patient situation is different, and there's nothing like examining someone and getting their history. There's is not a one size fits all approach for antibiotic treatment. - Dr. Swain

When suffering from a cold and you start to feel the pain in your teeth, and they're starting to feel swollen, that's when they need to give your doctor a call and get an appointment. - Dr. Swain

 

Need an Appointment or Sinus Consultation?

Call Dr. Swain’s nursing staff at 251-470-8823 or schedule an appointment here.

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