5 Times When You Should Say ‘No’ to Antibiotics


Antibiotics | Source: iStock

Proceed with caution the next time you visit your doctor. Public health officials have estimated that up to half of all antibiotic use in America is either unnecessary or inappropriate. Alexander Fleming, who discovered penicillin, warned that misusing the drug could result in selection for resistant bacteria. Antibiotic resistance then emerged just 10 years after the widespread introduction of penicillin. Today, superbugs have grown into one of the major health crises of the modern era. The CDC even called one of these antibiotic-resistant superbugs the “nightmare bacteria.”

The sources of the problem span from how we raise livestock to rapidly-spreading infections in hospitals to doctors grossly over-prescribing antibiotics. When it comes to the inappropriate use of antibiotics, the costs go way beyond your pocketbook. No one wants to pay for a medication that’s not going to work anyway, but that should be the least of your concerns. Each year, at least 2 million people are infected with drug-resistant superbugs. Roughly 23,000 die from them.

As a patient, there are things you can do to help. One of the most important steps you should take is to start questioning whether you truly need a prescription for antibiotics, even when your doctor is ready to dole them out.

Consumer Reports says first you should take precautions to prevent infections from occurring in the first place. When you do need the drugs, take them as directed. Do not use leftover antibiotics or share them. Use antibiotic creams sparingly. If you don’t have a bacterial infection, don’t try to convince your doctor otherwise. You can also request targeted drugs or ask to delay treatment for a few days so you can attempt to fight off the infection without drugs.

With the help of a list from Consumer Reports and the Choosing Wisely initiative, we have outlined five common conditions that typically don’t require antibiotics.

1. Ear infections

having ears examined at the doctor

Treating an ear infection | Source: iStock

When your child gets an ear infection, you don’t want to sit back and do nothing. But according to the American Academy of Family Physicians, most ear infections improve on their own in two to three days without the use of drugs, especially in children age two or older. In severe cases or when children under two years old experience moderate to severe pain, antibiotics might be required.

2. Eczema

itching skin

Eczema doesn’t always require antibiotics | Source: iStock

Some doctors try to control eczema symptoms with antibiotics, but these drugs do nothing to help relieve the itching, redness, or severity of the skin condition. Ask your doctor about other ways to control symptoms, such as moisturizing the skin and avoiding irritants. In some cases, a medicated cream is prescribed. Antibiotics should be prescribed only when there are signs of a bacterial infection like bumps or sores full of pus, honey-colored crusting, very red or warm skin, and/or fever.

3. Pink eye

pink eye

Pink eye | Source: iStock

According to Mayo Clinic, not all cases of conjunctivitis are bacterial. Pink eye can also be viral or allergic. The American Academy of Ophthalmology says most cases are not bacterial and even in cases when bacteria are responsible, the condition usually goes away by itself within 10 days. If you have bacterial pinkeye plus a weak immune system, or you are experiencing severe or persistent symptoms, then you should consider antibiotics.

4. Respiratory infections


A man coughing | Source: iStock

Most colds, coughs, and cases of bronchitis or the flu are actually viral, so antibiotics will be no help at all. Strep throat, however, is bacterial. But according to the American Academy of Pediatrics, less than 15% of sore throats in adults are strep. So if you have a sore throat, insist on a strep test before taking antibiotics. For other respiratory infections, you should only think about antibiotics if your symptoms last longer than 10 to 14 days or you are diagnosed with a bacterial illness.

5. Sinus infections

blowing your nose

A sinus infection | Source: iStock

Sinusitis is typically viral as well, and even when bacteria are the cause, infections often clear up without treatment after about a week. Many sinus infections can be treated with saline nasal washes, when done properly. “Each rinsing will simply wash away about 90% of the infection and make it much easier for your body to heal,” Jacob Teitelbaum, MD, told Prevention. Consider antibiotics for a sinus infection only if symptoms are severe, show no improvement after 10 days, or get better but then worsen.

For the full list of conditions that commonly trigger inappropriate use of antibiotics, see Consumer Reports’ full report.

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