Doctor’s Tip: Overuse of antibiotics |

Doctor’s Tip: Overuse of antibiotics

Dr. Greg Feinsinger
Dr. Greg Feinsinger

Sulfa antibiotics were first used in the 1930s. Penicillin was discovered in 1928 and first used as a drug in the early 1940s. This class of drugs revolutionized the practice of medicine, and subsequently several additional antibiotics were developed. 

Antibiotics have saved millions of lives. For example, it is now rare for people to die from bacterial infections such as bacterial pneumonia, kidney infections, blood infections, wound infections and meningitis. However, largely because of overuse of antibiotics in humans and in farm animals, some bacteria have developed resistance to available antibiotics. 

An article in the December issue of the American Family Physician journal notes that “antibiotic resistance is among the greatest public health threats today. The CDC estimates that more than two million antibiotic-resistant infections result in at least 23,000 deaths annually in the United States.” 

Furthermore, antibiotics can have side effects such as allergic reactions, which can sometimes be fatal. In addition, antibiotics destroy good bacteria such as health-promoting bacteria in the gut microbiome, and it can take a year after a course of antibiotics for the microbiome to fully recover. You might have heard of C. diff, a harmful bacterium that can overwhelm the gut when “good” bacteria are destroyed. 

Antibiotics treat bacterial infections but have no effect on viruses, such as those that cause illnesses like the common cold, influenza and COVID. The average adult gets a few viral infections a year, and the average child more. Typical cold symptoms include low-grade fever, head and body aching, nasal congestion, sore throat and cough, which usually resolve in 7-10 days. 

Unfortunately, colds are often treated with antibiotics, even though they are useless for this condition. The American Family Physician journal article notes that “studies show that up to 10 million antibiotic prescriptions per year are inappropriately directed toward respiratory tract infections” caused by viruses. One recent study of 15,000 outpatients with acute URIs (upper respiratory infections) found that 41% of patients prescribed antibiotics did not have an indication for them. 

There are three primary reasons that inappropriate antibiotic use continues to occur:

1. Patient demand: Often patients demand antibiotics and become upset if they leave the office without a prescription for one.

2. Physicians often take the easy way out: Unfortunately, there are pressures on physicians these days to see a lot of patients quickly, and the easiest way to get a patient out the door and move on to the next patient is to write a prescription for an antibiotic, rather than taking the time to explain why antibiotics are inappropriate.

3. Eighty percent of antibiotics in the U.S. are used for farm animals. Conscientious farmers only use antibiotics for sick animals with bacterial infections, but factory farms often use them routinely and inappropriately to “prevent illness.” 

If you just have a sore throat, especially if you also have swollen, tender lymph nodes in your neck, you should have a test to see if you have an infection caused by the streptococcus bacteria, which should be treated with penicillin to avoid rheumatic fever and glomerulonephritis (a kidney disease). Other symptoms that could indicate something serious and which should lead you to seek urgent medical care include difficulty breathing, swallowing or talking; chest pain; high fever; stiff neck; or shaking chills. 

If you have typical URI symptoms noted above, there is no reason to see a doctor, and certainly no reason to take an antibiotic. If you develop red flag symptoms listed above, this could mean a complication such as pneumonia, and you should seek immediate care. Also consider getting checked out if you have less severe symptoms lasting much over 10 days. 

For aching or low-grade fever, acetaminophen is the safest thing to take. Be aware that OTC cold and cough meds often cause side effects that are worse than the cold symptoms and should generally be avoided. 

In summary: Antibiotics can be lifesaving if you have a bacterial infection, but are ineffective against viral infections such as the common cold. Don’t put pressure on your doctor to prescribe them, and if an antibiotic is appropriate, don’t demand a “big gun” antibiotic when a less strong one will do. If your provider does prescribe an antibiotic, question whether it is really necessary. 

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment, or email

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