By Dr Umberto Russo MBBS, FRACGP
In my many years practising as a GP and after hours home doctor, I have seen thousands and thousands of cases of acute respiratory infections (e.g. colds and flu). When treating this type of illness, there is one question patients ask more than any other. “Doctor, do I need antibiotics?” And the answer in most cases is a resounding “No”.
Most people mistakenly believe that antibiotics will cure their cold or flu, and help them recover more quickly. Antibiotics are seen as a “magic medicine”, and a trip to the doctor that doesn’t result in a script for antibiotics is often seen as a waste of time. Hence, doctors are under enormous pressure to prescribe antibiotics, even though they know it will have little effect against the viruses which cause colds and flu.
Since their momentous discovery in 1928, when scientist Alexander Fleming first noticed that a mould called Penicillium notatum inhibited the growth of bacteria, antibiotics have saved millions of lives. Their role in fighting bacterial infections has been the most significant advance in life-saving medicine.
Unfortunately, the world embraced antibiotics with a gusto that led to them being taken even when the infection being treated was not bacterial. And the biggest culprit of antibiotic overuse by far is humankind’s most frequent infectious disease – acute respiratory infections or the “common cold”.
Respiratory infections, characterised by fever, chills, sore throat, runny nose, and cough, are responsible for more than seven million visits to the doctor each year in Australia. The average adult will catch two to four colds a year, while the average child may catch between six and eight.
Coughs, colds, and flu, and the accompanying symptoms, are caused by viruses, and so do not respond to antibiotics. The majority of colds and flu are “self limiting” infections (infections that will get better on their own). Despite this, it is estimated that more than half of cases presented to GPs result in an antibiotic prescription. In fact, Australia has one of the highest rates of antibiotic use in the world. The misuse and overuse of antibiotics has now reached crisis proportions – because bacteria, as they always have, are fighting back.
Bacterial resistance to antibiotics is a threat to healthcare worldwide, with 25,000 deaths in Europe alone being directly attributed to antibiotic resistance. New strains of bacteria are becoming resistant to most commonly available antibiotics, and “superbugs” have developed that can pass their resistance to other bacteria. This means that many common infections (such as ‘strep’ throat or UTIs) may eventually become untreatable with medicines.
At the same time, taking antibiotics unnecessarily is also bad news for your gut, where millions of “good” bacteria reside, doing all kinds of important work maintaining your immune system, balancing your blood and breaking down nutrients in food. Antibiotics target both “good” and “bad” bacteria indiscriminately, so each time you take antibiotics unnecessarily, or “just in case”, there are side effects you should be aware of.
I’m not saying that you should never take antibiotics, but you should only take them when your doctor recommends it. Patients and carers should understand that coughs and most colds, ear aches, sore throats and other common symptoms of respiratory infections – even middle ear infections and bronchitis - will improve without antibiotics. We should save the power of antibiotics for when you or your children need them.
Unfortunately we still don’t have a magical cure for the common cold. The best treatment is rest, fluids and over-the-counter medication such as Lemsip or Cold and Flu tablets. And it is vitally important to practise good hand hygiene, to prevent the spread of germs.
Of course, when you are concerned about an illness you should always seek medical advice. Especially with babies and young children, illness is always a worry, and it’s always best to talk to your Doctor if you are concerned. If illness strikes in the after hours, you can call 13SICK or use the App to book a bulk billed doctor home visit. Our Doctors treat all kinds of illnesses in the after hours, they carry starter packs of most commonly prescribed medications, so you can get started straight away if a prescription is required.
Dr Umberto Russo MBBS (Adelaide) FRACGP is Chief Medical Officer at 13SICK, National Home Doctor Service. He has more than 25 years' experience both as a General Practitioner and a visiting home doctor, with a special interest in urgent medical care.
NPS Medicinewise Antibiotic Resistance: the facts
The Conversation Why GPs prescribe too many antibiotics
Australian Family Physician The respiratory tract: addressing antibiotic resistance
NPS Medicinewise Cold Coughs and Flu: What you can do
NPS Medicinewise My Child has a middle ear infection: is an antibiotic necessary?