Why won’t my provider prescribe me antibiotics? Providers want the very best for each of their patients. If your provider thinks otherwise you may need to get a new provider. Seriously. If a patient does not need an antibiotic, it will not be prescribed. Because antibiotics can be harmful. How? Top 11 reasons antibiotics can be harmful –cause 10 was just not enough.
But Antibiotics Can Be Helpful…
Yes they can be helpful sometimes. Not beating around the bush here. Antibiotics are overused and overprescribed and they can hurt you. Yes, they save people from life-threatening bacterial infections. They kill group A strep –the bad guy that causes strep throat- preventing the rare rheumatic heart disease and kidney damage this can cause. They will cure your urinary tract infection. But their overuse is causing increased bacterial resistance. This may make the antibiotics we now have useless in the future.
Sweden has an extremely low antibiotic resistance rate. Their antibiotic use in 2015 was 4,722 daily doses per 1000 individuals. At the same time in the US our antibiotic use is 10,298 daily doses per 1,000 people. Do they get sick less often in Sweden? No, but they do a phenomenal job of educating the public about how antibiotics can be harmful and when antibiotic use is appropriate. Of the 40 patients I see in a day, about ½ mention antibiotics or directly ask for them while describing their symptoms. Keep in mind this is before the exam, before they have a diagnosis. Here are the top 12 ways antibiotics can be harmful:
Top 11 Reasons Why Antibiotics May Not be the Best Choice
Here’s my top 11 list of why antibiotics may not be the best choice for you. Understanding that sometimes we do NEED them, but maybe not as much as we think we do.
1. Increased Colon Cancer Risk
Increased risk of colon cancers. Antibiotic use has been found to have a causal relationship with rectal cancers. And in a ‘more you use the higher your risk’ kinda way (Brower 2019).
2. Not helpful
In many cases patient ask for antibiotics for viral infections or allergies. Antibiotics will not help these conditions. Providers try to educate our patients without creating an adversarial relationship or even gasp –a bad online review. Some patients are open to learning about what will really help them and others are not.
Then why are they prescribed? Sometimes for patient satisfaction. Sometimes we are concerned about upsetting the patient-provider relationship.
There was a great study done about provider fatigue –as a group we prescribe way more antibiotics in the afternoon than in the am. Why? Because we providers get tired, not great but true.
3. $$$$
Save your money, in the case of viral infections, you’ll get well in the same amount of time without spending the money on an antibiotic.
4. Pregnancy Risk
Antibiotics may make birth control ineffective –There is no medical proof this happens but there have been sooo many anecdotal studies. Medicine believes antibiotic pills may make oral contraception fail.
5.Antibioitc Resistance
We are seeing increased antibiotic resistance throughout communities, the country and the world. This may mean that when you really need an antibiotic, it may not be effective. Antibiotic Resistance – Check out the Resistance Map here https://resistancemap.cddep.org/AntibioticUse.php
6. Weight Gain
Antibiotics cause weight gain. Weight gain is one of the reasons we give antibiotics to cattle, chickens, and bacon, I mean pigs. In 2012, Professor Martin Blaser demonstrated that mice exposed to antibiotics gained 2X the amount of mice not exposed to antibiotics on the same diet. There are a number of mechanisms we think are at work to cause this.
In a human study, patients put on antibiotics for H. Pylori infections, saw a weight gain and an increase in the hormone Gherlin. Gherlin is often called the hunger hormone. It actually increased 6x and stayed elevated for 18 months. To make matters worse, Leptin, the satiety hormone, also gets kicked out of whack, so you still feel hungry even when you are not.
Antibiotics are equal opportunity killers. They kill the good bacteria as well as the bad bacteria. We are just starting to understand how important our gut microbiome (all the living bacteria and flora that co-exist) actually is. It has been suspected as being a key player in our immune system and having a role in cardiac health, Alzheimer’s, cancer, neurological development, urinary tract health just to name a few.
But Kim, I can just take some probiotics after I finish my antibiotics and wham bam I’m back to normal. Ahh I wish it was that easy. Some of the microflora becomes permanently extinct and we are not able to recover some bacteria again.
7. Side Effects: Nausea, Vomiting and Diarrhea.
The most common side effects. Therefore, it makes sense since antibiotics are killing the good bacteria in the gut so we wind up with….the trifecta NVD.
8. Yeast Infections
Yeast infections -Poor ladies! If antibiotics aren’t bad enough killing the good bacteria can also give us vaginitis and thrush in children or immunocompromised folks.
The Next 3 are Life Threatening
9. Stevens-Johnson Syndrome
This is a life threatening reaction that can occur in response to many medications, most of them antibiotics. Starts with flu-like symptoms progresses to skin sloughing off sometimes death. There currently is no cure for this.
10. Clostridium difficile
C difficile is a bacteria that can cause infections up to 2 months after antibiotic use. Infections range from mild diarrhea to life-threatening illness.
11. Allergic Reactions
Allergic Reactions don’t always occur the first time we take a medication. Often they occur after multiple exposures. They are usually unpredictable.
Reactions include anything from a rash to anaphylaxis (swelling of the mouth and throat that cuts off the air supply). About 15 years ago I was on an extended course of antibiotics, I had a life threatening anaphylactic reaction. I was rushed to the ER and given steroids and epinephrine IV to reverse swelling in my throat. I was fine a couple days later. Until I got my hospital bill. When I was very happy to have insurance.
That’s it –I’ll get off the soap box now. But please consider going for 10 days the next time you have a chest cold or bronchitis. This is usually an allergic or viral illness with a cough expected to last up to 4 weeks. Finally, before asking for antibiotics, listen to your diagnosis and your provider’s recommendations.
Please note: Search engines penalize us if we quote our sources correctly. Instead, we use links like below so you can see our sources directly. Email me if you have more questions about a source:
https://www.medpagetoday.org/gastroenterology/coloncancer/81827?vpass=1
https://www.larabriden.com/how-antibiotics-cause-weight-gain/
https://gut.bmj.com/content/early/2019/07/11/gutjnl-2019-318593
#antibiotics can be harmful #antibiotics can cause weight gain #antibiotics can cause Stevens Johnson # antibiotics and the microbiome
