Mindful medicine: What you need to know about antibiotics.

With advice from Dr. Stephanie Reznick

Dr. Stephanie Reznick is a board-certified internal medicine specialist with over 13 years of experience. She has extensive experience working in virtual primary and urgent care and is currently MDLIVE Clinical Lead of Product.

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When you're feeling sick and just want your illness to go away as soon as possible, receiving antibiotics from your doctor can feel reassuring. And antibiotics can be lifesavers – when used correctly. But do you always need antibiotics? It depends on the nature of your illness.

Antibiotics can be necessary, but they may not always be the best course of action to help you recover. And, if you experience side effects, antibiotics can make you feel even worse. There is also widespread concern for overuse in the medical community. Overuse leads to antibiotic resistance, meaning antibiotics may not work when you need them in the future. So, if you're unsure when to take antibiotics, Dr. Reznick explains what you need to know during your next doctor's visit.

"When do I need antibiotics?"

Dr. Reznick: Antibiotics are designed to combat bacterial infections. They will not work against viral infections. MDLIVE doctors have many years of education and experience to help decide if your condition requires an antibiotic. So, they will likely prescribe an antibiotic if they believe it's a bacterial infection.1 They will avoid giving you an antibiotic if they think it's a viral infection since it can add more harmful symptoms to your illness, such as diarrhea.

In healthy people, most upper respiratory infections, such as sinusitis and ear infections, are caused by a virus. Other common viral infections include RSV (respiratory syncytial virus), COVID-19,2 cold, and flu. You can use over-the-counter medications to help ease your symptoms, and you may be prescribed an antiviral to help your immune system fight the infection, if medically appropriate. Antibiotics are not typically needed unless symptoms haven't improved after 10 to 14 days—or if your symptoms improve but then worsen again. In some cases, bacteria can sometimes take advantage of the inflamed nasal passages from a virus, causing a secondary bacterial infection to develop.

1Prescriptions are available at the physician's discretion when medically necessary.
2MDLIVE doctors can prescribe the antiviral Paxlovid in the treatment of COVID-19 to patients ages 18 and older when medically appropriate. MDLIVE doctors cannot prescribe Molnupiravir or other medications beyond Paxlovid in the treatment of COVID-19.

"What happens if I take antibiotics too often?"

Dr. Reznick: Antibiotics are becoming less effective in the United States as we have overused them for many years, creating antibiotic resistance.3 Additionally, we haven’t seen any new types of antibiotics become available recently, so we need to be careful with what we have. In other words, not using an antibiotic today may mean you will respond better to them when you really need them.

3https://www.who.int/publications/i/item/9789240062702

"What are the side effects of antibiotics?"

Dr. Reznick: Side effects can include gastrointestinal upset, diarrhea, vaginal yeast infections, and decreased effectiveness of oral birth control. Some people can develop an allergic reaction ranging from a mild rash to severe life-threatening breathing difficulties and anaphylactic shock. An increasingly common risk is developing a severe form of diarrhea called C. difficile or C. diff, which happens when the good bacteria in your gut are killed off by an antibiotic, allowing harmful bacteria to grow. C. diff can be fatal in the most severe cases.

"How will my doctor decide if I need antibiotics?"

Dr. Reznick: The decision to use an antibiotic isn't taken lightly. During your visit, give as much detailed information about your illness so your doctor can make the best assessment and treatment plan for your health. When doctors decide not to use antibiotics, they consider the risks and benefits to determine the best treatment option. And there is increasing evidence showing that many infections often resolve on their own without antibiotics.

"What can I use to help my symptoms?"

Dr. Reznick: You can manage viral infections such as an ear infection, sore throat, sinus infection, and cough with medications that improve symptoms while your immune system naturally overcomes the condition.

Depending on your symptoms and your health history, you can use over-the-counter medications such as acetaminophen (Tylenol), guaifenesin (Mucinex), ibuprofen (Advil or Motrin), or dextromethorphan (Robitussin). Prescription medications, such as ipratropium nasal spray or benzonatate (Tessalon Perles), may also help your symptoms if medically appropriate.

"Can MDLIVE help with viral Infections?"

Dr. Reznick: Absolutely! Your MDLIVE doctor will assess your symptoms to confirm the infection is viral and may recommend flu or COVID-19 testing, which, if positive, could lead to different treatment options. They can recommend the best over-the-counter medications for you, tell you what signs to look out for if you develop a bacterial infection, and potentially prescribe non-antibiotic prescriptions to help relieve your symptoms.

Antibiotics are a valuable tool in the fight against bacterial infections, but they aren't always the answer. Knowing when you genuinely need them can help prevent antibiotic resistance and protect your overall health in the long run. Your MDLIVE board-certified doctor can guide you based on your symptoms and health situation.

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Posted date: March 08, 2024