ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, March 19, 1996 TAG: 9603190042
SECTION: EXTRA PAGE: 1 EDITION: METRO
COLUMN: Personal Health
SOURCE: JANE BRODY
Test your antibiotics IQ:
Have you ever asked a doctor to prescribe an antibiotic when you had a cold or the flu?
Do you sometimes stop taking a prescribed antibiotic when you are feeling better, even though there are pills left?
Do you ever skip or forget to take a dose or fail to take doses at prescribed intervals?
Have you ever saved leftover antibiotics and taken them the next time you got sick or given them to someone else?
Have you ever taken antibiotics prescribed for someone else?
If you answered yes to any of these questions, read on. You need to learn potentially lifesaving facts about antibiotics. Studies have shown that antibiotics, the ``miracle drugs'' that have helped Americans achieve a 30-year increase in life expectancy in less than a century, routinely are abused and misused by patients and physicians.
Patients are not necessarily the primary source of the problem, since doctors must first prescribe the drugs.
And the consequences go beyond the personal. As a result of both use and misuse of these drugs, more and more bacteria are becoming resistant even to the most potent antibiotics known, and growing numbers of people are dying of infections that once were readily cured.
Last fall, the American Lung Association released the telling results of a two-part Gallup survey of 1,010 adults and 100 physicians. Although antibiotics are effective only against bacterial, not viral, infections, the physicians reported that 70 percent of patients ask for antibiotics when they are told they have a viral illness.
When asked if antibiotics were effective against viruses, such as those that cause colds and influenza, 60 percent of patients said they were. Many patients also wrongly believe that antibiotics should be taken during a viral illness to prevent complications such as sinusitis, bronchitis or ear infection.
Although three-fourths of the patients and 94 percent of the physicians surveyed said the importance of finishing an antibiotic was explained at the time it was prescribed, more than half of the patients failed to take all the doses.
Of patients who failed to finish their prescription, 94 percent said they feared the development of bacterial resistance. Yet, along with the inappropriate use of antibiotics for infections not caused by bacteria, the failure to take enough of an antibiotic to wipe out a bacterial infection totally is largely responsible for the emergence of resistance.
Three-fourths of patients also cited ``inconvenience'' as a reason they did not complete their prescription. Antibiotics like penicillin that have long been available must be taken several times a day for 10 or more days to be fully effective. But when patients no longer feel sick, they tend to forget.
nDo not press your doctor to prescribe an antibiotic when you are told your illness is most likely viral, even if you worry about developing a bacterial infection. Dr. Michael S. Niederman, a respiratory disease specialist at Winthrop University Hospital in Mineola, N.Y., said for an otherwise healthy person, taking antibiotics in anticipation of a bacterial infection can change the distribution and resistance patterns of micro-organisms already present in the body, setting the stage for a future infection that cannot be cured by the antibiotic. Preventive antibiotic treatment is reserved for special cases.
nWhen an antibiotic is prescribed for what the doctor knows or believes is a bacterial infection, it is very important to take all the medicine at the prescribed times. A missed dose of an antibiotic that should be taken three or four times a day is less of a problem than it is with a drug that is to be taken only once or twice a day, but it is never ideal. Skipping doses allows the blood level of the antibiotic to drop, which may result in a temporary setback in treatment and can encourage emergence of antibiotic-resistant bacteria. Doubling up on a dose when you finally remember to take it usually does not help.
nNever save leftover antibiotics or take ones prescribed for a previous illness or for someone else, unless so instructed by your physician. Different bacteria are sensitive to different antibiotics, and the drug you took before may do you no good now. Besides, you will not have enough of the leftover antibiotic to treat a new infection properly.
nMake sure you understand exactly how and how often you are supposed to take a prescribed antibiotic. Should it be taken before or with meals or on an empty or full stomach? Should you avoid alcohol or milk or any other foods? Is it safe to take it with other medications you are taking? Ask!
nAsk the physician, pharmacist or both about common side effects, like nausea or diarrhea, and what reactions you should call the doctor about. Tell the doctor about any previous adverse reactions to an antibiotic. If you develop a rash while taking an antibiotic, call the doctor right away.
nAsk how to know if the drug is working. With a correctly prescribed antibiotic, you should begin to feel better in 24 to 48 hours. If not, you may need a different medication.
The American Lung Association has a brochure, ``A Common Sense Guide to Antibiotics.'' It's free by calling (800) 586-4872.
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