Dr. Oz is in big trouble. Last week he was grilled by a United States Senate hearing that was called to examine the marketing of dietary supplements. They took him to task for the colourful language he uses to promote questionable weight loss supplements. On his TV show he routinely uses words like “magic”, “miraculous” and “lightning in a bottle” to describe these dubious products.
There is one family of drugs that Dr. Oz could have used those words for: Antibiotics. Everyday in the Emergency Department I see these drugs work miracles and save lives.
When you step back and think about it, antibiotics are truly miraculous. There was a time not so very long ago when a simple pneumonia, or infected wound, could and did kill people.
Of course antibiotics aren’t the only factor that has caused this remarkable change in our health. Advances in housing, nutrition and public sanitation have probably played a greater role in the fight against infectious disease. Unfortunately due to Canada’s ongoing mistreatment of indigenous people, inadequate housing and malnutrition remain important factors contributing to illness and death from infectious disease for Onkwehon:we people.
However if you get really sick with a bacterial infection antibiotics are the lifeline back to shore. But like with any great gift, there is a need to use them wisely. Antibiotics have no role in the treatment of viral infections. In addition, many minor bacterial infections such as bronchitis, sinusitis and inner ear infections can be overcome naturally by a healthy person.
There are two major problems with the overuse of antibiotics. First they do not discriminate between the “good” bacteria that keep us healthy and the “bad” bacteria that make us sick. Secondly, inappropriate use of these medications for viral infections or minor bacterial infections results in breeding bacteria that are resistant to antibiotics.
Our understanding of the role of bacteria in our body has grown by leaps and bounds. Did you know for instance that we have ten times more bacteria in and on our body then we have human cells? The vast majority of these bacteria help us ward off aggressive infections or digest our food.
If you imagine all of the different kinds of bacteria as a beautiful diverse old growth forest, which then gets infected by a dangerous weed, an antibiotic clear-cuts that forest in order to kill off the weed. When your doctor determines that you have a life threatening infection this is the right step to take. However too often, as doctors, when our patients come with viral infections we feel a lot of pressure from our patients who want an antibiotic prescription and we give antibiotics unnecessarily.
This results in many side effects. Most commonly things like belly pain, diarrhea, yeast infections and rashes, but rarely severe complications like C dificil colitis and life threatening allergic reactions. While there our some studies suggesting a benefit of commercial probiotics to prevent the diarrhea that comes along with many antibiotic prescriptions these can be costly and the key ingredient, the healthy bacteria, can easily and inexpensively be obtained by eating yogurt.
Because bacteria breed very quickly when they are exposed to antibiotics they can adapt remarkably fast. As a result they are rapidly finding ways to defend themselves from these miraculous drugs. Our infectious disease experts warn us that due to overzealous antibiotic use we are heading towards a “post-antibiotic era” in which simple infections like pneumonia will once again become untreatable.
So what can you the patient do? Try to have an open mind and remember that antibiotics can have side effects. Ask your doctor if the benefits of an antibiotic outweigh the harms for the kind of infection that you have. If your doctor thinks that you have a viral infection make sure to ask her if there is anything else you can take to help you feel better. For example regular dosing of Tylenol can really help you get through the misery of a cold.
In the meantime lets all play our part in taking care of these “magic” drugs so that the miracles can continue and the sick can become well again. Maybe Dr. Oz could do a show about that!
