by Carole Jackson>, Bottom Line Health
Itâs January, which means that itâs time for warm gloves, furry coats andâ¦antibiotics.
A new study shows that adults in the US are prescribed antibiotics most often right now, during the first three months of the year.
Now, you might argue,Â Well, thatâs because more people get bacterial infections during the winter.
But check out what else these researchers found, and youâll see that there may be another reason for itâ¦and, frankly, itâs a reason that outrages meâthe findings suggest that many doctors may be behaving badly and putting people at risk.
DOCS PRESCRIBE AT THEIR DISCRETION
Scientists examined the national Medicare records of about 1 million seniors annually over three years. They tracked antibiotic prescriptions month by month to see when the most antibiotics were prescribed. They also analyzed the prevalence of the following conditionsâ¦
- Category 1: Bacterial pneumonia.Â This disease almost always requires antibiotics, according to the study authors.
- Category 2: Acute nasopharyngitisÂ (the common cold) and nonspecific upper respiratory tract infections. These diseases are usually viral infections, so antibiotics are almost never necessary, according to the study authors.
- Category 3: Sinusitis, pharyngitis, tonsillitis and bronchitis.Â These diseases sometimes require antibiotics, but often they donât, according to the study authors.
In addition, they compared disease prevalence and antibiotic prescription rates in the four main US regionsâthe Northeast, South, Midwest and West.
Results:Â As I mentioned earlier, antibiotics were prescribed most often during the first three months of the year. And the rate of bacterial pneumonia (category one), which almost always requires antibiotics, also spiked during those months. So upon first glance, you might think that solely explains the spike in antibiotic prescriptions.
But take a close look at this next finding. When the researchers compared the four regions, they found that the areas that had the highest prevalence of bacterial pneumonia, on average, did not have the highest rate of antibiotic prescriptions, on average, as you would expect. For example, the Northeast had theÂ highestÂ prevalence of bacterial pneumonia, but it didnât have the highest antibiotic prescription rateâit had the second lowest, after the South and the Midwest. Very peculiar, isnât it?
In addition, the rates of the diseases that fell into categories two and three (which donât usually require antibiotics) also spiked during the first three months of the yearânot just bacterial pneumonia. âThese findings imply that itâs likely that some antibiotics were prescribed inappropriately to older adults to treat diseases that donât typically require those drugs,â explained lead study author Yuting Zhang, PhD.
A QUESTIONING ATTITUDE
You, of course, know that overusing antibiotics can cause bacteria to become drug-resistant, leading to disease strains that canât be wiped out with standard antibiotics. And taking antibiotics can be pretty hard on your body, too. This knowledge, coupled with the finding above, means that you may want to be extra inquisitive if and when you visit a doctorâespecially in the winter.
If your doctor prescribes an antibiotic, should you automatically accept it? Thatâs a personal decision, but if you ask me, I make sure that my doctor has a darn good reason to give me one before I take it.
In fact, you may want to consider the following advice from regularÂ Daily Health Newscontributor Andrew Rubman, ND, founder and medical director of the Southbury Clinic for Traditional Medicines in Southbury, Connecticut. He told me that when your doctor prescribes an antibiotic, always ask, âHow confident are you that bacteria are causing my illness?â Physicians can rarely be 100% certain that bacteria are the root cause of health problems, Dr, Rubman saidâbut you should expect at least a fair degree of confidence from your doctor before swallowing antibiotics. Here are more of Dr. Rubmanâs tips, belowâ¦
- If bacteria are definitely the causeâ¦Ask these two follow-up questionsâare antibiotics absolutely necessary?Â And what do recent studies show about the effectiveness of the antibiotic youâre suggesting?Some bacterial diseases, such as bacterial pneumonia, which was mentioned earlier, almost always require an antibiotic. But others, such as the diseases in categories two and three above, can often be resolved with over-the-counter remedies. âThe OTC antihistamine drugÂ diphenhydramineÂ (Benadryl) is a good decongestant for occasional use, and your naturopath may consider prescribing you natural treatments such as nettle, echinacea, horehound, cajaput seed oil and/or henbane to shorten the duration and symptom intensity of your condition,â said Dr. Rubman. So find out from your doctor whether you can try an OTC product first. Keep in mind that all supplements have potential side effects and contraindications based on certain medical conditions that you may have and drugs that you may take, so take them under a doctorâs care.
If your doctor insists that an antibiotic is necessary and explains that there is scientific evidence that itâs shown to be effective in relieving or curing your particular health problem, then ask whether you need a âbroad-spectrumâ type or whether a ânarrow-spectrumâ type will do, because a broad-spectrum type may be overkill for the problem at hand.
- If your doctor isnât sure whether the cause is bacterial or viralâ¦Youâre faced with a more difficult decision. Ask what your options are besides antibiotics and how likely they are to help, and then, after weighing all the benefits and risks with your doctor, make a judgment call.
- If a virus is definitely the causeâ¦Skip the antibiotics and ask your doctor what sort of treatment might help. If youâre interested in using a natural treatment, specifically, itâs best to consult a naturopathic doctor. Supplements containing the herbsÂ lobeliaÂ (Indian tobacco),Â Ligusticum porteriÂ (calledÂ oshaÂ by Native Americans) or larch tree bark (Larix occidentalis) can help clear mucus from the respiratory tract, for instance, if you have a respiratory infection.
Now, your doctor may say, âthe cause of the illness is viral, but I want to give you an antibiotic to prevent any secondary bacterial infections.â Dr. Rubman said that in this type of situation, itâs best to consult a naturopathic doctor for a second opinion. And if you do eventually get a secondary infection, first ask your doctor to try to confirm that itâs bacterial through symptom examination and/or lab tests before considering an antibiotic.
Sources:Â Yuting Zhang, PhD, associate professor, health economics, and director, Pharmaceutical Economics Research Group, University of Pittsburgh. Her study was published inÂ Archives of Internal Medicine.
Andrew Rubman, ND, founder and medical director of Southbury Clinic for Traditional Medicines, Southbury, Connecticut. He is contributing medical editor toÂ Daily Health News.Â www.SouthburyClinic.com