The longer medicine exists, the more myths, speculations and rumors around doctors and drugs are created. Even in our time, when scientific information is available to almost everyone, this «folk art» doesn’t disappear. Alas, for many people it is easier to believe rumors, than to find out what things really are.
Perhaps one of the most «mythologized» group of drugs is antibiotics. It is not surprising: their appearance made a real revolution in medicine, made it possible to cope with a variety of diseases, including those for centuries considered incurable, and going through the planet as deadly epidemics. Without exaggeration, we can say that antibiotics changed mankind destiny – so in 1950 – 70ies both professionals and «self-medicators» got carried away by their application.
But, alas, admiration for this «panacea» was followed by a cruel and painful disappointment: solving some problems, antibiotics gave rise to another – and, as it is often the case with «fallen idols», caused a wave of suspicions and fears. So now often patient, who was prescribed antibiotics, stands at the pharmacy counter and painfully ponders: to take or not to take? Of course, in this moment he asks pharmacist for advice – and so, willing or not, he has to deal with modern misconceptions.
Myths and Truth about Antibiotics
Myth
Any drug that kills bacteria is antibiotic.
Truth
This myth is based on ignorance of elementary terminology. Microorganisms are destroyed by also antiseptics and synthetic antibacterial agents (such as sulfonamides or nitrofurans). True antibiotics are based on substances extracted from microorganisms or obtained by semisynthetic method, and thus differ in mechanism of action on both microflora and human body. So such popular means as Biseptolum, furasolidone, Furacilin, metronidazole, etc., despite their high antimicrobial activity, still are not antibiotics.
Myth
Any infection can be cured with antibiotics.
Truth
Myth, remained after antibiotics «boom» 50 – 60 years ago, now inherited from patient to patient, and, unfortunately, sometimes from doctor to doctor.
There is a variety of infectious agents, for which antibiotics are ineffective. These are primarily pathogens of viral infections – acute respiratory viral infections, chicken pox, measles, rubella, mumps, hepatitis A, B, C. For diseases treatment caused by viruses, special drugs are needed – antivirals and immunomodulators, specific serums, etc. Also, in most cases, antibiotics do not help if infection is caused by fungi, protozoa (amoebas, lamblia, trichomonad, etc.), worms, some rickettsia. And even for bacterial infections treatment antibiotics are prescribed only during acute disease phase to suppress massively multiplying microflora, and at other periods the rest of modern medicine arsenal is used – from antiseptic treatment to herbal medicine.
Myth
At viral infections antibiotics are needless.
Truth
Viral infections are often combined with bacterial, and the disease itself can greatly weaken the body, making it more susceptible to pathogenic and potentially pathogenic microflora, constantly existing in our body. Therefore, if a doctor has prescribed antibiotics for viral disease, it is necessary to strictly implement recommendations, otherwise there may be serious complications.
Myth
At common cold for complications prevention you should immediately take antibiotics.
Truth
In most cases, disease in everyday life called «cold» is respiratory viral infection, causing not too severe inflammation, which ordinary person’s immunity copes by itself or with a little support – such as elimination of most unpleasant symptoms, using symptomatic treatment. Besides, sometimes disease onset is taken for allergic rhinitis. In all these cases, there will be no benefits from antibiotic «preventive therapy», but potentially pathogenic microflora can develop resistance to received means (which in case of complications will only complicate treatment) or allergic reaction to medication taken. So taking antibiotics is necessary only when prescribed by doctor.
Myth
If antibiotic helped at some disease, in case of the same disease you have to take the same – proven – drug.
Truth
One and the same in its clinical manifestations disease can be caused by various pathogens, e. g., pneumonia symptoms are the same as staphylococcal infection (what is it?), and lesion with mycoplasmas, for which many antibiotics are not effective. In addition, the same type of bacteria often has strains resistant to certain antibiotics, and first of all to «proven» ones, for a long time popular among self-medicators. And resistance may develop even in course of treatment – if not followed or incorrectly prescribed dosage, treatment duration, etc. If pathogen is not «finished to the end» – the most resistant bacteria will survive, which will multiply, causing new relapses.
Actually, with each passing year more and more new strains appear, that are resistant to certain antibiotics, primarily due to irrational use of these drugs – without cover by other means, without accurate analysis of pathogen resistance, without individual dosage selection and, of course, without doctor’s supervision.
Myth
Antibiotics injections are more efficient and safer than taking pills.
Truth
Some time ago it was true – many antibiotics (e. g., penicillin) were not released in pills. But now modern preparations are developed, reception of which in pills, capsules etc. in effectiveness is comparable with intramuscular injections, but much easier tolerated, allowing patients to timely take medication without outside help. Side effects are exactly the same – they are determined primarily by systemic antibiotic action. Sometimes injections supporters explain their choices by flora preservation care, which, when taking pills, is affected more quickly. In some cases it is justified, but usually at injections systemic antibiotics action affects both gut and mucosa. So, for disbacteriosis prevention measures have to be taken anyway. In general, intramuscular antibiotics are usually prescribed only for severe infectious diseases, parenterally – for generalized infections and sepsis, when possible side effects from overdose, individual body reaction, etc. are not as important as saving patient’s life.
Myth
Children and adults can use the same antibiotics, the difference is only in dosage that can be determined independently.
Truth
It is a dangerous delusion. In pediatrics antibiotics are used with caution, strictly on indications, which spectrum is very limited compared to «adult» medicines. Instructions for each antibiotic, allowed for children, precisely specified age and dosage – they are calculated as a result of special clinical studies. If dosage for children is not specified and there is age limit, this antibiotic is not recommended for children, its safety profile is not high enough!
And even those antibiotics, that are prescribed to children, are better to buy in special children’s dosage forms – it makes easier both exact dosage, and medication intake due to pleasant taste, syrup form, etc.
Myth
Pregnant or breastfeeding mothers should not take antibiotics.
Truth
Of course, during this period patients should more responsibly take any medication prescription and reception, carefully compare possible consequences and take into account all risks, but there are situations when antibiotics are imperative, and abandoning them might just be dangerous for both mother and a child.
There is no absolute prohibition for all without exception antibiotics during pregnancy and lactation period – in this period penicillins, cephalosporins, macrolides are used, and if doctor claims it necessary – other groups of drugs. At this gestational age (special caution is needed during I trimester) and individual dose titration should be taken into account. Violating dosage and time of administration (taking less of the drug less often than prescribed by doctor, «not to poison the child») is not allowed in any case – it will only lead to chronic disease form, which will require even more drugs. It is possible that antibiotic-resistant strains potentially pathogenic microflora will appear, which will be inherited by the child.
With all doubts about safety of particular agent during pregnancy you should first and foremost read instructions to the drug – if there is contraindications, manufacturer has to indicate them. If stated that safety studies for pregnant and breast-feeding women were not carried out, it is best to consult your doctor and choose another antibiotic, clinically proven.