Premium ContentMouse over Home then click on Premium Content for information.

Antibiotics, once viewed as a bazooka against bacteria, are encountering increasingly rugged germs.

A St. Louis study published this week offers fresh evidence of the unnecessary use of antibiotics, which only serves to toughen bacteria and weaken the effectiveness of those drugs.

Local physicians weren't surprised by the results, which they said bolster their belief that patients shouldn't demand antibiotics and doctors shouldn't cave under that pressure.

The study, from Washington University in St. Louis, found that antibiotics did no better than placebos in relieving the symptoms of sinusitis — inflamed sinuses during a severe common cold. Nevertheless, the study said, some 20 percent of antibiotics prescriptions were written for that purpose.

The St. Louis research examined only sinusitis cases that fit the guidelines for potential antibiotics use laid out by the federal Centers for Disease Control and Prevention and other medical groups. In other words, they were severe enough cases that antibiotics generally would be viewed by medical professionals as a reasonable therapy. But antibiotics made no difference.

The criteria included sickness lasting seven days or more, facial pain and green and yellow nasal discharge.

"We need to be more judicious about using antibiotics," Dr. Jane Garbutt, lead author on the study, said in an interview.

Patients and parents see illness and expect their doctors to take action, said Amy Friedman Wilson, an associate professor of pharmacy at Creighton University. But while occasional sinusitis cases involve bacteria, most are caused by viruses, and antibiotics have no effect on them.

"So taking an antibiotic does no good if you're treating a viral infection," said Wilson, who has a doctorate in pharmacy.

Dr. Anthony Yonkers, a professor in the University of Nebraska Medical Center's otolaryngology department, agreed that patient expectations are part of the problem.

"They see the green stuff or the yellow stuff and they say 'Oh, I need an antibiotic,' " Yonkers said. "Patients almost demand it. . A lot of guys will just cave and say 'All right, all right, I'll give it to you.'"

But the more that bacteria encounter antibiotics, the better they become at resisting them. Sometimes, Yonkers said, antibiotics even knock out the good bacteria in the intestinal tract and elsewhere while the bacteria that sicken people survive.

Dr. Trevor Van Schooneveld, an assistant professor of infectious disease at UNMC, said American scientists began seeing highly resistant bacteria strains in large quantities in the 1990s. But Alexander Fleming, who discovered penicillin, warned some 65 years ago that bacteria would become resistant to antibiotics, Van Schooneveld said.

Antibiotics still work well against some illnesses, such as strep throat. But bacteria that cause gonorrhea, skin infections such as MRSA and some urinary tract infections are growing tougher to defeat with antibiotics.

Creighton's Wilson said drug-resistant bacteria are of even greater concern because there aren't many new antibiotics being created now.

Yonkers said that when it comes to sinusitis, a hot shower and over-the-counter sinus wash will help clear out blockage and establish drainage.

Van Schooneveld said that in most instances, the patient just needs patience.

"Viral infections get better on their own," he said. "Antibiotics are not going to make people with viral infections better."

Garbutt's recommendation was "watchful waiting" in cases that linger. In rare instances, complications from sinusitis can lead to severe disease, such as meningitis.

So patients shouldn't automatically dismiss their symptoms or assume they will get better. Some with sinusitis symptoms might have a bacterial infection, Garbutt said, that would benefit from antibiotics.

Contact the writer:

402-444-1123, rick.ruggles@owh.com

« Live Well - Health & Medicine

Share