There are many different schools of thought when it comes to the treatment of illnesses. Some people subscribe to a more natural approach, citing preventative measures, diet and homeopathic medicines as the solution to managing illnesses. Others believe in eradicating illness through aggressive treatment and medication. For many concerned healthcare consumers, and parents in particular, antibiotics are often viewed as the "cure all".
"The reality is that, as doctors, we tend to have a fairly hard time to convince patients that they do not need antibiotics," says Dr Neville Wellington of Medicross Kenilworth in the Cape. "I believe that antibiotics are prescribed too often. If a patient does not respond as predicted, more antibiotics seem to be prescribed as treatment, when often time is still the best healer."
When to use antibiotics
According to Dr Wellington the best approach is to use antibiotics cautiously and only really when it is required.
Antibiotics are best suited to treat bacterial infections and not illnesses that are caused by a virus like common colds, flu, most sore throats or runny noses. These will often go away by themselves.
Some ear infections, severe sinus infections, strep throat, urinary tract and many wound and skin infections tend to be bacterial infections and will need to be treated with antibiotics.
Yet the role of physicians to identify and prescribe antibiotics, when appropriate, should not be underestimated. Correctly diagnosing clinical symptoms goes a long way in the management and treatment of illness.
In many cases antibiotics are mistakenly prescribed due to misdiagnosis that stems from a physician's level of experience, or due to a lack of time and resources.
"Sometimes it is difficult to tell the difference between a viral or bacterial tonsillitis,” Wellington adds. “In this instance most doctors would prescribe an antibiotic. The risk of having a virulent strep which causes rheumatic fever is a concern and, in these instances, prescribing antibiotics is acceptable and has helped to reduce the incidence of this disease."
Why overuse can harm you
One concerned mother from Johannesburg says that her children are often prescribed antibiotics for ear infections, especially at the beginning of the year following lots of summer swimming.
"Once they have taken the antibiotics, the rest of the year is always a non-stop battle with other little illnesses. I keep the antibiotic scripts handy and only fill it when they show no signs of improvement. As a result my children seem healthier."
The problem with overusing antibiotics is that continuous usage breeds more virulent bacteria which then become more resistant to the medication. Eventually this requires stronger drugs to be developed to treat disease. This naturally increases the cost of treatment.
For Dr Wellington the answer lies in rather using fewer antibiotics in order to help slow down the formation of more hardy and difficult to treat bacteria. "Ideally, the newer antibiotics should be reserved for serious infections like pneumonias, abscesses or severe tonsillitis."
Dr Kim Faure, General Manager of Clinical Governance at Netcare, fully agrees: "Antibiotics treat bacterial infections, so they should only be prescribed in the event of a suspected or proven bacterial infection. In any event, the use of antibiotics for viral infections is not effective."
"If one looks at the increasing incidence of antibiotic resistant organisms, it is becoming more obvious that doctors are not prescribing antibiotics correctly."
"They are either prescribing a too powerful drug for the infection or otherwise not prescribing the antibiotic for the correct duration of time. At the same time, patients are also to blame for insisting on antibiotics when they don't have a bacterial infection or by not finishing the complete course of antibiotics." - Press Release by Medicross and Netcare