Rarely are antibiotics really useful

19/11/2012

Antibiotics can save lives, that's out of the question. The drug is also one of the most important achievements of conventional medicine. But due to the almost inflationary use of antibiotic drugs are often no longer effective. „If in doubt, prescribe antibiotics“, For a long time the motto of the family doctors was. The funds, for example, do not help at all with viral infectious diseases. Many patients are insecure and still require an antibiotic to only get well in the wrong faith.

The fact is, patients suffer from, for example, bacterial pneumonia or sepsis (blood poisoning), antibiotics can save lives. In addition, antibiotic drugs can alleviate the discomfort of an infectious disease caused by bacteria and accelerate the healing process. Because antibiotics as „panacea“ are also viewed by doctors, the funds are taken much more frequently than the medical benefits it gives.

Bacteria are very adaptable
In the meantime, it has got around, but the number of regulations is not proportionate to the benefit. With each administration so-called antibiotic resistances threaten because many bacterial strains are very adaptable. Mutations allow adjustments to be made. The result: The bacteria are virtually immune to the drugs and form veritable resistance. Thereafter, the drugs no longer work. If infected resistant bacteria pass on to others, they spread. There are threats of epidemics due to antibiotic-resistant bacteria.

The President of the German Society for General Medicine and Family Medicine, Prof. Dr. med. Ferdinand Gerlach emphasized: „Our goal must be to use antibiotics as specifically as possible and as little as possible and as much as necessary. The appeal is aimed not only at the doctors but also patients. Because many patients require antibiotics from the doctor because they believe that they will get better faster. This is also confirmed by Professor Markus Dettenkofer from the Institute for Environmental Medicine and Hospital Hygiene at the University Hospital Freiburg / Breisgau. There are the patients, „Often there are parents who ask for their children an antibiotic, or workers who want to be quickly operational again.Since the doctor then puts himself under pressure, the preparation is often premature and unnecessarily prescribed, although the physician actually knows that in the long run unnecessarily used antibiotics are dangerous not only for the patient but also for the whole of society.

Patients do not know enough about possible consequences
„Many patients think that it is the best practice to take an antibiotic“, reports Carsten Matthias, general practitioner from Hamburg. Many also know too little about possible consequences and side effects. The drugs in fungi or viruses without any mechanism of action. However, in order to specifically distinguish whether the disease was caused by a virus or bacterium, the family doctor would have to do a saliva sample or a urine test and have laboratory tests. However, such a diagnosis takes several days and is usually not in proportion to the infection. Also, patients often do not want to wait that long or the effort seems too high for the doctor. Therefore, in addition to pressure from patients, doctors are tempted to prescribe an antibiotic.

Antibiotic in flu ineffective
Helmut Schröder of the Scientific Institute of the AOK in Berlin emphasizes: "A classic flu is usually caused by viruses". Evaluations of the health insurance have shown, however, that with increasing patient numbers of viral infections in winter, the prescriptions of antibiotics increase, although these funds do not help at all with a flu. But Schröder does not want to be misunderstood: "Without a doubt, antibiotics have to be used for pneumonia, for suspected Lyme disease after a tick bite and for urinary tract infections." The use of antibiotics, however, can be useful if a bacterial inflammation is added to the flu. Because the body is greatly weakened in an infection, so that bacteria have an easy game of invading the organism.

Different mechanisms of action of antibiotics
Antibiotics are not just antibiotics. The composition of the drugs either inhibits the growth of the bacteria or kills them completely. While some active substances specifically combat specific strains of bacteria, broad-spectrum antibiotics such as penicillin or tetracycline have the same effect against several types of bacteria. If pathogens can be localized, then they can also be treated more purposefully. If no proof can be given for the pathogen, because an emergency exists, on a trial basis therapies are preferred. "One will first use a broad-spectrum antibiotic and carry out a parallel diagnostic in the laboratory," explains the physician. If the results from the laboratory or suggests the previous antibiotic therapy not, so the treatment is adjusted.

Antibiotics are not always useful for bacterial infections
Not every bacterial infection needs to be treated with antibiotics. Many otolaryngologists have changed their treatment for middle ear inflammation. Because with an acute otitis media the course of the disease is very similar with and without antibiotics. "We therefore recommend the following strategy: Four out of five children no longer feel pain after 24 hours if they are given painkillers such as juices“, says Schröder. Very important is the physical protection of the patient and the guarantee of sufficient supply of fluid. If the symptoms persist for longer than two to three days, a doctor should be consulted. This then decides whether antibiotic therapy is suitable. Home remedies for middle ear infections can also be supportive. Especially children receive antibiotics too often.

It's Friday afternoon and all the doctors have already closed, but the child is crying with earache. In the emergency room, doctors give an antibiotic prescription at best, which can be used after 48 hours if the symptoms persist. This is how the parents feel reassured. "In most cases, the recipe is not used because the pain is gone even without antibiotics.

Antibiotics have numerous side effects
What many do not know: Every antibiotic drug therapy has consequences for the body. "Antibiotics have numerous side effects such as nausea, diarrhea or vomiting," says Gerlach. Some patients also have an allergic reaction. In addition, the intestinal flora is severely disturbed, as determined by a recent study by Stanford University (Palo Alto, California). Therefore, naturopaths and naturopathic-oriented physicians recommend after an antibiotic therapy to a colon cleansing in order to rebuild the intestinal flora.

It is now undisputed that bacteria learn to adapt after a short time. They form defense mechanisms or change their genetic material sustainably. Therefore, the funds should be taken until the end not be discontinued when the state of health has improved.

Not only subsequent therapies are made more difficult. Infants, patients with weakened immune systems, or hospitalized patients may be exposed to an acute mortal danger. If patients are severely injured or major surgeries occur, there is always a risk of bacterial infection or sepsis. For this reason, patients at risk are always examined for germs before being admitted to the hospital. (Sb)

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Picture: Rainer Sturm