If You Have a Cold, You Do Not Need Antibiotics
Tuesday, November 19, 2013

Paul Allesi, Kennedy Health AllianceMary came into the office with a very bad urinary tract infection (UTI), and I had to tell her that the bacteria was so resistant that there were no antibiotics available to treat the infection.  She asked ‘how  could this happen?’ I told her because of the over use of antibiotics for conditions where they are not required, such as the common cold. 

 Patients often come to the office with symptoms of running nose with sinus congestion and cough -- and request antibiotics.  These infections are caused by viruses and antibiotics are of no use.  Many patients will reply that their old doctor gave them antibiotics and it always worked!

Your old doctor may not have been aware of the extensive numbers of studies which show that antibiotics do not help treat a cold, and can be harmful.  In my 35 years of practice, I have never seen a patient die from a cold, but I have had patients die from resistant infections, allergic reactions to antibiotics and clostridium difficle (“C-Diff”) infection.  These conditions can all be related to the improper use of antibiotic.

Why do bacteria become resistant?  Like any living organism, bacteria want to survive and can adapt .  Bacteria are smart and when they are repeatedly exposed to antibiotics,they will alter themselves so that antibiotics are no longer effective.  We have been using antibiotics for more than 70 years and we have seen the progression of resistance.  When penicillin was first developed, a majority of bacteria -including staphylococcus - were sensitive even to very low doses.  Over the years, penicillin is now useless against this bacteria, and now for the past several years, we has seen the emergence of the more resistant and aggressive bacteria, methicillin resistance staphylococcus aureus  (MRSA).  These infections can be very destructive and hard to cure. 

MRSA was first seen only in hospital settings, but now it is not uncommon in the community and is a frequent cause of skin infections and can infect an entire family.  This bacteria can  live on the body for years and wait for an opportunity to cause an infection.  Sometimes just washing with soap may not be effective in getting rid of it and may require an antiseptic.  The antibiotics that we do use have more side effects and occasionally require intravenous therapy.  Even these antibiotics are becoming less effective.

If you go to the hospital your chances of getting an infection has increased because of the formation of resistant bacteria.  About two million hospitalized patients will get an infection and account for about 90,000 deaths every year.  This is more than the entire population of Cherry Hill and Haddonfield combined!  In the hospital, we now see very resistant what we call “gram negative rod infections.”  These bacteria are highly aggressive and life threatening.  For some of these infections, there are no effective antibiotics.  Hospitals have put in place stringent handwashing, isolation and limiting the use of antibiotics to prevent further resistance and spread of these bacteria.  We have also seen the emergence of a new deadly bacteria called clostridium difficle, directly related to the use of antibiotics which eradicate the normal good bacteria in our intestines and causes the growth of this bacteria which form a toxin which destroys the colon.  Even one dose of an antibiotic can cause this infection.

What can you do?  Don’t ask for an antibiotic when you have a cold or sinus congestion.  You will not die! If you doctor wants to give you one, question the necessity and discuss other treatments which can relieve the symptoms.  Wash your hands frequently and thoroughly or use an alcohol gel if soap and water are not available. If you need an antibiotic, ask your doctor for a “narrow spectrum” antibiotic and for the shortest duration.  There is some data which shows that probiotics like those in yogurt can help in preventing the loss of the normal bacteria in the colon and can help.  The pharmaceutical industry is making very few new antibiotics.  The antibiotic you may refuse or not be given today may save your life tomorrow.

Dr. Paul Alessi is an Internal Medicine Physician with a specialty in infectious diseases. He practices in Cherry Hill and can be reached at (856) 406-4091.