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22nd March 1998

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Antibiotics to the rescue

Your Health

Antibiotics have been around for so long that most of us now take them for granted.

When it comes to treating infections these days, your doctor has to make an important judgement - which is whether the germs causing the infection are bacteria or viruses.

If they are bacteria, then antibiotics are usually effective. If on the other hand the problem is a viral infection, then antibiotics won't have any effect on these germs - and your doctor may instead recommend other medicines. These other (less glamorous) drugs will not wipe out the germs, but will relieve your symptoms until the body's natural defenses overcome the infection.

Antibiotics work by damaging bacteria so that the body's immune system can set about the job of destroying them . In simple terms, what the different types of antibiotics do is to breach the defenses on the surface of the bacterial cell so that the immune system gets a chance to attack it. Different types of antibiotics have different properties, and so are useful for different types of infections. An antibiotic that is very effective against one type of bacterium may not have any effect on another type.

The main reason for taking antibiotics when you are ill is that they help you to get better quickly, and reduce possible complications from the infection.

Bacteria are organisms that can live on their own, and so are susceptible to attack by antibiotics. Viruses in contrast grow by entering other living cells (like human cells) and so are protected from attack by antibiotics. Many of the common infections - colds, "flu" and sore throats - are caused by viruses and not bacteria. Other infections such as gastroenteritis ("stomach upsets") and bronchitis can be caused by both viruses and bacteria; virus-caused gastroenteritis and bronchitis, however, are more common than the bacterial ones.

Although drug companies that manufacture antibiotics would like us to think so, antibiotics are not the "cure all" for all infections. Viral infections are not affected by antibiotics, and even some bacterial infections don't always respond to antibiotics alone. This can happen if the patient's immune system is in poor shape (for example, if the patient has AIDS or malnutrition or leukaemia or cancer) or if the infection is located around a piece of foreign material (like an artificial heart valve or a bladder catheter). Another reason for infections not responding to antibiotics is if a patient has diabetes - or if the bacteria have developed resistance to the particular antibiotic used.

Now all medicines have side effects, and what your doctor does when he or she prescribes antibiotics is to make a decision that the benefits of using antibiotics outweigh the adverse effects. The common side effects include vomiting, rashes, cramping stomach pains and diarrhoea. Rarer possibilities are breathing difficulties and allergies.

Although human beings cannot become "used to" antibiotics, bacteria can do so - a situation brought on by excessive use of inappropriate antibiotics, as well as stopping a course of antibiotics before all the bacteria are destroyed. When bacteria get used to (resistant) to a particular antibiotic, it will not work when taken to treat a subsequent infection caused by that germ.

If antibiotics are not going to be effective in a case of viral infection (such as a cold or sore throat) what can you do?

. You should get plenty of rest and drink a lot of fluids - and take the other medicines that your doctor may prescribe to help to relieve the symptoms.


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