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Here's what you need to know about antibiotics and when to ask for them

November 20, 2015

Over 100 different antibiotics exist on the market today designed to cure minor, as well as life-threatening infections.

“These same drugs created to help patients are now sometimes working against them because of their overuse and misuse, especially for children who have the highest rates of antibiotic use,” said Dr. Daniel Skiest, chief, Infectious Disease Division, Baystate Medical Center.

What do Antibiotics do?

Nov. 16-22 is Get Smart About Antibiotics Week, an annual one-week observance to raise awareness of antibiotic resistance and the importance of appropriate antibiotic prescribing and use.

“Many patients often ask for an antibiotic to cure their cold, flu or sore throat, and many parents often ask for an antibiotic for their child’s ear ache, which isn’t always needed. Antibiotics only treat bacterial infections, not the viruses which are the cause of colds, and flu and many ear infections,” he added.

How are antibiotic resistant bacteria formed?

The increasing prevalence of antibiotic resistance has been considered by the Centers for Disease Control and Prevention (CDC) to be “one of the world’s most pressing public health problems” today.

The problem is that when infectious organisms such as bacteria are exposed to an appropriate antibiotic, they are normally killed or slowed down enough for the body to destroy them. However, random mutations that occur during replication lead to antibiotic resistance in a small number of these organisms. These mutated, antibiotic-resistant microbes are then able to continue to multiply, unaffected by the antibiotic. In addition to resulting in an infection that is more difficult to treat, or in some cases untreatable, these resistant bacteria may also spread to others.

The CDC estimates that each year two million Americans get an infection with an antibiotic-resistant germ, which means the recommended antibiotic treatment may not work, and each year 23,000 of those patients die.

In addition to the overuse of antibiotics, some studies have shown that 40% to 50% of all antibiotics are prescribed inappropriately.

The most common conditions for which antibiotics are inappropriately prescribed in children are acute upper respiratory tract infections. These include the common cold, sinusitis, and ear infections, which are primarily caused by viruses, not bacteria, and most of which are self-limited – meaning they will resolve within a specific time period and require no treatment or there is no treatment available.

However, we can’t just blame patients and their parents, said Dr. Skiest. In some instances, well intentioned physicians prescribe overly broad or powerful antibiotics, what he referred to as "using a sledgehammer to crack a nut.”

"Physicians often want to cover all possibilities, especially in ill patients, but these powerful antibiotics may result in collateral damage, said Dr. Skiest. Such collateral damage can include the development of multi-drug resistant bacteria, and “super-infections,” which result due to the void left when the patients “good bacteria” are killed off.

“We need to better educate patients about the safe and appropriate use of antibiotics as well as health care providers,” said Dr. Skiest.

Learn more

To “Get Smart” about knowing when antibiotics work, visit

The Get Smart program focuses on common illnesses that account for most of the antibiotic prescriptions written for adults and children in doctors’ offices and other outpatient settings.