Antibiotics for Colds, Bronchitis, and Sinusitis
Inappropriate use of antibiotics is causing serious problems as a result of drug-resistant bacteria.
By Joel Fuhrman, M.D.
Antibiotic use has skyrocketed
in recent years, but the
misuse of antibiotics isn’t a
new problem. Since the 1970s,
medical studies have concluded
that as much as 80 percent of all
outpatient prescriptions are prescribed
inappropriately.
Antibiotic sales are soaring,
but—in direct response—so are
drug-resistant infections. As more
and more antibiotics are used inappropriately,
more and more strains
of bacteria are mutating and becoming
resistant to antibiotics.As a
result, many patients who have
infections that in the past could
have been appropriately and effectively
treated with antibiotics will
die because the antibiotics will no
longer work.
Drug companies are a big part of
this problem.They promote the use
of their products through widespread
advertising and the practice
of giving free samples of the more
potent, broad-spectrum antibiotics
to doctors. The more widely these
newer (and often ten times more
expensive) antibiotics are used, the
greater the chances that the bacteria
will develop resistance.
Demanding patients
Many patients don’t think a doctor is
doing his job if he doesn’t prescribe
antibiotics or other medication. If he
doesn’t prescribe the medication
they want, some patients actually
will look for another doctor who
will. For example, Robert Dristan is
an emergency room physician well
aware of the dangerous and inappropriate
overuse of antibiotics. He told
me that he sees a steady stream of
patients with colds,bronchitis,or the
flu. He always patiently describes
the viral nature of these ailments,
explains that no antibiotic can kill a
virus, and informs patients that inappropriate
use of antibiotics for these
conditions could only harm them.
He said that on more than one occasion,
patients for whom he did not
prescribe antibiotics returned, waving
bottles of pills in his face, triumphantly
stating,“My doctor said I
almost had pneumonia.”Patients can
easily find a doctor willing to fabricate
a diagnosis to justify coming to
the rescue with a treatment.
Once a patient called me screaming
on the telephone that her husband
came to me for an antibiotic for
his terrible cold, and all he got was a
lecture. She wanted her money back
and said she and her husband would
never be coming again. Numerous
patients have made similar demands.
Most doctors perpetuate this problem
because they give in to the pressure
to prescribe antibiotics. They
like to appear that they are offering
an important and necessary service
by writing prescriptions.
Powerful medicine
Antibiotics are not harmless. Their
use should not be undertaken without
a convincing prognosis that serious
harm will result if the antibiotic
is not used. Antibiotics kill the normal
bacteria that inhabit the intestines.
These healthy bacteria serve
an important function in digestion
and production of fatty acids and
nutrients.The use of antibiotics, and
the change in flora that results,
reduces vitamin absorption (for
example, of vitamin K) and can lead
to nutritional deficiency.
Furthermore, the use of antibiotics
results in yeast overgrowth. It
can cause severe allergic reaction,
as well as food and environmental
allergies to develop more readily.
Overuse of antibiotics also can
result in future infections with
more serious (and resistant) bacterial
organisms. Side effects can
range from mild diarrhea and stomach
upset to severe bone marrow
suppression and serum sickness.
When to use antibiotics
Antibiotics are the appropriate treatment
for severe bacterial infections.
These infections include cellulitis,
Lyme disease,pneumonia,joint infections,
cat bites, meningitis, and bronchitis
in a long-term smoker. Bronchitis
in a non-smoker is just a bad
cold. Almost every viral syndrome
involves the bronchial tree and sinuses.
The presence of yellow, brown, or
green mucus does not indicate the
need for an antibiotic. Likewise,
sinusitis is not an appropriate diagnosis
for the routine use of an antibiotic.
Antibiotics should be reserved
for the more serious sinus infections
that show evidence of persistent
symptoms lasting more than a week,
such as continual fever and headache
that accompanies facial pain
and facial tenderness.
Childhood ear infections, a
multi-billion dollar industry
Ear infections (otitis media) are the
most common medical problem in
children under seven years of age
in the United States. Not only do
nine out of ten children develop at
least one ear infection each year,
almost one-third of them develop
chronic congestion with fluid in
the middle ear that can lead to hearing
loss and make the child a canddate for myringotomy or tube
placement. Children who are
breast fed for over a year have
been shown to have many fewer
infections than those weaned earlier.
Studies also point to the fact
that most ear infections early in
life are viral, not bacterial. The
vast majority of ear infections
resolve nicely on their own,
whether bacterial or viral, without
an antibiotic. An international
study following 3,660 children
treated by general practitioners in
nine countries showed that antibiotics
did not improve the rate of
recovery from ear infections.
It is common practice in this
country to treat all ear infections
with an antibiotic.Whether bacterial
or not, our children get a routine
prescription for an antibiotic
at every minor illness. This cycle
often is repeated many times,
which may beget other medical
problems in adulthood.This use of
antibiotics early in life is likely a
contributor to the increasing incidence
of allergies and asthma and
other problems later in life.
Medical studies have linked a significant
increased incidence of
asthma, hay fever, and eczema to
those who received multiple
antibiotic prescriptions early in
childhood, especially in the first
year of life.
Conservative treatment
In Europe, antibiotics are used for
ear infections only when there is
persistent drainage or persistent
pain because these infections resolve
on their own, without treatment,
over 85 percent of the time.
Studies show that the majority of
ear infections are of viral etiology.
For example, a microbiologic survey
found that 75 percent of pediatric
ear infections were caused
by common respiratory viruses.
Generally speaking, the use of antibiotics
should be reserved for serious
infections, not conditions the
body is well equipped to resolve on
its own. More and more physicians
and authorities are recommending
only treating ear infections with
antibiotics when symptoms are not
improving after three days and they
are accompanied by drainage, fever,
or persistent pain.Instead,ear drops
for pain relief and other pain relievers
can be used if the child is too
uncomfortable to sleep.
A British study reported on 168
children treated in this manner.
Antibiotics only were used if the illness
followed an unusual course
with high fever or profound weakness,
or if the child had a history of
purulent meningitis or a concurrent
documented bacterial infection.
They followed up on any child
who did not recover in the typical
time frame.As a result of this welldesigned
protocol,antibiotics were
recommended by the physicians in
only 10 children—fewer than 6 percent
of all children presenting with
acute ear infections. No serious
complications, such as mastoiditis,
meningitis, or permanent hearing
loss,were observed
This is similar to the way I treat
childhood ear infections, except I
also incorporate nutritional excellence,
which I find reduces even
further the likelihood of needing
an antibiotic.The children of families
who adopt my dietary recommendations
simply stop getting
ear infections.