Antibiotics: Not so fast, doc

The doctor’s promise to ‘first do no harm’ may have to be altered to: ‘First do nothing’.  Doctors who do not immediately prescribe antibiotics for treating conjunctivitis and upper respiratory infections find their patients do just as well – and without suffering any drug side effects.

With or without antibiotics, common and minor ailments seem to last for about the same amount of time and with similar levels of discomfort, new research has found.

The one advantage of antibiotic therapy is that it can prevent complications – but the risk is so small with most of the common ailments that the possible side effects of the drug outweigh any benefit.  Side effects such as nausea, vomiting, diarrhea and rash are common, and unnecessary prescribing is merely adding to the problem of antibiotic resistance.

In one study researchers tracked the progress of 307 patients with acute conjunctivitis, the eye infection.  Some were immediately prescribed antibiotic eye drops, others were given nothing, while the rest started antibiotic treatment three days after visiting the doctor.

There was no difference between the immediate and delayed action groups in terms of the severity and duration of the disease, although the delayed action group had used fewer eye drops.

It’s a pattern that repeats across a range of minor ailments.  Previous studies found that delayed, and reduced, antibiotic use made no difference in the recovery of children with acute otitis media, the ear infection, or in patients with upper respiratory tract infections, such as the cold.

(Source: British Medical Journal, 2006; 333: 321-4, and 311-2).

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