Why Won’t My Doctor Give Me Antibiotics?

“Doctor, I’ve been feeling really sick with a horrible cold for the past few days. I need some antibiotics.” Have you or someone you know ever said that? And has the doctor refused? Why? Shouldn’t antibiotics make you feel better? To help mark World Antimicrobial Awareness Week, read on to learn about why doctors may not prescribe an antibiotic when you are sick.

You may not have a bacterial infection.

Antibiotics, which are part of a group called antimicrobials, only fight bacterial infections. These include post-surgery infections, dental abscesses, most urinary tract infections (UTIs), and strep throat, to name a few. Antibiotics won’t treat viral infections (like influenza, colds, and COVID-19), fungal infections (like vaginal yeast infections or thrush), or parasitic infections (like malaria). Other antimicrobials (antivirals, antifungals, and antiparasitics) treat those infections.

It can be harmful to your health to take unnecessary antibiotics.

Antibiotics cause side effects, some of which can cause serious problems. These are some common side effects of antibiotics, and why they are bad:

• Severe diarrhea can cause dehydration.
• Dizziness can cause falls or accidents when operating machinery.
• Fatal heart arrhythmias can be triggered by azithromycin if you have a heart condition.
• Allergic reactions can cause anaphylactic shock, which can be fatal if not treated quickly enough.

Taking unnecessary antibiotics can also lead to other health problems. These drugs are filtered through your liver or kidneys and could cause damage to the organs. Or they can cause another bacterial infection called Clostridioides difficile, often called C. difficile or simply C. diff. This infection causes severe diarrhea and can lead to a perforated bowel, which can lead to sepsis and death.

Overusing antibiotics (taking them unnecessarily, too often, or not correctly) creates antibiotic-resistant bacteria.

When Sir Alexander Fleming discovered penicillin in the 1920s, he predicted bacteria might become resistant to the drug if used too often or incorrectly. His prediction came true not only for penicillin but for other antibiotics as well, leading to a new problem, antimicrobial resistance, or AMR.

According to the Centers for Disease Control and Prevention (CDC), there are almost 3 million antibiotic-resistance infections yearly in the United States, resulting in nearly 40,000 deaths.

Learn more about antimicrobial resistance at Power The AMRevolution.

Your cold and many viral infections will usually go away on their own.

Some people argue that they recovered from their cold faster when they took antibiotics. Chances are they would have recovered just as quickly without them and that it’s a coincidence. A cold generally lasts about a week, sometimes a bit longer. Most viral infections generally last from two to four weeks—both last the same time whether you take antibiotics or not.

Your current infection may not be the same as your last one, even if the symptoms are the same.

You may have had bacterial pneumonia a couple of years ago, and your doctor gave you antibiotics. But let’s say you have some of the same symptoms and your doctor diagnoses you with pneumonia again. But this time, your doctor tells you it’s viral pneumonia, and you should go home and rest until the virus goes away. Why can’t you have antibiotics like you did the last time? Because it’s not a bacterial infection.

Bacterial pneumonia, the most common type, is usually more severe. The symptoms come on very suddenly and the fever can rise quite high – up to 105 degrees Fahrenheit. Viral pneumonia tends to develop more slowly and is usually milder.

Fungi can also cause pneumonia, although it’s not as common. This type of pneumonia only responds to antifungal medications.

Not all bacterial infections need antibiotics.

It used to be that as soon as someone was diagnosed with a bacterial infection, they automatically got antibiotics. For example, ear infections in children were almost always treated with antibiotics. But research shows that even if bacteria cause the infections, they often go away on their own in a few days, especially among children over two years old.

Sinusitis is another infection that doesn’t always need antibiotics. It often goes away on its own.

However, if your doctor doesn’t recommend antibiotics and prefers a watch-and-wait approach, ask what you should watch for in terms of the infection getting worse. Under what circumstances should you call or come back to the office for re-evaluation? When might you need antibiotics?

Regardless of the type of infection you have and if you get antibiotics or not, you should always be aware that any infection can lead to sepsis. And if you suspect you may have sepsis, this is a medical emergency.

To learn more about different types of infections and sepsis, visit the Sepsis and… library.