Antibiotics are very useful when needed. But now bacteria are becoming resistant and there are almost no new antibiotics being developed. Without them, operations will no longer be routine, success rates for leukaemia and other cancer treatments would plummet and an infected scratch or chest infection could be fatal. Even more worryingly, if bacteria run out of resistance weapons, they steal from or do swaps with other bacteria. This means that if you visit a country with a high level of resistant bacteria (Greece is a good example) even exposure to a few on food or surfaces will increase the chance of swaps going on with your own bacterial populations.
Several factors contribute to resistance build-up. The routine use of antobiotics on farm animals, antibacterial products at home, multiple courses of antibiotics, not taking a full course, and the way we use them too often - especially for trivial conditions.
We associate getting better with antibiotics, even though we would have got better without them. We no longer accept that it is normal for a sore throat to last for a few days - and be very sore sometimes.
If you are elderly or vulnerable in other ways, have a condition like COPD or cardivascular disease, or are pregnant or immune suppressed, antibiotics are very important. But for the conditions lissted below, visit your pharmacist, stay at home for a few days and take simple measures like painkillers. Avoid getting an infection in the first place by washing hands often with ordinary soap and water, and protect others by using tissues if you have a cold and disposing of them properly.
Colds: Usual length: 4 days. What's normal? Feel unwell, have a bit of a temperature, green or yellow mucus. Adults can expect 2 to 4 colds a year (6 to 8 for children). Antiobiotics: Never needed. Why: Caused by viruses not bacteria, colds resolve without them. Treatment: paracetamol and other over-the-counter remedies. Tip: Don't blow you nose too hard as it blasts bacteria filled pus into your sinuses.
Sinusitis: Usual length: Up to 18 days. What's normal? Horrible blocked-up feeling, pain, bit of a temperatre, headache. Antiobiotics: rarely needed, but consider them if you have recurrent bouts of smelly nasal discharge. Why: 80% of cases resolve in 14 days without them. For every 15 people treated with them, only one has a slight benefit a week later. Treatment: painkillers and steam inhalation.
Acute sore throat: Usual length: Up to 7 days. What's normal? Scratchy pain. Antiobiotics: No, unless you have 3 out of four symptoms - raised glands, pus at the back of the throat, fever, no cough. Why: 90% of sore throats resolve within a week withoutt them. If 4,000 people were treated with them, it would prevent only one case of quinsy (abscess on the tonsils). Treatment: Warm drinks are soothing, take paracetamol and suck sweets. Tip: If you have a cough, it's almost certainly not a bacterial infection, so you won't need antibiotics.
Middle ear infection: Usual length: Up to 3 days - 60% of cases resolve in 24 hours without antibiotics. What's normal? Throbbing pain. Antiobiotics: Not usually needed, except in under-twos with both ears affected. Or at any age isyou have an ear discharge. definitely yes if you have hgih fever and vomiting. Why: For every 15 people given antibiotics, only two have reduced pain and they do not prevent deafness. Treatment: X. Painkilles and distraction (try watching your favourite feel-good film).
Urinary tract infection: Usual length: a few days. What's normal? Burning sensation and needing to pee often. Antiobiotics: No, if mild and you have clear urine with no more than two of the following symptoms- burning when peeing, frequency, smelly pee. Yes, if severe, symptoms last more than seven days, urine is cloudy, or if you have side or back pain and high fever. Why: 50% of UTIs with a bacterial cause will resolve in 3 days. Serious complications are rare. Antibiotics use may disturb natural gut / vaginal flora. Treatment: Hot water bottle and lots of fluids. Drink cranberry juice (it stops bacteria sticking to the bladder wall). if it recurs, take avoidance measures: pee after sex, drink more water, avoid soap and bubble bath.
Vivienne Parry in Good Housekeeping, February 2015
