With the discovery of penicillin in the 1920s came a new medication with great healing effects, but over the years antibiotics have started to get a bad rap. While a course of antibiotics won’t help your winter cold or flu (more on that later), they may be needed to wipe out infections and other serious illnesses. Antibiotics get a lot of buzz and it might be confusing to sort it all out – don’t worry, we’re here to help.
What’s the deal?
Antibiotics have become a hot healthcare topic of conversation in hospitals, articles, doctor’s offices, even grocery stores. Antibiotics are widely used, but the line between use and overuse can be blurred, which is where potential problems arise. One of the more common issues that comes from inappropriate antibiotic use is antibiotic resistance – where bad bacteria become unresponsive to traditional antibiotic treatment. This can mean more serious illnesses with longer recovery times and more expensive treatments needed to clear the infections. Part of the reason behind this is that each time you take antibiotics, some of the good bugs that naturally live in your body (creating what we call the microbiome) get wiped out as well, as antibiotics cannot discern between good and bad bacteria. This creates an environment in your body for other (bad) bugs to move in. And if not all of the bacteria are killed off from an infection, the remaining critters may mutate and become resistant to future treatments – enter superbugs. While it may sound like a cute term, superbugs (such as MRSA) are serious business and can be difficult to treat. For the scoop on antibiotic resistance and superbugs (and how you can help prevent them), check out the CDC’s antibiotic resistance initiative here.
So how have we come to overusing antibiotics? In addition to those your doctor may prescribe, many items contain low-dose or traces of antibiotics, creating trickle-down exposure to antibiotics that many people don’t realize they are getting. Farmers may provide antibiotics to their herds to prevent large outbreaks of illness amongst the animals, and these antibiotics then end up in the food stream (and our bodies). Even items in your home can be sneaky sources of antibiotics – in our quest for clean and germ-free homes and bodies, antibiotics have made their way into cleaning and personal grooming products. Toothpaste, hand soap, and mouthwash are a few of the main culprits, however antibiotic-free versions do just as good a job of eliminating germs and their antimicrobial counterparts and reduce the risk of unnecessary over-exposure.
Looking to cut down on unnecessary exposure? One of the easiest places to start is with your food. Check the packaging of animal products (meats and dairy in particular) and opt for sources or brands that do not provide antibiotics to the animals. By USDA guidelines, organic meats cannot contain antibiotics and prohibits farmers from using them on animals. Another label to look out for is “no antibiotics” and the many variations of it, such as “never given antibiotics,” as these claims are also USDA approved and verified. A tricky one to look out for: antibiotic free. While this may seem very similar to “no antibiotics,” “free” is not a regulated term and therefore cannot guarantee that products are actually completely free of antibiotics. For additional guidance on food labeling rules, check out this handy guide. Another simple way to reduce antibiotic exposure in your foods? Swap out some of your meat-based meals for plant-based proteins such as beans, lentils, and tofu throughout the week. Not only will these items not contain antibiotics, but the nutrients and fiber found in plant-based foods give these protein sources an extra nutritional punch to support a healthy microbiome.
Check out the ingredients label on your household products – triclosan is a common antibiotic added to products. While triclosan is no longer found in soap products (thanks to an FDA ban), it can still be found in oral care items, specifically toothpaste. Another easy way to spot antibiotics? Look for labeling that says antibacterial or antimicrobial, this is usually a sign that there are antibiotics in products.
When to take ’em
There is a time and a place for antibiotic use, and serious infections certainly fit the bill. Common bacterial infections include urinary tract infections, sinus and ear infections, and strep throat. When harmful bacteria take up residence in the body, antibiotics are among the only drugs that can wipe them out. They can be prescribed along a spectrum to target specific bacteria (narrow spectrum) or affect a wider range of potentially harmful bugs (broad spectrum). Note: narrow-spectrum antibiotics may require additional testing or cultures to be run. Your provider may determine that treating the infection early is more beneficial than waiting for results. Discuss these your treatment plan with your provider and be sure to take your course as prescribed (more on this later).
And when to avoid ’em
While antibiotics can be a powerful healing tool, they are not a cure-all and will not be effective against all that ails you. Antibiotics only work to fight bacterial infections and therefore pack no punch against fungus or viruses. Fungal infections (athlete’s foot, yeast infections, ringworm) will require an antifungal medication. Common ailments such as sniffles, coughs, colds, and flus, are caused by viruses (not bacteria) and certainly will not respond to antibiotics. If you suspect your cough could be the result of a respiratory infection, or if you develop an ear infection throughout the course of your illness, make an appointment to see a care provider to be evaluated for potential bacterial infections.
Things to keep in mind
While there are negative effects to overdoing it on the antibiotic use, there may very well be a time (or multiple times) in your life when antibiotics are the best treatment course. If you end up needing to take antibiotics, here are a few things to keep in mind to keep you and your microbiome healthy long-term.
Take the entire dose as directed – even if you feel improvements in symptoms before your treatment course is complete, be sure to finish the entire dose as prescribed (including following timing directions). Stopping a course early can lead to bacterial regrowth, opening the door for drug-resistant versions of your original illness to develop.
Supplement with probiotics – to keep your gut microbiome in top shape, introduce sources of probiotics into your body while taking antibiotics. The timing of when to take probiotics in relation to your antibiotics is up for debate if you take them in the supplement form, check in with your doctor for their recommendation about timing. Probiotics can also be found in plenty of food sources like yogurt, kefir, kimchi, and other fermented products.
Minimize stress – busy lives are inevitable, but excess stress messes with the body’s ability to heal itself. While you’re fighting off infection, try to create a supportive environment for the antibiotics to do their work. Need a few tips for chilling? Check some out here.
Take health into your own hands (literally) – go back to the basics and focus on hand hygiene to prevent the spread of germs. Plain old soap and water will always do the trick, but in a pinch alcohol-based hand sanitizer is a good way to go (no need for antibacterial sanitizers or soaps – just another source of antibiotics!).
The bottom line
Overuse of antibiotics in medicine, food systems, and everyday products leads to antibiotic resistant bugs. Using antibiotics properly when necessary and avoiding unnecessary exposure helps preserve the power of this important healing tool.
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Reviewed by Kelsea Hoover, MS, RDN
on March 10, 2020. Kelsea is a Registered Dietitian with her Master's degree in Nutrition from Bastyr University in Kenmore, WA, and is one of our Brook Experts.