Let's Talk About Your Antibiotic

“You are still coughing?” When I faced this question for the fifth time in a month, I realized I had to change. I was a fourth-year medical student located a few miles from the Texas-Mexico border for a month-long rotation. I am also an asthmatic whose symptoms are triggered by hot air, dirt, and mold, which are in ample supply mid-June in Texas.

Using online medical resources, I had just received a third dose of an Antibiotic regimen, having used azithromycin twice and now on augmentin with no real improvement of my symptoms. I had been stuck in Uber at 10:30 the night before, struggling to get to a local pharmacy that would fill the prescription. I had finished the antibiotic without improvement of my symptoms; where could I be wrong? Aren’t antibiotics the best resource against an infection?

After suffering for three weeks out of a month-long stint, I summoned the courage to ask my supervising physician for help. I took a day off and went to local urgent care seeking help. It must have taken her a few minutes to figure out the real cause of my symptoms was not an underlying bacterial infection but rather an Asthma exacerbation. I needed steroids and immediately got an injection of steroids and a prednisone taper.

With the advent of Coronavirus Disease-19 [COVID-19], we now face this as a reality in modern medicine. Each day we see patients that would instead get antibiotics than think this could be a viral infection. There are genuine cases where antibiotics are warranted, but these cases are 1/3 out of all patients who have had a runny nose, body aches, cough, and cold.

Forget that antibiotics are medication and ingesting any medicines without reason is abusing them; through improper use of antibiotics, we are now developing a “super-bacteria.” Bacteria can get resistant to antibiotics from their continued use. Over the past few years, we have seen resistance develop to some common antibiotics like azithromycin. Even antibiotics can create an infection: Clostridium difficile or C-Diff.

So what do I need, Dr. Mehta? Talk to your doctor and get examined, but if they ask you to wait and monitor your symptoms, please do so. They recommend over-the-counter medications, staying hydrated, and eating healthy meals. Not everything that walks and talks is a bacteria; even viruses produce similar symptoms.

Nihit N. Mehta, MD
Family Medicine Resident
CVPH Family Medicine Residency