The Nuance
When Should You Take an Antibiotic?
How to assess whether you really need that prescription
Antibiotics save lives by slaying infectious bacteria, but they’re indiscriminate killers. While some are more precise than others, all of them wipe out good bacteria along with the bad.
The loss of good bacteria can leave a person vulnerable to developing post-antibiotic health issues. For example, people who are on antibiotics or have recently been on them are up to 10 times more likely to contract a Clostridium difficile (C. diff) infection than those who have not been on antibiotics. C. diff usually causes symptoms like diarrhea and stomach pain, and it can return again and again. Antibiotics can also trigger allergic reactions, and they may disrupt the gut microbiome in ways that cause or contribute to inflammatory bowel disease and other health issues.
The rise of antibiotic-resistant bacteria is another, broader concern. “We’re creating superbugs,” says Dr. Ateev Mehrotra, an associate professor of health care policy and medicine at Harvard Medical School.
The more a species of bacteria is exposed to an antibiotic, the more likely that species is to adapt and develop defenses against that antibiotic. Over time, those defenses can render an antibiotic ineffective…
