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We know (or should know) that the overuse of antibiotics is causing a rise in "superbugs" that are resistant to them.
This means that we should avoid using them when we don't need to, for example, in soaps and similar products.

How far should we be going to avoid using them?
For example, are there occasions when even prescribed antibiotics should be avoided?

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How refreshing to see someone with this attitude! Kudos.

Doctors have been so long accustomed - and accosted - to prescribe unnecessary antibiotics (you wouldn't believe some of my experiences***) that sometimes on a borderline case, they'll just write out the script. What a welcome question this would be:

Doctor, I'd like to avoid antibiotics if it's safe to do so. Is there an alternative, or do you think it's better to be on one?

No decent doctor will be dissuaded by this question from prescribing a necessary antibiotic (if they're not decent, you shouldn't be seeing them!)

I doubt you would ever pressure a doctor to give you an antibiotic if they don't think you need one. For anyone else reading this: please don't.

The following pertains to all members of your family.

  • Never save the last few pills "in case you get sick again".
  • Don't take anyone else's antibiotics "'til you have a chance to see a doctor".
  • Better a higher dose for a shorter time than a lower dose for a longer time.
  • Ask if a narrow-spectrum antibiotic would treat your illness as well as a broad spectrum antibiotic.
  • Get all your recommended vaccines! Some of them are for common bacteria now.
  • Don't ask for an antibiotic over the phone because "this is exactly like what I had last time".
  • Read about when antibiotics (and doctor visits) are and aren't necessary, e.g. at the CDC's Get Smart: Know When Antibiotics Work, etc. (See links)
  • Take and finish your antibiotics as prescribed.

In terms of home and personal hygiene, don't be afraid of germs; there are more harmless ones out there than dangerous ones.

  • Don't try to sanitize your house. Water and mild detergent is good enough for cleaning.
  • Use a mild soap for bathing, something without anti-bacterials.

***I once saw a patient who presented with "sinusitis" since "this morning". He wanted antibiotics. On reviewing his symptoms (and clinical exam), he had no evidence of sinusitis. I gently refused, explaining the common risks of unnecessary antibiotics. He persisted. I went further, explaining to him the uncommon but much more serious risks, e.g. Antibiotic-Associated Diarrhea (aka C. diff). He persisted. I went even further, explaining the really serious - but possible - risks and discussed the risk-to-benefit ratio. He called me ridiculous and left in a huff. Two days later, I got a call from the Hospital Administrator's office (my employer's boss). Turned out that the patient was a golfing buddy of his. The Hospital Administrator (not a physician, but a businessman) told me in no uncertain terms that he expected me to give patients antibiotics when they asked for them! (I'll spare you the details of the rest of the story.)

Reducing Unnecessary Antibiotics Prescribed to Children: What Next?
Get Smart: Know When Antibiotics Work
Choosing Wisely
Appropriate Antimicrobial Prescribing: Approaches that Limit Antibiotic Resistance

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  • 1
    +1 for the warning about sanitizing your home. Right now all the "7 places dirtier than your toilet" are all the range, and we are actually seeing rises in numbers of cases of Asthma. I am forever having to tell my girlfriend the risks of sanitizing everywhere - it is all the range to over use them... In fact I feel more confident about my immune system than hers because of the amount of germs I've been exposed to (barefoot in the garden, avoiding detergents). – Tim Apr 7 '15 at 10:27
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    @Tim - absolutely. Had this question been framed differently, I'd have included, "garden, own a dog, visit a dairy farm..." Some "germs" are very good for us. :-) – anongoodnurse Apr 7 '15 at 16:40
  • Please try to avoid quoting someone else's answer as your primary answer. For examples and instruction on how to write a better answer see here: meta.health.stackexchange.com/questions/211/… – Dr. Duncan Sep 10 '15 at 20:31
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I agree humans are over prescribed antibiotics. I think doctors should be more scientific. Take a culture and wait three days for sensitivities to grow (if any). Then and only then prescribe the best antibiotic.

The real issue to me though is the use of antibiotics in livestock to promote growth more than as a prophylactic. One study in Arizona took bacterial samples from chicken, turkey, and pork from local supermarkets. They sequenced the bacterial DNA and compared them against bacterial strains from hospitalized patients. There were many matches which suggest improperly handled meat can spread antibiotic resistant bacteria that are a result from overuse in there meat industry.

Source: http:/:www.pbs.org/wgbh/frontline/film/trouble-with-antibiotics/transcript/

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