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Antibiotics Overview: Uses, Risks, and History

Antibiotics are important drugs used to treat bacterial infections worldwide. The first antibiotic, penicillin, was discovered by Dr. Alexander Fleming in 1928. There are now hundreds of antibiotics in use. 

Antibiotics For Treating Bacterial Infections

Antibiotics are used to treat infections caused by bacteria. Common infections caused by bacteria include strep throat, urinary tract infections, skin infections (Staph or staphylococcus), sexually transmitted infections (chlamydia, gonorrhea, syphilis), pneumonia, gastrointestinal infections (Salmonella, E. coli), and serious bacterial infections such as meningitis and sepsis. 

Antibiotics work by killing harmful bacteria. For example, some antibiotics prevent bacteria from forming a cell wall that they need to grow and multiply.

Your doctor will only prescribe an antibiotic if you have a bacterial infection. Antibiotics are ineffective against infections caused by viruses, such as the common cold, flu, and COVID-19. 

Consequences of Misusing Antibiotics

The Centers for Disease Control and Prevention (CDC) estimates that over 236 million antibiotic prescriptions are dispensed from US pharmacies each year. However, at least 28% of antibiotics prescribed in the outpatient setting are unnecessary. Here are some of the serious consequences of misusing antibiotics.

Immediate Health Risks of Antibiotic Use Without an Infection

Antibiotic Side Effects 

Common side effects of antibiotics are listed below. These side effects are usually mild and go away once you stop antibiotics. 

• Nausea

• Diarrhea

• Feeling sick

• Rash

Allergic Reactions

Just like any medication, in some rare cases, antibiotics can cause more serious side effects, including allergic reactions. Seek emergency medical care if you develop the following symptoms after taking antibiotics:

• Skin rash, itching, hives

• Tightness in the throat

• Difficulty breathing or swallowing, wheezing

• Swelling of the face, mouth, lips, or tongue

Impact on Natural Flora in the Body

There are good and bad bacteria in the body. For example, good bacteria in the human gut help to break down food and prevent the overgrowth of bad bacteria that cause infections. 

Antibiotics cannot discriminate between beneficial and harmful bacteria. By killing all bacteria, antibiotics upset the balance between good and bad bacteria in the body. 

For instance, taking a round of antibiotics can put you at risk of Clostridioides difficile, which is a bacteria that causes severe diarrhea, stomach pain, nausea, and fever. This happens because antibiotics wipe out the beneficial bacteria that normally keep C. diff in check. 

Antibiotic use can also increase the risk of vaginal yeast infections in women. This is because antibiotics kill healthy bacteria in the vagina, which leads to an overgrowth of yeast.

Long-term Risks: Antibiotic Resistance Explained

What Are Antibiotic-Resistant Bacteria?

Antibiotic-resistant bacteria are bacteria that cannot be killed by antibiotics. They are able to survive and multiply in the presence of an antibiotic. 

Taking antibiotics when they are not needed allows bad bacteria to build a resistance to antibiotics. Meaning, the bacteria learn to outsmart antibiotics. They do this by either learning to destroy the drug or undergoing genetic changes so that an antibiotic is no longer harmful to them. 

Bacteria that survive antibiotic treatment continue to multiply and pass on their drug-resistant properties. Additionally, some bacteria also pass on their antibiotic-resistant properties to other bacteria. In other words, bacteria share antibiotic survival tips with each other. As a result, antibiotics may not work well against harmful bacteria when you really need them. 

Taking unnecessary antibiotics can lead to drug resistance. This can cause more severe bacterial infections, health complications, longer hospital stays, and increased death rates from bacterial infections. 

Another consequence of taking antibiotics when they are not indicated is that they can promote opportunistic infections such as those caused by fungi, viruses, or parasites.

Threat of Antibiotic-Resistant Infections to Individual and Public Health

Most infection-causing bacteria become resistant to at least some antibiotics. It is a natural process, and it is expected that bacteria will develop some drug resistance. However, the way antibiotics are used affects how quickly and to what extent antibiotic resistance develops.

Antimicrobial resistance is a global public health crisis, according to the World Health Organization (WHO). Antimicrobials, including antibiotics, antifungals, antiparasitics, and antivirals, are widely used to prevent and treat infectious diseases. As a result of widespread utilization, including inappropriate use, the rate of antibiotic resistance has increased at an alarming rate. Many medicines have become ineffective, and infections have become difficult or impossible to treat. 

The World Health Organization estimates that bacterial antimicrobial resistance was directly responsible for 1.27 million deaths globally and contributed to nearly 5 million deaths in 2019. New antibiotics are being developed to treat drug-resistant strains of bacteria.  However, to adequately combat this global health concern, education is essential for raising awareness of antibiotic-resistant bacteria. We must use antibiotics responsibly to prevent drug-resistant infections. Learn about How To Rebuild Your Microbiome After Antibiotics.

Common Misconceptions About Antibiotics

Treating Viral Infections with Antibiotics: Why It Doesn't Work

Viruses and bacteria are different. Bacteria attack cells in the body from the outside. In contrast, viruses live inside the cells. Bacteria can reproduce on their own while viruses need to latch on to human cells to multiply. In addition, bacteria and viruses also have different survival mechanisms. Viruses have a protective coating while bacteria have a cell wall that can be destroyed by antibiotics. For these reasons, antibiotics are not effective against viruses.

The Myth of "Boosting Immunity" with Antibiotics

Antibiotics do not boost immunity. In fact, antibiotic use when it isn’t necessary or taking antibiotics too often can actually weaken your immune system. Here’s why:

• Antibiotics may kill good bacteria that support the immune system and help it fight infections.

• Overuse of antibiotics can lead to antibiotic resistance in bacteria and make infections harder to treat.

Risks of Self-Prescribing Antibiotics

It is important to get a proper diagnosis and prescribed antibiotics from a healthcare professional. This is because many bacterial and viral infections can cause similar symptoms. For instance, most sore throats are from a viral infection such as the flu. However, they can also be from a streptococcal throat infection which is a bacterial infection. Allergies can also cause cough and throat irritation. Similarly, sinus infections can be both bacterial and viral.

Frequently Asked Questions

What happens if you take antibiotics when you don’t need them?

Taking antibiotics when it’s not necessary  (for example, to treat symptoms of a viral infection) will be ineffective. You may remain sick longer, and you are at risk to develop serious health complications. 

Antibiotics can cause a vast host of side effects, from nausea, diarrhea, and stomach discomfort to more severe issues like heart rhythm problems. Inappropriate use of antibiotics is not only ineffective, but it can also cause side effects while increasing the risk of antibiotic resistance, a global health threat.  

Is it bad to take UTI antibiotics if you don't have one?

It is not recommended to take UTI antibiotics if you don’t have a urinary tract infection. Antibiotics can cause side effects such as stomach pain, nausea, diarrhea, and feeling sick. Also, bacteria develop resistance to antibiotics if you take them when they’re not needed. Preemptive use of UTI antibiotics will not prevent UTI from occurring. 

What happens if you mistakenly take antibiotics?

Accidentally taking one extra dose of your antibiotic is unlikely to be harmful, although it may cause more severe side effects. If you have overdosed on antibiotics, seek emergency medical care.

Best Practices for Antibiotic Use

When Should You Take Antibiotics? Guidelines from Health Care Providers

Your health care provider will prescribe antibiotics only for certain infections caused by bacteria, only when it’s truly necessary. Do not insist on an antibiotic prescription just because you’re feeling under the weather. Understand that antibiotics don’t work for illnesses caused by viruses, fungi, or parasites.

Diagnostic Testing Before Antibiotic Prescriptions

It’s important to follow your healthcare provider’s recommendations for diagnostic testing before starting antibiotics. Physical exams and laboratory tests, such as nasal swabs, urine analysis, and blood cultures, are tools used by healthcare providers to diagnose illnesses. These tools not only help clinicians diagnose a bacterial infection but also help differentiate between bacterial and viral infections, reducing unnecessary antibiotic use. 

For example, a throat swab can help diagnose strep throat, which can be treated with an appropriate antibiotic. However, if the test comes back negative, your doctor will recommend other treatments for a viral infection or allergies.

Similarly, your healthcare provider may order a urine culture and sensitivity test to determine if your symptoms are caused by bacteria, which bacteria are present, and what antibiotic is the most suitable. 

Completing Prescribed Antibiotic Courses

It’s important to take antibiotics exactly how they are prescribed. Do not skip doses or stop antibiotic treatment sooner than advised by your provider, even if you start feeling better. Doing so can cause your infection to come back and be harder to treat in the future.