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ADVANCE Perspective: Respiratory Views

Getting It Right

Published December 17, 2015 12:55 PM by ADVANCE for Respiratory Care & Sleep Medicine

By Tamer Abouras


As a kid, few things were less satisfying than a trip to the doctor’s office that ended without being handed some kind of prescription antibiotic. Aside from the validation that your day off of school was in fact merited, most antibiotics have you feeling significantly better in a matter of 24 hours.

Probably the only thing worse in these circumstances than leaving without a prescription is leaving with one and then having to come back because it was woefully ineffective against your sickness.

The source of these issues primarily comes down to the difference between bacteria and viruses and how each is treated. While antibiotics are used to address bacterial infections, they’re powerless to stop viruses such as the flu which, provided you’ve already been vaccinated against, leaves you with little recourse should you contract it.

SEE ALSO: Preventing Respiratory Syncytial Virus

One piece of bad news is that regardless of whether your doctor happens to be tightfisted or liberal about how he or she distributes their antibiotics, research suggests that, (much) more often than not, most of them aren’t hitting the mark with whatever they prescribe.

According to Healthline, “Just 5 percent of antibiotics given worldwide are correctly prescribed, a problem whose proportions have become even more significant as antibiotic-resistant bacteria have emerged as a serious health threat.”

Healthline reports that a study recently published in the journal Immunity looked at the difference in immune response to viruses and bacterial illnesses among “ … 3,000 blood samples that come from a dozen countries and multiple viral and bacterial respiratory infections.” And that research, reportedly, hoped to bring doctors and medical professionals closer to two “Holy Grails”: A) Allowing doctors to tell patients with certainty whether they do or don’t need antibiotics; and B) A hope that the findings can point the way to broad-spectrum antiviral drugs.

According to Ephraim Tsalik, MD, PhD, and an assistant professor of medicine at Duke University, the main loophole (and one which leads to many mistakenly given antibiotics) is that some patients can have both bacterial and viral infections.

“What clinicians really need to know is, ‘Do I need to give antibiotics or not?’ Unfortunately a lot of what’s driving overuse of antibiotics is that clinicians are aware of the possibility of co-infection,” he said.

The study’s author, Purvesh Khatri, PhD, and a research professor at Stanford University School of Medicine, said “The core motivation for this study came from the hypothesis that we would be able to find pathways that multiple viruses are using. If we can find those pathways, then we could use drugs that would target those pathways.”

The only drawback? Those types of drugs are known as cytotoxic, meaning they destroy human cells and would therefore be more likely to have side effects attached to them. As noted in Healthline, however, “Depending on the circumstances — which could include deadly outbreaks — even cytotoxic drugs can be useful.”

So all in all, the accuracy with which viruses and bacterial infections are being prescribed the proper medications is hopefully on the increase. In the meantime, there’s one contagious condition you absolutely can prevent all on your own, whether or not you head home with a prescription: fear.

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