Antibiotics are a precious resource. It’s in all our best interests to ensure they don’t become a finite one; they must be managed sustainably.
Over and incorrect use of antibiotics is taking a toll on their effectiveness. Already, 25,000 people die in Europe each year from bugs that are resistant to antibiotics, and someone in the world dies every 10 minutes because antibiotics don’t work.
It’s worth bearing this in mind as we move through the winter illness season.
[Feeling under the weather? Get practical advice on how to mind yourself, or your family, when sick.]
"Typically, it starts off when the kids go back to school, bugs like rhinoviruses and respiratory viruses get passed around and people start to get head colds, sore throats, croupy coughs and earaches. After that we hit the influenza season," says Cork-based GP Nuala O'Connor, lead advisor on antibiotics for the Irish College of General Practitioners.
These illnesses can make you feel terrible but antibiotics won’t make you feel better.
“A lot of people still believe antibiotics can help to treat common illnesses like colds, flu, earaches, tummy bugs and rashes. In fact, antibiotics are useless against most of these infections because they are caused by viruses and antibiotics don’t work on viruses,” she says.
However, there is plenty we can do to help ourselves, not least of which is to get the flu vaccine, particularly older people, those with chronic conditions or those who, perhaps because of cancer treatment, have a compromised immune system.
Good coughing etiquette
If you do succumb, you can help others. Good coughing etiquette means coughing into a tissue, binning the tissue and then washing your hands. In the absence of a tissue, cough into your elbow.
Not going to work and not sending your sick children to school also helps limit the spread of infection. But if you do have to go out, limit your physical contact with others, she suggests. “These viruses are airborne in tiny droplets so you can pick them up from someone coughing within three metres of you, or simply by using a door handle or desktops they have used and then touching your face,” says O’Connor.
Where the symptoms of flu are severe, and the person afflicted falls into one of the vulnerable classes listed above, or is pregnant, there are highly specialised anti-viral medications that can be prescribed. These are not the appropriate treatment otherwise.
“These medicines are really good when used appropriately. However, if you can recover by yourself that is better for you and better for everybody,” she says.
The most recent Healthy Ireland Survey indicates that 90 per cent of us know that if we take antibiotics too often, or when we don't need to, that they may not work at all in the future. Moreover, 92 per cent of us are happy to trust our GP's advice about whether or not we need an antibiotic, and if so, which one.
“It’s important to make the right decision because antibiotics can themselves lead to unwanted side effects, such as tummy upset or diarrhoea,” she says. “They can cause serious interactions with medications you are on, for example cholesterol-lowering drugs. And they can kill good bacteria - the kind that help keep you healthy - as well as bad.
Learning how to manage common illnesses with confidence and common sense is a great life skill
“If you are prescribed an antibiotic it is important to take the course as prescribed, otherwise some bad bugs may survive and become resistant. Never share leftover antibiotics, or take them without medical supervision. ”
Managing symptoms ourselves
For the vast majority of us, we can manage our symptoms by ourselves, alleviating the worst of them while the virus runs its course.
“Learning how to manage common illnesses with confidence and common sense is a great life skill and improves our understanding of when we need antibiotics and when we don’t,” says Dr O’Connor.
“Looking after our health is something that we learn from our parents, friends, doctors, from our own experience and, more and more, from the internet.”
It's for this reason that the HSE, in partnership with the Irish College of General Practitioners and the Irish Pharmacy Union, has developed undertheweather.ie.
The website gives practical, common-sense advice and information on dealing with many common illnesses like colds, flu, earaches, sore throats, tummy bugs and rashes.
“98 per cent of sinus infections are caused by viruses,” O'Connor points out. “What we really need to do is educate people about all the ways they can manage the symptoms of sinusitis and other viral infections themselves.”
There is plenty you can do, such as taking paracetamol or ibuprofen for pain relief and to bring down temperature, to running a steamy shower to clear out nasal passages. If you are coming down with a virus, accept that it will take time to run its course. “We expect to feel better straight away but in fact, if you have a sore throat it’s typically going to take seven days, an earache will take three to five days and a cough can last three weeks,” she says.
"If you are worried, you should see a doctor, particularly when it comes to the young and the elderly. But what is great about undertheweather.ie is that it is written by GPs. It's what I tell patients when they come in to see me. We all Google everything these days, so it's important to go to a trustworthy website. Undertheweather.ie is also free and it's not advertising anything other than sound advice," she says.
The website should also help change the culture around antibiotics, she feels. “We need to ensure that we reserve antibiotics for those cases where they are really needed. Part of that is having people accept that if they can get better by themselves, without antibiotics, that’s better for everybody.”