Duration Health

Infection

Introduction

Minor infections will often go away on their own without antibiotics. When the body isn't able to clear an infection on its own, or if a serious bacterial infection is suspected, antibiotics are sometimes used to treat the infection.

The choice of whether to use an antibiotic, and which antibiotic to use, is complex. Antibiotics treat only bacterial infections, but most infections are caused by viruses, not bacteria.

Each antibiotic is effective against certain groups of bacteria, but often it is not known which bacteria are responsible for a given infection. Practitioners will therefore often choose an antibiotic based on the part of the body in which the infection occurs, since certain classes of bacteria are most often responsible for infections in a particular organ system.

Do not take multiple antibiotics at once. A better strategy is to choose one antibiotic, take a full course, and consider taking a different, second antibiotic if the infection has not resolved after the full course is completed. One exception to this rule is ciprofloxacin PLUS metronidazole, which may sometimes be taken together, as a pair, for abdominal infection.

Infections with a change in someone’s behavior, lethargy, decreased urination, or rapid or shallow breathing, may indicate sepsis and are always a medical emergency. Seek help immediately.

If most infections are viral, why do I get better when I take an antibiotic when I'm sick?

Antibiotics are drugs specifically design to kill bacteria. Each class of antibiotics kills bacteria by interfering with a particular component of the bacterial cell that the bacteria needs to survive. Viruses don't have these components, so they simply aren't affected by antibiotics.

It's not uncommon, however, for people to report that they feel better after taking an antibiotic during a viral infection. Why?

One explanation is the placebo effect, a well-known and extensively studied phenomenon whereby people feel better after taking a pill, no matter what the pill contains. This effect is so strong that when new drugs are developed, they are compared to a pill containing an inactive ingredient, because test subjects will report or experience an effect just by taking a pill, whether the new drug is working or not.

Another explanation is that during the time a patient is taking an antibiotic, the body is fighting the viral infection on its own. By the time the antibiotic is finished, the body has cleared the infection, and the person feels better. But this would have happened without the antibiotic.

Yet another explanation is that some antibiotics have anti-inflammatory effects on the body as a whole, as a side effect of the antibiotic. This reduction in inflammation makes a person feel better, but it's not because the antibiotic is treating the infection. A regular anti-inflammatory drug, such as ibuprofen, would have the same effect without the potential side effects of the antibiotic.

If an antibiotic might help, why not just try it?

The decision to give an antibiotic is a balancing act between the antibiotic's benefits (potentially treating a bacterial infection) and risks (side effects). These side effects can be serious. While you may have never personally experienced side effects from an antibiotic, experienced practicioners know that these side effects are in fact very common.

Side effects from antibiotics include diarrhea (the most common), allergic reaction (ranging from mild rash to life-threatening anaphylaxis), and, paradoxically, infection. Because antibiotics are designed to kill bacteria, they also kill "good" bacteria in the body. (See: Human Microbiome) The loss of "good" bacteria gives "bad" bacteria (and fungi) an opportunity to grow and make you sick.

The bottom line is that the decision to start an antibiotic is tantamount to deciding that the benefits outweigh the risks. If the benefits are in doubt, it would be unwise to assume the risks.

Reference

Azithromycin is an antibiotic. Azithromycin can be used for for respiratory infections, such as pneumonia, or sexually transmitted infections

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Metronidazole (generic for Flagyl) is an antiprotozoal and antibiotic, which means it fights bacteria as well as other organisms that cause disease. Metronidazole can be used to treat infections in the abdomen.

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Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat bite wounds, skin infections, strep throat and pneumonia. This medication should be taken with food.

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Trimethoprim-sulfamethoxazole (TMP-SMX, generic for Bactrim) is an antibiotic. It can be used to treat urinary tract infections and skin infections.

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Nitrofurantoin (generic for Macrobid) is an antibiotic used specifically to treat urinary tract infections.

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Ofloxacin is an antibiotic. Ofloxacin drops can be used to treat eye or ear infections.

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Mupirocin (generic for Bactroban) is an antibiotic ointment. Mupirocin can be used to treat a localized skin infection, including infections caused by methicillin-resistant S. aureus bacteria (MRSA).

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Oseltamivir (generic for Tamiflu) treats influenza.

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Ciprofloxacin (generic for Cipro) is an antibiotic. It can be used to treat infections in the abdomen. Consider ciprofloxacin for diarrhea with blood or mucous. It is also used in cases of anthrax exposure. Ciprofloxacin can be taken with ondansetron. Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice.

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Doxycycline is an antibiotic. Doxycycline can be used to treat Lyme disease, Yersinia (bubonic plague), Tularemia, and other infections. This medication should be taken with food.

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Emtricitabine is used in combination with other medications for HIV post-exposure prophylaxis. The decision to start post-exposure prophylaxis after a possible exposure to HIV is complex, and the standard of care is to initiate post-exposure prophylaxis medication only after laboratory testing. Seeking immediate medical attention is the best option. However, in an emergency or disaster situation in which medical care is unavailable, take this medication, along with tenofovir and raltegravir, as soon as possible (and within 72 hours) to prevent infection if you believe you have suffered a major exposure to HIV. Immediately seek qualified medical care.

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Tenofovir is used for HIV post-exposure prophylaxis. The decision to start post-exposure prophylaxis after a possible exposure to HIV is complex, and the standard of care is to initiate post-exposure prophylaxis medication only after laboratory testing. Seeking immediate medical attention is the best option. However, in an emergency or disaster situation in which medical care is unavailable, take this medication, along with emtricitabine and raltegravir, as soon as possible (and within 72 hours) to prevent infection if you believe you have suffered a major exposure to HIV. Immediately seek qualified medical care.

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Raltegravir (generic for Isentress) is used for HIV post-exposure prophylaxis. The decision to start post-exposure prophylaxis after a possible exposure to HIV is complex, and the standard of care is to initiate post-exposure prophylaxis medication only after laboratory testing. Seeking immediate medical attention is the best option. However, in an emergency or disaster situation in which medical care is unavailable, take this medication, along with emtricitabine/tenofovir, as soon as possible (and within 72 hours) to prevent infection if you believe you have suffered a major exposure to HIV. Immediately seek qualified medical care.

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Atovaquone-proguanil (generic for Malarone) is used for malaria prophylaxis in areas with chloroquine-resistant Plasmodium falciparum, and can be used in most parts of the world where malaria occurs. Take it daily for 1-2 days before possible exposure to malaria, and continue daily for 7 days after leaving an exposed area. If you plan to travel to malaria-endemic areas, discuss with your Duration Health provider to determine which prophylaxis is appropriate for you.

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Ivermectin is used to treat parasite infections like head lice and scabies. This medication should be taken on an empty stomach.

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Praziquantel is used to treat flatworm infections like schistosomiasis. This medication should be taken with food.

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Albendazole is used to treat tapeworm infections. This medication should be taken with food.

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Urine test strips are an amazing and inexpensive diagnostic tool. They can be used to detect urinary tract infections, dehydration, diabetes, and blood in the urine. A urine test showing positive leukocytes or nitrites may indicate a urinary tract infection. A high specific gravity or ketones in the urine may indicate dehyration. Glucose in the urine is a sign of uncontrolled diabetes.

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The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.