What’s the story about antibiotics? These powerful and important medications are quite controversial and often misunderstood so let’s just clear up a few basics…

Antibiotics have been around for about 100 years. Penicillin was the first type of antibiotic used but there are now several types of antibiotics and probably hundreds of brands.

Antibiotics fight germs. There are many different types of germ but for simplicity we’ll consider just two: viruses and bacteria.

  • Viruses are the tiniest germs and they infect host cells to replicate and survive. Viruses cause colds, flu, gastroenteritis as well as more serious conditions like HIV.
  • Bacteria are also small germs but can survive outside of / without host cells. Bacteria cause illnesses like tonsillitis, meningitis, and pneumonia.

The BIG THING is that antibiotics are useless against viruses. They only work on bacteria. This is why it makes no sense to use antibiotics for viral illness like colds and flu – in fact doing so only builds resistant bacteria (when bacteria are frequently exposed to antibiotics they eventually evolve and become resistant), which is a growing problem today.

The real-world difficulty is that it is not always possible or practical to determine if an illness is viral or bacterial – to be sure you’d have to take a sample (e.g. sputum, blood, urine) and then wait several days for laboratory test results. Today’s patients are, well, impatient. Today’s doctors are unwilling to take risks and or upset demanding patients. Sometimes (less often than is thought) a viral illness develops into a bacterial illness. For these and other reasons a “safety-first” approach is often used whereby antibiotics get prescribed “just in case”.

There is much more that can be said about antibiotics. Do they weaken our own immune systems (probably not or not-much, on balance)? Do they cause horrible side effects (only rarely)? Are they over-prescribed (definitely)? Do they save lives (yes)? Can they render the contraceptive pill ineffective (yes)? Are some of them dangerous for unborn babies (yes)? And more…much more…but we just want to focus on the most important facts here.

Antibiotics are powerful life-saving medications that we are grateful to have. They are also massively over-used although the reasons for this are understandable enough.