Dear Dr. Jeff: Last time I had the flu, my doctor prescribed Levaquin for me. I feel like I'm coming down with the same thing again. Do I need to come in for an appointment, or can you just call in some Levaquin for me? - M.B.B.
Dear M.B.B.: I can't really comment about your previous illness, but I would like to try to assess your current one before prescribing any medications. If it really is the flu, or a flu-like illness, it's very likely your infection is viral, and not bacterial. And as I'm sure you know, antibiotics don't kill viruses.
Even if you do have a viral illness, would an antibiotic help cover you, "just in case?"
Unless you have other complicated and complicating medical problems, probably not.
In fact, unnecessary antibiotics can be harmful. They can have side effects (allergic reactions, nausea, diarrhea, and yeast infections, to name a few). They kill off helpful bacteria in your body (bacteria which help you digest food and offer protection against viral pathogens). And, they promote the development of antibiotic-resistant bacteria (so that diseases that used to be easy to treat become very difficult to cure).
According to most experts, nearly half of the antibiotic prescriptions written each year are inappropriate. Over half of the adults who go to their health care providers for a cold are treated with antibiotics. Despite the lack of evidence of any benefit for most people from these treatments, more than 23 million prescriptions a year are written for colds, bronchitis, and upper respiratory infections. These 23 million prescriptions account for nearly one fifth of all prescriptions for antibiotics written for children and adults.
Even when antibiotics are appropriately prescribed, choosing the wrong one, or choosing an excessively broad spectrum antibiotic, may give organisms in your body a chance to develop resistance. Levaquin is certainly easy to take, and it's very effective for certain kinds of infections. It is also aggressively marketed, very expensive, and very broad spectrum. Levaquin is almost never indicated as a first-line treatment for uncomplicated infections.
You may have heard differently from advertisers. The pharmaceutical industry now spends over $21 billion per year on marketing, and over $3 billion on direct-to-consumer (DTC) ads. Reputable studies show that only 40 percent of these DTC ads fairly describe a medication's efficacy, benefits, and side-effects.
As you're probably all well aware, cold and flu season is starting up. We haven't yet diagnosed our first case of influenza, but like most viral illnesses, colds and the flu mostly need to "run their course." Treatment is aimed at relieving symptoms. Most people turn to some combination of decongestants, gargles, cough syrup, Tylenol or Ibuprofen, steam, extra fluids, and rest. Lots of rest.
Come into our Self-Care Room, and pick up a "Cold Care Packet." If you have access to a stove or microwave, you can also cook up some chicken soup, a favorite, nearly world-wide, home remedy. My personal suggestion would be to load it up with lots of fresh garlic and ginger. If you're vegetarian, try the garlic and ginger in a vegetable broth.
Sometimes viral illnesses take longer than you think they should to resolve. If you're concerned, please come into the health center to be checked out. Sometimes these illnesses progress into other problems, such as ear infections or bronchitis. Warning signs might include severe ear pain, fever greater than 101.5 for more than three days, prolonged or severe sinus pain, shortness of breath, deep cough productive of green or bloody phlegm, or swollen red tonsils with white spots. If you develop any of these signs or symptoms, please come in to see us.
We will likely not prescribe any Levaquin for you, but we promise to evaluate you thoroughly and thoughtfully.
Be well!
Jeff Benson, M.D.
Dudley Coe Health Center