Antibiotic Misinformation

Many patients assume an antibiotic is the answer to everything, from a head cold to a stomach virus, even an ingrown toenail. So how do you inform a patient that they do not need an antibiotic?

Environment

What type of environment you are working in has a significant input on informing the patient what their medication is, and is not? In a private doctor’s office, there is more of a chance that the doctor is willing to discuss the patient's concerns if they are requesting an antibiotic. In a hospital, well, it's probably on you. It may be a good time to brush up on the differences of virus versus bacteria, so you will be well informed when educating your patient.

Bacterial Infections

It’s a bit of a misconception that every bacterial infection requires an antibiotic. Some bacterial infections may clear up on their own, depending on severity. A mild sore throat may in fact be bacterial, however if it is slightly sore, and does not last for more than 3 days, there is a good chance the body itself can fight the infection off without the aid of an antibiotic. Some physicians will write a prescription, and suggest it be held a day or two to determine if the infection clears.

If it is up to you, as the nurse to explain why no antibiotic is being prescribed, it’s a great idea to a small speech in mind, explaining why antibiotics are not always the answer. One survey of 1000 nurses found that patients not being prescribed antibiotics came in as the second complaint from nurses, right behind not being prescribed pain medications. It is a known fact that antibiotics are overused in this country, and have been for some time. This creates a problem not only for the user themselves, but for the public. Bacteria evolve with the overuse of antibiotics, and that is bad news for everyone. In the event an antibiotic is needed, it may need stronger due to resistant bacteria. It may not always be easy to convince a mother that her child running a temperature of 100 degrees should not take an antibiotic, however it’s a necessary part of the job.

Over-Prescribed Antibiotics

Many over-prescribed antibiotic situations occur with a parent and child.

Here is an example:

A patient, 9 or 10 years of age, had a mom that was a bit over protective. If the girl got sniffles, her mom wanted a 10 day course of an antibiotic. She took the girl to multiple doctors, and eventually made a weekend trip to another country so she could buy and stock up on antibiotics. This young lady ended up with a case of pneumonia, and it was in fact bacterial. The problem was, the antibiotics used to normally treat this condition were not working for her. The fact is, her body had developed an immunity to the antibiotic, the bacteria was resistant to the antibiotic now needed. In this case, a super antibiotic was used; however it came with significant side effects. The child lost a portion of her hearing, and clumps of her hair.

A virus will not respond to an antibiotic under any circumstances. In fact, depending on the type and location of the virus within the body, an antibiotic could make the patient much sicker. In the case of a stomach virus, many antibiotics could contribute to both a nausea and diarrhea problem. Antibiotics are notorious for causing both, the last thing one needs when they are already ill. A virus will run its course, and the body should be able to fight it off, and then get better, which in most cases happens.

Related: What does an RN Do?

It’s important to educate patients as to when an antibiotic is necessary, and when it is not. For a patient suffering with a virus, the suggestions for improvement include:

Getting plenty of rest
Drink plenty of fluids
Eat something, even if it's soup, broth, or jello
Be sure to wash hand frequently

Most viruses last 48 hours at the most, and making sure dehydration is not an issue, is extremely important. Most doctors’ advice to patients with a virus is to wait it out, while caring for the body. in the event the conditions do not clear with 3 days, patients would be advised to see their doctor. If at any point a healthcare professional discovers it has transitioned into bacterial, they may assign a course of antibiotics. It is always important to remind patients to take all of their prescribed antibiotics unless their physician directs them otherwise.

Related: List of nursing organizations

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