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why you don't need antibiotics if you

have a common cold what I'm telling you

are you sure I'm not sure so I've got an

infectious disease specialist here Dr

Tom Warren who's going to explain to us

the difference between a virus a

bacteria a cold a bacterial illness I'm

Dr Paul zel I'm Dr Brad we welcome to

talking with docs and the other thing is

the reason to not do it is not just for

your cold it's for the greater good of

all of us so stay till the end and we're

going to we're going to tell you kind of

how to approach this welcome Tom let's

start at the

how crazy does it make you when people

say listen I want antibiotics cuz I got

my kids got a runny nose yeah so

antibiotics are medications that treat

bacterial infections okay so it's

bacteria that uh are affected by

antibiotics okay so I'm a mom so I'm

like well how do you know that my kids's

runny nose is not a bacteria yeah so

viruses are very common we all have

several viral infections per year and so

most of the uh colds and and flu that

have are due to viruses and most viruses

don't have medications that treat them

there are some that do um but most don't

there's a there's a key difference

between a virus and a bacteria they're

both germs I guess you would consider

them a bacteria is a living organism

it's a one cell I guess not even

organism it's a one cell living thing

okay it lives on its own a virus is

doesn't even meet the definition of

living thing I I don't think it's

basically like a protein inside some

kind of shell it's not it's not a living

entity on its own like a bacteria

they're two totally different things and

viral infections thankfully are much

much much more common than bacterial

infections in the general population

that's right fair fair to say coming

from not an infectious disease

specialist sure and the way antibiotics

work is a very specific mechanism that

attacks a very specific part of the

bacteria that make it die or reduce its

effect or whatever but those similar

strategies don't work against a virus so

an antibiotic will not kill a virus

that's right an antibiotic has no effect

on viruses take home Point number one

antibiotics don't work for viruses so as

a clinician so a child comes into your

clinic maybe not your clinic but even a

family doctor's office or walkin clinic

everybody knows like how how do you know

it's not how do you know it's not a

bacteria do you have to do you have to

test like the exate like the the runny

nose or swab the ear or the throat to

know that it's not a bacteria there are

some tests for bacteria and cultures

that we can do but we just know uh based

on how common viruses are okay and the

symptoms that someone has that it's most

likely going to be a virus and so we

know for things like sinusitis for

instance that can be caused by bacteria

but is often initially caused by viral

infections that we can wait we can see

if the person or it's going to get

better like most people frequently do

when they have head colds the the runny

nose will go away after a few days days

the cough will go away after a few days

and so there are some people where it

won't and that's when we can start doing

potentially more tests for bacteria and

say it look like a virus but the way

it's behaving now we think it might be a

bacteria that's right well we have

antibiotics for bacterial infections why

don't we just give people antivirals for

these virus infections that'd be great

um we just don't have those medications

and there's a variety of reasons why one

of the main ones is that viruses just

change so frequently and so it's a cat

and game and we've seen that you know

with uh other viruses that we

potentially can treat like Co or

influenza U we do have some medication

for them but it's not they're not

perfect and so antivirals are in general

a little harder to uh to to make okay so

so I'm a parent little Jimmy's got

hockey playoffs next week he's kind of

got a bit of a runny nose is is there

any downside to just giving them some

antibiotics just in case on the 1%

chance that it's a bacterial infection

cuz I need them good for Saturday play

center he's he's going to the playoffs

can we not just give him some

antibiotics like the cost is low right

well there are definitely side effects

so okay let's talk about the reasons not

to take antibiotics willy-nilly yeah so

there's definitely side effects for the

the patient themselves okay so

antibiotics you know can cause toxicity

to different organs like the kidneys yes

people can have allergic reactions to

them right and they can kill some of the

good bacteria that are in people's bowel

and those good bacteria on the skin in

the bowel can have a protective effect

and we have learned lots of I'd say in

the last 10 years the microbiome has

just really popular thing to talk about

we've learned that there are

consequences to killing the good

bacteria in our gut so there's three

good reasons what about the financial

cost to say you don't have benefits like

are they expensive yeah some some

antibiotics are very expensive there are

lots we're using things like penicilin

and Amoxicillin that have been around

for decades so they're not that

expensive anymore but some antibiotics

can be expensive but the other the other

main risk is that uh the antibiotics can

select for more resistant organisms okay

so the antibiotics are just killing

bacteria that are susceptible to them

but there's going to be lots of other

bacteria around that aren't susceptible

and they're usually more resistant and

harder to treat right so by taking

antibiotics you're actually screening

for the more resistant bacteria because

they're going to no longer be fighting

the other bacteria competitive

inhibition it's called so if you kill

off a whole population of bacteria other

bacteria are going to thrive and those

bacteria might be harder to treat with

antibiotics that's right I like the

analogy of using a herbicide on your

lawn right that kills most of the weeds

but one weed survives then that weed

like you said slowly just takes over

your whole lawn um so you have to be

careful so that's the first problem with

taking antibotic fling is there a

problem that eventually if you don't

take the right dose or take it for long

enough or don't Target it well enough

that the bacteria can learn how to evade

the antibiotics that we have yeah so and

uh bacteria can develop resistance right

and would you say that this is a

significant problem in our world today

very significant abolutely and and and

like lifethreatening potentially like

World threatening but I think we don't

really appreciate this the average

person that just wants to take

antibotics for five days to make the

runny nose go away doesn't realize that

this could lead to a bacteria that could

kill millions of people so what why why

is this important and how does it work

yeah so as bacteria are exposed to

different antibiotics they select for

resistance

and so it's only the strong that survive

and so Darwin those bacteria that

develop resistance are going to grow

more and spread more right and we got to

realize that when we take antibiotics

they eventually make their way into the

sewage system right we excrete them and

it's we can find antibiotics in lakes

and rivers and things like that and so

side note never put your pills in the

toilet never flush them into the water

system return them to the pharmacy sorry

i s to say that okay so they're

everywhere so and we're giving them to

animals right we're not uncommonly

feeding them to chickens and cows and

pigs to prevent disease and and I think

I read a stat like 80% of the world's

antibiotics actually are consumed by

animals not by human beings that's right

which is very concern okay so then this

presence of antibiotics everywhere is is

helping these bacteria evolve to become

resistant to the antibio give us the

name of like just three super bad

bacteria that we just can't treat well

with antibiotics just so people can

Google them if they want yeah so MRSA is

a big one so methy resistant St cus orus

so staf orus very common lives in the

skin lives everywhere but there's a

specific brand of that one that's extra

strong and hard to treat that's right

okay so Mera and then there's bacteria

like eoli and and other similar bacteria

gram negative organisms that can become

very resistant as well okay so this is

why you might have a loved one or know

someone who died from overwhelming

infection because they may have had an

infection with one of these bacteria

that we can't treat and this bacteria

came about because we've been

overtreating bacteria with antibiotics

yeah yeah we're seeing this in common

infections uh like salmonella infections

in different parts of the world are

extremely resistant we have almost no uh

drugs to to treat it gonorrhea um

there's many common infections that are

just becoming more and more antibiotic

resistant because there's more and more

antibiotics being used and then when it

comes to survival of the fit is

literally be we have no medication for

you so it's either your body fights it

or unfortunately you to come that's

right it takes us back to hundreds of

years ago before we had uh back

antibiotics an antibiotics take a long

time to develop uh it's very expensive

it's you know a billion dollars to

develop a new medication right and we

sent you cannot react fast enough to the

rate which is changing right now because

of the 8 billion people in our world and

the amount of that's being used that's

right so we have to use the precious

resource that we have antibiotics in a

in a you know logical way right so

Physicians and patients need to be

stewards of this Essen protect it okay

so what just quickly what are some of

the key features now now I know teting

antibiotics is bad I have something

going on how what are like the key

things that'll tell me this is a virus

or maybe this is a bacteria and I and I

might have to take antibiotics can you

can you think a few key that's a hard

question yeah that's that's hard but you

know for a lot of the common viruses

that we have uh people have experienced

these we all experience them a couple

times a year and so if it's something

that is progressively getting worse okay

if it's something that's not going away

right if there's a high fever really

high fever yeah sure or people are just

feeling very unwell they're just not

able to work they're not able to get out

of bed uh you know those severe features

but for most of the common runny nose

kind of sore throat the usual kind of

aches of flu and uh you know head colds

those are going to be viral infections

okay and now let's say I do have an

infection and it is H um it is actually

a bacterial infection in my throat for

example is there a chance that my body

can get over it without antibiotics or I

do I 100% definitely need antibiotics

like if you're anti- antibiotics you're

like no way I'm not taking that double

anti double anti yeah so you know our

immune systems are are wonderful

things yeah the body has an ability to

fight off infections including bacterial

infections so whether it's sinusitis or

ear infections or pneumonia there's

definitely a possibility that we can

fight those off without antibiotics okay

so you got time before you have to jump

into the antibiotic thing definitely see

your healthcare provider if you're

feeling unwell um but just recognize it

if your healthcare provider does not

give you antibiotics on that first visit

they're not being mean to you agreed and

I think that people think it's like a

conspiracy against doctor yeah it's not

the reason is because it's that your

health care provider thinks you probably

have a viral illness and thinks you're

probably going to get better without the

antibiotics and the reason we're not

prescribing antibiotics willy-nilly as

you said is for the reasons we talked

about the the bad effects on you and the

bad effects on the population it's kind

of like the crying wolf story right you

don't want to use them use them use them

and then you finally need them like well

they don't work anymore that's right um

I think the other thing we'd be remiss

not to talk about with respect to

antibiotics is is C diff so claustrum

defal is a very specific unique

infection that happens to people often

they can even after one dose of

antibiotics potentially and this can be

very debilitating even life-threatening

so this is just another reason along the

long list of reasons not to take

antibiotics when you don't need them

sometimes you take them and you still

get this but if that part's unavoidable

so yeah the take messages only take them

if you need them listen to your doctor

don't be mad at your doctor don't get

mad at leave a comment if you have an

experience with antibiotics or negative

positive whatever your thoughts are and

if you like this video please like it

subscribe to our Channel and remember

you are in charge of your own health and

thanks to Dr Warren for explaining this

very complicated subject to us thank you

see you next time