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why you don't need antibiotics if you
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have a common cold what I'm telling you
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are you sure I'm not sure so I've got an
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infectious disease specialist here Dr
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Tom Warren who's going to explain to us
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the difference between a virus a
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bacteria a cold a bacterial illness I'm
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Dr Paul zel I'm Dr Brad we welcome to
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talking with docs and the other thing is
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the reason to not do it is not just for
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your cold it's for the greater good of
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all of us so stay till the end and we're
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going to we're going to tell you kind of
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how to approach this welcome Tom let's
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start at the
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how crazy does it make you when people
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say listen I want antibiotics cuz I got
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my kids got a runny nose yeah so
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antibiotics are medications that treat
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bacterial infections okay so it's
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bacteria that uh are affected by
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antibiotics okay so I'm a mom so I'm
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like well how do you know that my kids's
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runny nose is not a bacteria yeah so
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viruses are very common we all have
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several viral infections per year and so
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most of the uh colds and and flu that
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have are due to viruses and most viruses
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don't have medications that treat them
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there are some that do um but most don't
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there's a there's a key difference
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between a virus and a bacteria they're
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both germs I guess you would consider
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them a bacteria is a living organism
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it's a one cell I guess not even
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organism it's a one cell living thing
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okay it lives on its own a virus is
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doesn't even meet the definition of
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living thing I I don't think it's
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basically like a protein inside some
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kind of shell it's not it's not a living
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entity on its own like a bacteria
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they're two totally different things and
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viral infections thankfully are much
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much much more common than bacterial
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infections in the general population
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that's right fair fair to say coming
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from not an infectious disease
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specialist sure and the way antibiotics
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work is a very specific mechanism that
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attacks a very specific part of the
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bacteria that make it die or reduce its
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effect or whatever but those similar
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strategies don't work against a virus so
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an antibiotic will not kill a virus
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that's right an antibiotic has no effect
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on viruses take home Point number one
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antibiotics don't work for viruses so as
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a clinician so a child comes into your
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clinic maybe not your clinic but even a
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family doctor's office or walkin clinic
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everybody knows like how how do you know
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it's not how do you know it's not a
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bacteria do you have to do you have to
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test like the exate like the the runny
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nose or swab the ear or the throat to
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know that it's not a bacteria there are
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some tests for bacteria and cultures
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that we can do but we just know uh based
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on how common viruses are okay and the
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symptoms that someone has that it's most
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likely going to be a virus and so we
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know for things like sinusitis for
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instance that can be caused by bacteria
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but is often initially caused by viral
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infections that we can wait we can see
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if the person or it's going to get
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better like most people frequently do
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when they have head colds the the runny
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nose will go away after a few days days
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the cough will go away after a few days
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and so there are some people where it
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won't and that's when we can start doing
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potentially more tests for bacteria and
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say it look like a virus but the way
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it's behaving now we think it might be a
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bacteria that's right well we have
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antibiotics for bacterial infections why
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don't we just give people antivirals for
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these virus infections that'd be great
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um we just don't have those medications
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and there's a variety of reasons why one
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of the main ones is that viruses just
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change so frequently and so it's a cat
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and game and we've seen that you know
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with uh other viruses that we
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potentially can treat like Co or
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influenza U we do have some medication
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for them but it's not they're not
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perfect and so antivirals are in general
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a little harder to uh to to make okay so
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so I'm a parent little Jimmy's got
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hockey playoffs next week he's kind of
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got a bit of a runny nose is is there
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any downside to just giving them some
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antibiotics just in case on the 1%
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chance that it's a bacterial infection
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cuz I need them good for Saturday play
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center he's he's going to the playoffs
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can we not just give him some
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antibiotics like the cost is low right
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well there are definitely side effects
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so okay let's talk about the reasons not
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to take antibiotics willy-nilly yeah so
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there's definitely side effects for the
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the patient themselves okay so
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antibiotics you know can cause toxicity
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to different organs like the kidneys yes
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people can have allergic reactions to
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them right and they can kill some of the
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good bacteria that are in people's bowel
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and those good bacteria on the skin in
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the bowel can have a protective effect
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and we have learned lots of I'd say in
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the last 10 years the microbiome has
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just really popular thing to talk about
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we've learned that there are
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consequences to killing the good
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bacteria in our gut so there's three
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good reasons what about the financial
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cost to say you don't have benefits like
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are they expensive yeah some some
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antibiotics are very expensive there are
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lots we're using things like penicilin
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and Amoxicillin that have been around
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for decades so they're not that
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expensive anymore but some antibiotics
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can be expensive but the other the other
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main risk is that uh the antibiotics can
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select for more resistant organisms okay
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so the antibiotics are just killing
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bacteria that are susceptible to them
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but there's going to be lots of other
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bacteria around that aren't susceptible
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and they're usually more resistant and
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harder to treat right so by taking
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antibiotics you're actually screening
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for the more resistant bacteria because
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they're going to no longer be fighting
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the other bacteria competitive
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inhibition it's called so if you kill
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off a whole population of bacteria other
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bacteria are going to thrive and those
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bacteria might be harder to treat with
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antibiotics that's right I like the
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analogy of using a herbicide on your
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lawn right that kills most of the weeds
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but one weed survives then that weed
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like you said slowly just takes over
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your whole lawn um so you have to be
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careful so that's the first problem with
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taking antibotic fling is there a
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problem that eventually if you don't
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take the right dose or take it for long
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enough or don't Target it well enough
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that the bacteria can learn how to evade
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the antibiotics that we have yeah so and
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uh bacteria can develop resistance right
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and would you say that this is a
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significant problem in our world today
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very significant abolutely and and and
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like lifethreatening potentially like
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World threatening but I think we don't
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really appreciate this the average
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person that just wants to take
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antibotics for five days to make the
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runny nose go away doesn't realize that
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this could lead to a bacteria that could
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kill millions of people so what why why
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is this important and how does it work
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yeah so as bacteria are exposed to
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different antibiotics they select for
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resistance
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and so it's only the strong that survive
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and so Darwin those bacteria that
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develop resistance are going to grow
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more and spread more right and we got to
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realize that when we take antibiotics
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they eventually make their way into the
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sewage system right we excrete them and
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it's we can find antibiotics in lakes
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and rivers and things like that and so
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side note never put your pills in the
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toilet never flush them into the water
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system return them to the pharmacy sorry
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i s to say that okay so they're
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everywhere so and we're giving them to
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animals right we're not uncommonly
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feeding them to chickens and cows and
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pigs to prevent disease and and I think
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I read a stat like 80% of the world's
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antibiotics actually are consumed by
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animals not by human beings that's right
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which is very concern okay so then this
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presence of antibiotics everywhere is is
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helping these bacteria evolve to become
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resistant to the antibio give us the
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name of like just three super bad
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bacteria that we just can't treat well
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with antibiotics just so people can
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Google them if they want yeah so MRSA is
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a big one so methy resistant St cus orus
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so staf orus very common lives in the
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skin lives everywhere but there's a
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specific brand of that one that's extra
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strong and hard to treat that's right
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okay so Mera and then there's bacteria
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like eoli and and other similar bacteria
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gram negative organisms that can become
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very resistant as well okay so this is
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why you might have a loved one or know
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someone who died from overwhelming
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infection because they may have had an
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infection with one of these bacteria
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that we can't treat and this bacteria
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came about because we've been
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overtreating bacteria with antibiotics
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yeah yeah we're seeing this in common
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infections uh like salmonella infections
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in different parts of the world are
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extremely resistant we have almost no uh
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drugs to to treat it gonorrhea um
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there's many common infections that are
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just becoming more and more antibiotic
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resistant because there's more and more
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antibiotics being used and then when it
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comes to survival of the fit is
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literally be we have no medication for
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you so it's either your body fights it
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or unfortunately you to come that's
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right it takes us back to hundreds of
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years ago before we had uh back
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antibiotics an antibiotics take a long
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time to develop uh it's very expensive
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it's you know a billion dollars to
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develop a new medication right and we
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sent you cannot react fast enough to the
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rate which is changing right now because
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of the 8 billion people in our world and
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the amount of that's being used that's
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right so we have to use the precious
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resource that we have antibiotics in a
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in a you know logical way right so
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Physicians and patients need to be
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stewards of this Essen protect it okay
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so what just quickly what are some of
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the key features now now I know teting
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antibiotics is bad I have something
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going on how what are like the key
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things that'll tell me this is a virus
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or maybe this is a bacteria and I and I
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might have to take antibiotics can you
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can you think a few key that's a hard
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question yeah that's that's hard but you
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know for a lot of the common viruses
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that we have uh people have experienced
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these we all experience them a couple
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times a year and so if it's something
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that is progressively getting worse okay
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if it's something that's not going away
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right if there's a high fever really
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high fever yeah sure or people are just
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feeling very unwell they're just not
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able to work they're not able to get out
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of bed uh you know those severe features
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but for most of the common runny nose
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kind of sore throat the usual kind of
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aches of flu and uh you know head colds
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those are going to be viral infections
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okay and now let's say I do have an
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infection and it is H um it is actually
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a bacterial infection in my throat for
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example is there a chance that my body
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can get over it without antibiotics or I
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do I 100% definitely need antibiotics
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like if you're anti- antibiotics you're
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like no way I'm not taking that double
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anti double anti yeah so you know our
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immune systems are are wonderful
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things yeah the body has an ability to
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fight off infections including bacterial
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infections so whether it's sinusitis or
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ear infections or pneumonia there's
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definitely a possibility that we can
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fight those off without antibiotics okay
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so you got time before you have to jump
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into the antibiotic thing definitely see
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your healthcare provider if you're
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feeling unwell um but just recognize it
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if your healthcare provider does not
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give you antibiotics on that first visit
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they're not being mean to you agreed and
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I think that people think it's like a
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conspiracy against doctor yeah it's not
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the reason is because it's that your
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health care provider thinks you probably
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have a viral illness and thinks you're
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probably going to get better without the
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antibiotics and the reason we're not
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prescribing antibiotics willy-nilly as
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you said is for the reasons we talked
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about the the bad effects on you and the
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bad effects on the population it's kind
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of like the crying wolf story right you
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don't want to use them use them use them
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and then you finally need them like well
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they don't work anymore that's right um
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I think the other thing we'd be remiss
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not to talk about with respect to
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antibiotics is is C diff so claustrum
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defal is a very specific unique
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infection that happens to people often
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they can even after one dose of
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antibiotics potentially and this can be
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very debilitating even life-threatening
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so this is just another reason along the
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long list of reasons not to take
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antibiotics when you don't need them
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sometimes you take them and you still
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get this but if that part's unavoidable
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so yeah the take messages only take them
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if you need them listen to your doctor
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don't be mad at your doctor don't get
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mad at leave a comment if you have an
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experience with antibiotics or negative
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positive whatever your thoughts are and
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if you like this video please like it
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subscribe to our Channel and remember
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you are in charge of your own health and
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thanks to Dr Warren for explaining this
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very complicated subject to us thank you
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see you next time26244
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