Consider the potential harms of antibiotics. Lives may depend on it | Opinion

By Dr. Tanaya Bhowmick
What happens in the dentist’s office or urgent care center in Somerset today or with a doctor from West Windsor next week can have a long-term impact in New Jersey – and it can affect your health in ways you might not have considered.
When used correctly, antibiotics are lifesaving treatments for potentially dangerous infections, but often people aren’t given information about the potential harms of antibiotic use. This is the time to encourage thoughtful use of these treatments, particularly as we mark the start of Antibiotic Awareness Week (Nov. 18-24) tomorrow in the United States and throughout the world.
The dentist’s office, urgent care and primary care offices are places where antibiotics are commonly overprescribed, according to data from the Centers for Disease Control and Prevention (CDC). Dentists, family doctors and internists have reported prescribing antibiotics because they believe patients expect them or because time constraints make it an easier choice than the alternative — which is to take the time to explain why they aren’t needed.
Antibiotics are rarely required as a preventive measure before dental procedures, and antibiotics don’t work against viral respiratory infections. When patient expectations are high and there’s uncertainty – such as whether respiratory symptoms are caused by a virus or bacteria (for which antibiotics are needed) – prescribing the antibiotics can be the least resistant path.
The harms of antibiotic use can outweigh the benefits in some circumstances, however, and harms come in many forms to you, your family, your community and even the world.
Antibiotics can harm you by killing off weaker bacteria and leaving resistant superbugs that multiply, making infections even harder to treat. Antibiotics also can reduce beneficial bacteria – especially in your gut – leading to other problems such as C. diff, an infection that can cause diarrhea and possibly lead to severe colon damage and death.
Unneeded antibiotics also can harm other members of your family, because resistant bacteria and C. diff spread easily and could make people in the same household sick. Those same hard-to-treat infections could spread to your broader community and eventually across the U.S. and around the world. A study published in The Lancet blamed misuse of antibiotics for growing antibiotic resistance that could kill 39 million people in the next 25 years.
Whether you want to look out for yourself or the broader communities you are part of, you can take a few simple steps to avoid unnecessary antibiotics.
The first step is to simply tell your dentist, urgent care provider, your family doctor or other health care provider that you don’t expect an antibiotic from them if it isn’t needed. Let them know that you understand the benefits and risks of antibiotics, and you will trust them if they tell you antibiotic treatment isn’t needed.
You also can ask some basic questions, which will give you a better understanding of any medications prescribed for you, especially antibiotics. You have the right to ask these questions, and any provider should willingly answer them:
♦ Why should I take this medication, and how will it help me?
♦ What will happen if I don’t take this medication?
♦ What potential harms or negative effects could this medication cause?
Antibiotics are lifesaving treatments that have extended the lives many and are essential to modern health care, from surgeries, to childbirth, to cancer treatment. All of us – patients, parents and prescribers – must do our part to use antibiotics responsibly to protect ourselves, our families, and our neighbors in New Jersey and the rest of the world, while ensuring their availability for generations to come.
Dr. Tanaya Bhowmick is an infectious diseases physician, an associate professor of medicine and program director for the infectious diseases fellowship program at Rutgers Robert Wood Johnson Medical School. She is chair of the antimicrobial stewardship program at RWJ University.
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