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Virus vs. bacteria

Drew Werner

EAGLE COUNTY – We’ve never seen them, but we all have them. Some are always there, some only when they’re causing trouble. Some can be good for us, others are always bad. Most go away with out any help although occasionally help is in order. They are called many names – bugs, germs, infections and most accurately viruses and bacteria.Dear Doc: Please tell me why sometimes when I go to see my doctor I get an antibiotic and others I don’t. I know when I’m sick and when I need something, so why is it always different?- Why Can’t I jJust Get What I Want?Dear Can’t: Your question is often the toughest one physicians face. Patients come to the office with often well-established expectations. At the same time, your doctor wants to provide not only the best care, but to satisfy your needs. The difficulty arises when those two do not match. The appropriate use of antibiotics is often at the center of such decisions. The true solution is just what you’ve asked, to become a better-educated patient.When something invades our bodies that shouldn’t be there, then grows and reproduces, causing illness, we often say we have an infection. Actually, we have contracted either a virus or bacteria. They are quite different germs, however. Bacteria are more likely to cause serious complications and serious illness, and commonly require antibiotics or antibacterial drugs. Antibiotics do not work for viruses, although it can seem like they do. If you have a virus and take an antibiotic, you will likely feel better in a few days only because your body is fighting off the virus on its own. Viruses are actually more common, and our immune systems are nearly always able to overcome them and get us feeling better. The few viruses that are exceptions to this are the ones you know, HIV (the AIDS virus), hepatitis B and C, as well as genital herpes. The common link to them all is that they are acquired only through direct blood or body fluid contact. HIV, hepatitis and genital herpes are NOT contagious from casual contact, hand-to-hand exposure, coughing, sneezing or sharing food.This list of common viral infections, which do not need antibiotics, may surprise you:– Common cold — Chest cold — The flu — Most coughs — Most sore throats — Some ear aches especially those of less than three days duration– Runny nose (with green or yellow discharge) — Bronchitis — Laryngitis Antibiotics are needed for bacterial infections, including: — Strep throat — Some sinus infections — Some ear infections — Urinary tract infections– Some pneumonias The problem for doctors is that viruses and bacteria can cause virtually identical symptoms. There are a few tests that tell them apart such as a throat culture, but generally the diagnosis is made by the history of the illness and certain findings on examination in the office. The difficulty for patients is that viruses can take days or, rarely, weeks to recover from and it can be hard to wait that long. What we should all be most concerned about is the very serious problem of growing resistance.If you have a bacterial infection, it is a war between the antibiotic (working with your body’s immune system) and the bacteria. Unfortunately, the bacteria are often winning and becoming resistant to our antibiotics. This rarely happens when we treat a true bacterial infection, but happens much more commonly when we take an antibiotic for a virus. In that case, the harmless bacteria occurring in our system still try to fight the antibiotic and become resistant. If those bacteria become invasive or infect someone else, they are now much harder to treat. This is even worse if you are given an antibiotic for a true bacterial infection, but either do not take it all or share it with a friend. Then the weak bacteria are killed, leaving not enough antibiotics to kill the stronger bacteria and they become resistant to that antibiotic the next time it is used. While it is not surprising many bacteria can be resistant to our older antibiotics, even newer antibiotics have some resistant bacteria.The next time you see your doctor for a respiratory infection, think twice before taking an antibiotic. Remember, it’s the bacteria that are resistant – not you. Finally, if you need an antibiotic, take all of it as prescribed and don’t share with a friend, even if you are feeling better.Next week, I’ll talk about how you can better decide if it is a virus or not, and when you need to see your doctor. A great web site for more information in Spanish and English is http://www.getsmartcolorado.com/qanda.htm. Until then, look for Harald, Joel, Dr, Larry Gaul and I on CNN New You Revolution on Tuesday at 5:40 and 7:40 a.m. Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.Vail, Colorado


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