In the midst of the flu and SARS season, few see a doctor, and many of us are used to self-medication, including "prescribing" antibiotics. Clinical pharmacologist of the N.N. N.N. Petrova Anna Seluta told how such "therapy" can turn out.
According to a survey conducted last year, about 60% of Russians prefer not to visit doctors when they fall ill and choose their own drugs. Such patients often, at the first signs of a respiratory tract infection - a runny nose, sore throat and fever - drink an antibiotic without a doctor's prescription, sometimes the same one. The motivation is simple: "It always helps me!" According to Anna Seluta, while people can drink the antibiotic for one to three days, not observing the frequency of administration, and cancel it at the first improvement in their health.
“In no case should this be done. Antibiotics also affect normal microflora, while microbes acquire resistance and the next time this drug will not work, ”the expert said, noting that the doctor should prescribe an antibiotic and any other drug. He will tell you how to take the drug correctly - the dose, the frequency of administration and its duration, when to take it: before meals, during or after.
“The acidity of the stomach at these times is different, and it can affect the absorption of the drug. And you also need to take into account the interaction of the antibiotic with other drugs taken by the patient. It is very important to maintain the dosage interval and apply the antibiotic in a course that can last from 5 to 14 days. To achieve the effectiveness of the antibiotic, a certain constant therapeutic concentration of the drug in the body must be achieved during the period of administration. Each dose of the drug maintains the concentration at the required level, which contributes to the death of bacteria. Some antibiotics are cleared from the body faster, so they need to be taken 2-3 times a day, ”the doctor said.
Patient's false friends
Anna Seluta also warned against taking so-called "antiviral" drugs with unproven efficacy, with active substances such as umifenovir, tilorone and other "immunomodulators". And even more so, do not rely on the healing properties of homeopathic medicines, which, unfortunately, are sometimes prescribed even by doctors.
“These medications should not be taken, because at the moment they do not have a sufficient scientific evidence base. And there have been no double-blind, randomized, placebo-controlled clinical trials about them - this is the highest level of evidence for the drug. Information about this is published on the PubMed website, where there is data on ongoing clinical trials. On the FDA website, you can familiarize yourself with the active substance of the drug. If you did not find it there, then, most likely, a drug with a low evidence base, ”the expert emphasized.
Note that antibiotic resistance is far from the only side effect of these drugs. In 2017, scientists from the Johns Hopkins University School of Medicine analyzed data from 1,500 patients who were in the hospital and took antibiotics. In total, 324 cases (21.6%) of the development of adverse reactions to antibiotics were noted, of which 186 (57%) occurred within 30 days from the start of therapy, 138 (9.2%) - within 90 days.
The most common adverse reactions that developed within 30 days were gastrointestinal (42%), renal (24%), and hematological (15%) reactions. In addition, the researchers found that every ten additional days of antibiotic therapy increased the risk of adverse reactions by 3%.
The authors of the study emphasized that, despite the obvious benefits that the competent use of antibiotics can bring, it is necessary to carefully weigh the appropriateness of their appointment and the duration of the course in order to minimize the risk of adverse reactions to drugs.