Why won’t my doctor prescribe antibiotics for my sore throat?
There are a few issues here, but this post will focus on just one: the antibiotics apocalypse. I don’t mean to sound alarmist, but it’s the cold truth: we’re nearing a post-antibiotics age, and it will kill many. Diseases which we live with now will become intractable again, and being sick will no longer be a matter of just taking a pill and shaking it off. Your doctor won’t prescribe antibiotics for your sore throat in part because they’re trying to put off the day when that happens.
To start at the beginning, antibiotics were discovered as substances which fungi could make to deter and kill bacteria. It’s a way for the fungus to make sure that it doesn’t have to share its environment and whatever it’s feeding on with a hungry bacterium! We can make that into medication which, once it’s in our bodies, can kill bacteria inside us. Since Alexander Fleming found penicillin, we’ve found many other antibiotics we can use, and they’ve transformed the way we live. Dangerous infections no longer kill us, and we can do complex surgeries without fear that subsequent infection will kill a patient anyway.
But bacteria are living things, and they can adapt. They change so rapidly, in fact, that we can’t keep up. When you take antibiotics, a lot of the bacteria in your body will be killed, including a lot of the bacteria which caused your infection (if your infection was caused by bacteria). But not all of them will be killed, and some of the bacteria that survive will know how to deal with antibiotics. They might have tiny changes in their DNA, but nonetheless those changes mean that the antibiotics can’t kill them. Even if you feel better, you can still infect someone else with those bacteria — and that person won’t be helped at all by the antibiotics that healed you!
The worst thing is, a bacterium doesn’t have to meet antibiotics itself to gain that protection against them. Different species of bacteria can pass genes between them. Even if the bacteria in your body that becomes resistant to the antibiotic is a harmless gut microbe, it might live next to E. coli. It’ll pass along the genes, and then you have an E. coli bacterium which knows exactly how to fight antibiotics — and E. coli can be very dangerous when it gets into the wrong places in your body.
In this way, we’re starting to see diseases which no longer respond to antibiotics. Often it’s just one type of antibiotic, and then another one can be used instead. But as time goes on, more and more bacteria gain immunity, and our antibiotics become less and less effective. Worse, we’re not finding new antibiotics at anything like the rate we need to replace the old, ineffective ones.
What can you do? If you are given antibiotics, take the full course exactly as the doctor told you to. Don’t stop early because you feel better; the full course ensures that as many bacteria as possible are dead, and you’ll probably start feeling better before they’re all gone. And if your doctor won’t give you antibiotics, understand that they don’t believe that they would actually help you. Your own immune system is already equipped to fight off most invaders. Get plenty of sleep, make sure you eat and stay hydrated, and though you might spend a week in bed feeling dreadful, your body will clear it up on its own and you’ll be back on your feet with no harm done.
Oh — and don’t always take paracetamol to lower your fever (as long as you’re an adult). That increased body heat is helping you fight the sickness, too.
Note: in some cases, doctors may misdiagnose an illness. This is rare, though. If you’re ill and your symptoms worsen, you should speak to a doctor again.