T.J. Samson | Destination Health | June 2019

June 2019 3 By Shweta Akhouri, MD, University of Louisville/ Glasgow Family Medicine Residency, T.J. Samson Family Medicine Center Antibiotics are essential, lifesaving medications. They not only treat bacterial infec- tions, but also help prevent them from spreading and help reduce the severity of the illness. However, we are now finding that antibiotics used to treat infections are less effective or do not work at all due to antibiotic resistance. It is one of the most urgent threats to the public’s health worldwide. HOW DOES ANTIBIOTIC RESISTANCE DEVELOP? Antibiotic resistance develops naturally over time; however, overuse of antibiotics is ac- celerating this process.The more exposure bacteria have to a medication, the more chances they have to fight it and develop ways to defend themselves.They are then able to pass along their defense plans to other bacteria, similar to students passing notes in a classroom. ANTIBIOTIC OVERUSE The Centers for Disease Control and Pre- vention (CDC) reports that up to one-third of all antibiotic prescriptions are either inappropriate or unnecessary. In 2017, Ken- tucky ranked 1st in the U.S. as the state with the highest number of antibiotic prescrip- tions. With antibiotic overuse, we are seeing a rise in the number of harmful side effects. These can range from mild nausea and an upset stomach to severe diarrhea that re- quires hospitalization. Tendon problems and heart rhythm disturbances are also possible side effects. WHEN ANTIBIOTICS AREN’T NEEDED Misuse is commonly seen when patients request or are given antibiotics for viral infections. Infections such as the common cold, flu, bronchitis and stomach flu are viral in nature and do not require antibiotics. Taking an- tibiotics for viral infections will not treat the illness, alter the dis- ease duration or severity, or stop you from spreading the infection to others. CONSEQUENCES OF ANTIBIOTIC RESISTANCE It is estimated that at least 2 million antibiotic-resistant infections occur in the U.S. yearly and approximately 23,000 people die as a result. Antibiotic-resistant infec- tions are harder to treat and lead to higher medical costs, prolonged hospital stays and increased risk of death. Treatment failures for certain infections have been reported in many countries, including the U.S. Over the past 30 years, resistance to antibiotics has risen faster than we can develop new antibi- otics to fight the bacteria. Failure to address the issue of resistance could lead us back to the time when people were dying from com- mon infections that we now cure. WHAT CAN YOU DO? ●  ● Only use antibiotics for bacterial infec- tions. Let milder, viral infections run their course. ●  ● Never share or use leftover antibiotics. ●  ● Finish the prescribed course of antibiot- ics as directed even if you start to feel better. ●  ● Consult your health care provider about your illness if necessary, but do not pressure them into prescribing antibiotics. ●  ● Prevent infections by regularly washing hands, avoiding close contact with sick peo- ple and staying up-to-date on vaccinations. Shweta Akhouri, MD T.J. Samson Family Medicine Center Is that headache a migraine? By some estimates, about 12 percent of Amer- icans experience migraines. Could you be one of them? Migraines aren’t the same for all people. But that pounding in your head could be a migraine if the pain begins in your forehead, on the side of your head or around your eyes and then gradually gets worse. Almost any movement, activity, bright lights or loud noise might make your head hurt even more. More tipoffs: You might feel nauseated and vomit. And as happens for about 1 out of 5 people with migraines, yours might begin with a warn- ing sign called an aura, which may include vision changes—such as flashing lights or zig-zag lines—or tingling in the lips, tongue, lower face or the fingers of one hand. CAUSE STILL A MYSTERY Doctors still don’t know just what happens in the brain to start a migraine. But it is clear that people who experience them are susceptible to certain triggers. Among them: ●  ● Loud noises, bright lights or strong smells. ●  ● Skipped meals, alcohol or certain foods—such as aged cheeses and cured meats. ●  ● Not enough sleep. ●  ● Stress. ●  ● Hormonal changes related to menstrual peri- ods and birth control pills. TAME YOUR HEADACHES While there’s no cure for migraines, your doctor can tell you about medicines that may stop them from becoming severe.These medicines work best when taken as soon as your headache starts. It may also help to lie down in a dark, quiet room and put a cold cloth over your forehead. Your doctor may also advise daily medicines— there’s a variety of them—to prevent migraines if they happen frequently or are severe. These steps may also help head off migraines: ●  ● Eat regularly—don’t miss meals. ●  ● Stick to a regular sleep schedule. ●  ● Slim down if you’re overweight. Obesity may contribute to migraines. ●  ● Keep a headache diary for a month. Try to fig- ure out your triggers. Then do your best to avoid them. Sources: American Academy of Family Physicians; American Migraine Foundation; National Institutes of Health; UpToDate Wellness Antibiotic overuse: Here’s why you should care