Tag Archives: Virus

Student Health never gives antibiotics!

chart from CDC showing bacterial infections and viral infections

Huh?

We hear it often, especially during cold and flu season. It is the most common reason parents call to talk to our Director. It leads to negative reviews on social media sometimes. It sounds something like this……

Students come in asking for a zpack by name because “that’s the only thing that works”

Parents call and are upset we didn’t “do anything” for their student

“My doctor at home just calls me in an antibiotic”

“Student Health told me I have a cold but I really have an upper respiratory infection!”

“My snot is green so I know it is bacterial”

“You told me I have a virus, but I went to another facility and got an antibiotic”

And finally………………………”Student Health never gives antibiotics!”

 

SO WHAT’S THE DEAL, STUDENT HEALTH?

Sore throat, cough, nasal congestion/drainage, fever, aches, ear pain, sinus pressure, and headache are some of the most common reasons for visits to Student Health. As you see from the chart, VERY few need antibiotics.

Some important facts to know:

  • 90-98% of sinus infections are viral (and even in bacterial cases, antibiotics do not necessarily help)
  • 90-95% of sore throats in adults are NOT strep
  • over 200 strains of the common cold exist
  • bronchitis should not be treated with antibiotics
  • most adults experience 2-4 colds annually, each lasting 7-10 days
  • colored snot means NOTHING in regards to whether the cause is bacterial or viral
  • high fever can be present in either bacterial or viral infections

chart from CDC showing bacterial infections and viral infections

 

So how do Providers know whether a patient needs an antibiotic or not?

Providers at Student Health follow national treatment guidelines, which aid diagnosis and treatment planning. The Centers for Disease Control has an excellent chart that you can check out here to see why we make the decisions we do. Part of the diagnosis is on patient reporting of symptoms, duration of illness, etc and the other is based on physical assessment, such as vital sign readings, visual inspection of eyes/throat/nose/ears, and listening to lungs (among other things depending on symptoms).

Do we give antibiotics? Of course we do–when it is the medically appropriate treatment.


Yeah, but wouldn’t an antibiotic help anyway????

NO. Incorrect antibiotic use causes a whole host of problems. People tend to forget that antibiotics can have side effects, some which may even make a patient feel worse than their original illness! Allergic reactions, stomach upset, diarrhea, yeast infections, and rashes are just some of the common side effects people can experience with antibiotics. Another issue is drug resistance–every time you take an antibiotic that you do not need, you are contributing to the fact that the antibiotic is less effective over time to bacteria. Did you know that by taking an antibiotic, you can actually help unleash a dangerous different bacteria into your gut, one that can lead to hospitalization and even death? (Don’t believe me? Check out  info on C.Difficile)

Superbugs like MRSA exist now because of incorrect use of antibiotics, and the scary thing is, our ability to fight these super infections is limited or in some cases, there is no way at all to treat them! And what about cost? Prescriptions are not always cheap. Why take a medication that won’t help, may hurt, leads to drug resistance, and costs money?

Health care providers have a duty to prescribe responsibly and to only use antibiotics in acute illness when a patient shows signs that a bacterial infection is present.


So you aren’t going to help.

Here is the part that comes into conversation with a lot of our patient/parent feedback about viral infections: if you are not giving an antibiotic, you are not doing anything to help. The hard truth is this: with most illnesses, including flu, bronchitis, upper respiratory infections, colds, sinus infections and most sore throats, THERE IS NO MAGIC FIX. We always advise patients on the best way to treat their symptoms to hopefully get some relief, but the only thing that cures is TIME. Illnesses can take days or WEEKS to resolve (yes, weeks.) Rest, good nutrition, light exercise, and increasing fluid intake help. We recommend which over the counter medications to take, and provide prescriptions for cough medications or inhalers if warranted; our on site pharmacists are also happy to help patients decide what may help their symptoms. Having a pharmacy right inside Main Campus SHS makes it easy for patients to pick up what they need to start feeling better.

 

“You told me I have a virus, but I went to another facility and got an antibiotic.”

Ah.

Our advice to patients would be to always ask why you are, or are not, receiving an antibiotic. Ask what guidelines are being used. Ask why a provider thinks an illness is viral or bacterial. Any high quality provider will be happy to share information and education about their clinical decision.

We hear stories of “urgent care gave me an antibiotic for my bronchitis” (cringe) or “the ED diagnosed an upper respiratory infection and wrote me a zpack” (AKA, you have a COLD. Double cringe) or, possibly the most irresponsible, “I called my doctor at home and he called me in an antibiotic since that always helps” (ugh….)

Some outside facilities may not be willing to practice evidenced based medicine when it comes to antibiotic prescribing because that may mean a patient will be unhappy (and therefore will not pay to come back). We cannot control what other offices do, but we can insist that our facility follows recommendations and best practices. Just because you can walk out of another office with one or more prescriptions does not mean it was the medically sound thing to do.

 

Possibly the most important part…..that many patients miss…..

While most illnesses are viral in nature, we ALWAYS tell patients that if they are not getting better, something suddenly worsens, or if they have any emergency symptoms such as difficulty breathing, inability to put their chin to their chest, severe headache, chest pain, high fever that does not respond to medication, or prolonged vomiting, THEY NEED TO BE RE-EVALUATED. Infections that start out as viral, or appear early on as viral, can lead to bacterial infections that do need antibiotics or other treatments. Most patients will recover from viral illnesses on their own, but if that is not the case, we will always be glad to see patients for follow up appointments. The great thing about Student Health is that if you pay fees with your tuition, you do not have to pay to be seen and evaluated….so never hesitate to come back with any new concerns, symptoms that are not improving, or other questions about your care.

 

Our goal is help the ECU campus community be as healthy as possible. By communicating how we form diagnoses and treatment plans, we hope patients and others will feel more educated and confident that safe and appropriate antibiotic prescribing is a important part of the care we provide at Student Health Services. As always, feel free to drop us a line at gotquestions@ecu.edu with your health or service related questions.

Stay well, ECU!

 

Sources:

Antibiotics Aren’t Always the Answer https://www.cdc.gov/features/antibioticuse/infographic2.html

Appropriate Antibiotic Use https://www.cdc.gov/antibiotic-use/

CDC Treatment Guidelines https://www.cdc.gov/antibiotic-use/community/for-hcp/outpatient-hcp/adult-treatment-rec.html

I spy with my little crusty eye…………..

clipart image of eye

 

Often students come in to be evaluated for “pink eye”…but what does it mean if you have redness, irritation, and/or crusty eye(s)?

And what do you need to do??????

 

 

Why is my eye red?

  • Although there is more than one cause of a red eye, the most common cause is conjunctivitis. Conjunctivitis, also known as pink eye, is a common eye condition that affects both children and adults.  It is caused by inflammation of the conjunctiva which makes the blood vessels visible giving the eye a red/pink appearance.

I woke up and my eye was crusted shut.  I need an antibiotic right?

  • Actually, most cases of conjunctivitis are caused by a virus. The most common virus to cause conjunctivitis is the adenovirus which also causes the common cold. Antibiotics will only treat conjunctivitis if it is caused by bacteria.  It is more likely to be bacterial if you only have symptoms in one eye and you have thick yellow, white or green eye discharge that recurs throughout the day.  Conjunctivitis can also be caused by allergies and irritants.

Do I need to see a healthcare provider?

  • You should seek care if you wear contacts, have moderate to severe pain, sensitivity to light, blurred vision, intense redness, weakened immune system, symptoms that do not improve, symptoms that worsen, or if you have a pre-existing eye condition. You can make an appointment at Student Health Services online, by phone, or in person to have your eye evaluated.

Are there any treatments I can try at home?

  • If you do not have the symptoms listed above, there are a few things you can try to relieve your symptoms including over the counter (OTC) antihistamine/decongestant eye drops, OTC eye lubricant drops and warm or cold compresses. The OTC eye drops can be picked up without a prescription at any pharmacy including the pharmacy at Student Health.  You should also avoid wearing contacts until your symptoms have resolved.

Can I still go to class?

  • Absolutely! Even though it is very contagious if it is caused by a virus or bacteria, you can prevent spreading it your peers with good hand hygiene. It is spread by direct contact, contact with secretions, or contact with contaminated objects/surfaces. Avoid touching and rubbing your eyes. Frequently wash your hands with soap and warm water or an alcohol-based hand sanitizer. Avoid sharing makeup and eyeglasses.

 

References: CDC, UpToDate

 

Get Smart About Antibiotics

ECU Student Health Services (SHS) is supporting Get Smart About Antibiotics Week, November 14-20, by sharing education and social media messages about when antibiotics are indicated, how to take them correctly, and why overuse contributes negatively to our health.  SHS and the Centers for Disease Control and Prevention (CDC) want you to know why antibiotics are not always the answer and why SHS providers are so careful about only prescribing antibiotics when indicated, not just because a patient requests them.

The CDC has news this cold and flu season:  antibiotics do not touch viruses—never have, never will!  And it is not really news—it is a long-documented medical fact. Antibiotics can only treat illnesses caused by bacteria. Colds, the flu, most sore throats, bronchitis, and many sinus and ear infections are caused by viruses, not bacteria. If you have a viral infection, antibiotics will not help you feel better or get well sooner. In fact, they can even be harmful.

Taking antibiotics when they are not needed is fueling an increase in drug-resistant bacteria, which cause infections that are more difficult, and sometimes even impossible, to cure. Almost all types of bacteria have become less responsive to antibiotic treatment. Heard of MRSA? These “superbugs” can quickly spread to family members, schoolmates and coworkers, and threaten our communities with illnesses that were once easily treatable. Combatting antibiotic resistance is a priority for CDC with estimates of more than 2 million resistant infections occurring annually in the United States alone.

When antibiotics are used for viral infections, you are not getting the best care. A course of antibiotics will not fight the virus, help you feel better, or lead to a quicker recovery. It may even be harmful. If you are diagnosed with a viral illness, SHS providers will give you advice on what to do to feel more comfortable while the immune system does its work. Suggestions might include drinking plenty of fluids, getting a lot of rest, using over the counter medications, using a cool mist humidifier, or gargling with salt water. Please help SHS continue its commitment to safe and smart antibiotic use by educating yourself about antibiotics.

antibiotic-usage

 

 

 

 

 

 

 

 

 

 

 

 

If an antibiotic is prescribed for you, take it as directed and complete the entire course of medication, regardless of when you start feeling better.  Partial doses of antibiotics should not be saved “for next time”—this increases resistance and allows the bacteria to possibly come back stronger.  You should also know to never take medication prescribed for others—even if you have similar symptoms as your roommate or think you have the same illness as a friend, it is NEVER okay to share prescriptions or take a dose of antibiotics from another person.

As always, if you have ANY questions about their diagnosis, treatment plan, or how to help your symptoms, call us at 252-328-6841 or email us at gotquestions@ecu.edu.   For more information about the right way to use antibiotics, visit www.cdc.gov/getsmart.

Article adapted from CDC’s educational materials for Get Smart About Antibiotics week.