I find old cemeteries interesting, both in terms of solitude and history.
When I was younger, I had occasion to stroll through a few old cemeteries dating back hundreds of years. During such walks, I was often overwhelmed by the numbers of gravestones of children from the late 1800s and early 1900s, often several from the same family.
I know most of these children and many of the adults died from infectious diseases caused by viruses and bacteria that are now controlled through immunizations and antibiotics. The discovery of penicillin in the early part of the last century marked the beginning of a revolutionary change in modern medicine. Since then, many antibiotics have been developed to fight bacterial illness.
An antibiotic is a drug that fights tiny microscopic organisms called bacteria. Unfortunately, these bacteria have been learning how to fight back. This is called drug resistance.
Doctors use antibiotics for very specific reasons. We have been trained to identify the symptoms, physical signs and certain lab findings that represent serious bacterial infections. When these findings are present, often an antibiotic is prescribed to treat the illness. Examples include bladder infections, bacterial pneumonia (different than viral pneumonia), skin infections and more serious infections, such as blood infections or bacterial meningitis.
Antibiotics are reserved for these types of problems rather than more broad use such as for cold or viral symptoms. Antibiotics do not help with viral infections.
Over the years, bacteria have become more and more resistant to certain antibiotics. Doctors have been strongly encouraged not to over-prescribe them, so that they can continue to be effective for their patients when they need them.
I have cared for many patients with serious infections from bacteria that used to respond easily to antibiotics but which are now resistant. The very real concern is that the resistant bacteria are becoming more common.
One of the jobs of a good doctor is to protect his/her patients from future risks to their health. Resistant bacteria are a very real threat to all of us. Patients are sometimes frustrated when a doctor will not prescribe an antibiotic for their cold or other infection symptoms. If the symptoms are attributable to a virus, the antibiotic will not help.
The easy thing is for the doctor to just give the antibiotic to satisfy the patient. A good doctor, however, will explain to the patient why the symptoms are most likely the result of a virus and why the antibiotic should be reserved for a time in the future when the patient may need it.
By practicing this good judgment, the frequency of bacterial resistance can be reduced, and antibiotics can continue to help patients in the future.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.