ANTIBIOTIC RESISTANCE IS REAL
2 years ago in the middle of my afternoon clinic I got a phone call from the pharmacist. “You prescribed the wrong dose of amoxicillin for this boy!” she told me.
I shook with fear. Did I prescribe too much by mistake? My worst fear of overdosing a child swept over me.
Turns out that I prescribed too little. The local guidelines for antibiotics had increased the recommended doses of amoxicillin (actually doubled) for children and adults – for kids it used to be 125mg-250mg 3 times daily, but it had become 250-500mg 3 times daily. Why? Antibiotic resistance.
The same dose of amoxicillin no longer worked for the same bugs. Isn’t this scary? For me it is deeply concerning and worrying, especially when I am so obsessed with gut health, the microbiome, and its relationship with health. Every time I prescribed that double dose of amoxicillin I felt uncomfortable. Because it meant double the destructive effect it had on friendly gut bacteria, not to mention extra strain on the body to metabolize the drug and excrete it. But I had no other options if I felt my patient needed an antibiotic to save their lives.
This isn’t scaremongering. Antibiotic resistance is very real and it is not just affecting those patients fighting for their lives on ICU anymore (MRSA and such). It is affecting all of us because whenever we need amoxicillin, we need a much higher dose, with increased risks of side effects. I am not saying don’t use them – they are life-saving and in many cases are absolutely necessary. However, there is no denying that they are over used. Doctors are busy, they need to cover their backs in this overly litigious world. A lot of patients are still of the mentality that antibiotics will make everything better, and their coughs will go away even if bacteria is not the cause.
Remember, a good doctor is someone who takes the time to examine you properly and frugal with their prescription pads. But if you do need a course of antibiotics make sure you replenish those friendly bacteria in the gut with high dose probiotics afterwards.