For many years, we have been fighting to prevent doctors from prescribing antibiotics to patients with acute respiratory viral infections (ARVIs), because it has long been known that antibiotics do not work against viruses. Explanatory work in the medical community was quite successful. Perhaps, in the early stage of the pandemic, surprise, even some panic, played a role; then in early 2020 no one knew what to do. Therefore, why didn’t doctors just prescribe then? The consumption of antibiotics increased significantly!
Of course, in the early stage of the pandemic there was a lack of knowledge about the coronavirus, so even in the first edition of the interim guidelines the need to prescribe antibiotics was indicated. But in the second edition, this recommendation disappeared. However, many patients know from their own experience that when a doctor prescribes for a coronavirus infection, he often prescribes antibiotics as well. And this stereotype has not been completely eliminated so far.
When a doctor wrote prescriptions for COVID-19, they often prescribed antibiotics, and this stereotype hasn’t been fully eliminated until now.
In March of last year, Chinese scientists published a very interesting article. They showed that if antibiotics are prescribed in the early period of COVID-19, when there are no complications yet, then the risk of a more severe course of the disease and the development of serious complications, up to death, is significantly increased.
This problem is old. With acute respiratory viral infections, especially in a child, some doctors have said, “I’m prescribing you an antibiotic to prevent bacterial infections.” But antibiotics do not have a preventive effect – this is an axiom! Already from the name of this class of drugs it is clear that they are directed against some kind of living object – a microorganism. For an antibiotic to work, it must have a microbe in front of it. If not, the antibiotic has no point of action. That is, we will not get a useful effect, and all sorts of undesirable effects will be in full.
However, stereotypes are passed down from generation to generation of doctors and are based on the usual reassurance: “come what may.” Of course, you can partly understand the doctor – you are afraid of missing a dangerous bacterial infection under the guise of a viral infection. It is often quite difficult to make a differential diagnosis. If it is a small child and only has a high body temperature and does not present other symptoms: catarrhal phenomena, runny nose, cough, etc. -no, and he himself cannot talk about his well-being, in this situation, of course, there is a fear of missing out on something. But the unjustified prescription of an antibiotic may not only not improve the situation, but may even worsen it.
The dispensing of antibiotics without a prescription in pharmacies and their inappropriate use by patients have also been long-standing problems. As a result, we were faced with the fact that microorganisms developed resistance to the main groups of antibiotics, and in severe cases there was simply nothing to treat the patients. I cannot provide data for the country as a whole, but in Moscow, step by step, it is possible to ensure that pharmacies do not sell antibiotics without a prescription, the situation is gradually improving.
But it is equally important that the patients themselves understand that without a prescription, the use of these drugs should be stopped! This is one of the important steps that will reduce the risk of pathogens developing resistance to antibiotics. Any patient should be aware that the uncontrolled intake of any medication can cause undesirable effects.
