Antibiotics Explained: What They Are and What They Aren’t

Imagine getting home with your family nice and relaxed from vacation and after setting your bags down, you begin to feel a little itch on your arm, and your neck, and then your legs. Little did you know that while your family was on vacation, a few pesky explorer fleas founded a new colony in your house, and it’s growing fast with little flea pilgrims everywhere. Now they’re launching their miniature flea revolution against your actual family members, including your dog that was also on vacation with you. Welcome home!

Ok, so you leave the house ASAP, rid everyone of fleas, and rent a hotel room down the street. Once everyone has calmed down and called dibs on the sleeping arrangements, you call pest control. No worries. The experts are going to help you fight off this infestation! After a few days of vacationing in your own town, you stop by the house to see if the coast is clear. Then, you’re faced with this reality: your pest control guy is an idiot! He tried to treat the flea problem by laying down a bunch of mouse traps! 😮 Not only are the fleas still there, but they’re flourishing! Even industrializing with little flea cities, factories, and local governments! But hey, at least you don’t have mice! 👍

Welcome to the frustration of doctors everywhere. Patients are constantly asking doctors to treat flea infestations with mouse traps.

Let’s continue to think about the above story, except let’s replace some of the characters.

Your house and family: your body

Fleas: viruses

Mice: bacteria

Mouse traps: antibiotics

Pest control: your doctor

Just as the mouse traps can’t kill fleas, antibiotics can’t kill viruses.

So, what are antibiotics?

Generally speaking, there are two different types of bugs, or germs, that can infect your body, viruses and bacteria, and there are many different “species” of each. Both can produce a range of the same symptoms and the resulting illness can range from a mild cold to something severe that lands you in the hospital. This often makes it difficult to tell viral and bacterial illnesses apart as there is no cut and dried way to definitively differentiate them based on symptoms. For example, I often have patients struggling with stuffy sinuses who believe green or colored mucus means their problem is bacterial and that clear mucus means their problem is viral. However, both colored and clear mucus is a common symptom of both, unfortunately. Thankfully, this is what doctors specialize in, making those distinctions.

Although they can cause similar problems, viruses and bacteria (or fleas and mice) are very different things requiring different solutions. Antibiotics are medications specifically designed to get rid of bacteria, which are essentially small pests that cause problems in your body. There are many different types of antibiotics for the many different types of bacteria, as there are different types of mouse traps. However, our actual problem above was with fleas (viruses), not mice (bacteria).

As opposed to bacteria, viruses are actually pretty difficult to describe scientifically and there’s some debate as to how they should be classified. They are tiny, travel in very large groups, and take over everything. Imagine little microscopic pirates plundering your cells, or fleas hijacking your home. As such, viruses can be tricky to handle, and we haven’t really discovered a cure for them yet. Meanwhile, this post is about antibiotics. Viruses deserve a separate post of their own. The point here is, as mouse traps won’t get rid of fleas, antibiotics won’t get rid of viruses; you need a completely different approach for two completely different bugs.

Though antibiotics are worthless against a virus, they are great at targeting bacteria. With the development of antibiotics the medical world changed forever, mostly for the better. Previously untreatable conditions that frequently killed people are now easily treated with something as easy as taking a pill a few times a day. That’s awesome! As Oprah would say, “YOU get antibiotics, and YOU get antibiotics, EVERYONE gets antibiotics!”

There’s a problem though. As someone once said, “With great power comes great responsibility.”

Whatever. What’s your point?

Resistance. That’s the point. Being powerful, antibiotics can be very harmful too. Remember that mice (bacteria) are smart and can learn to navigate mazes and avoid mouse traps. If you have seen the movie “Mouse Hunt,” then you know how clever mice can be. Then they tell all their little mice friends and family what they’ve learned. Before long they all navigate the maze effortlessly and are not fooled by mouse traps. This is called “resistance,” and bacteria do it well. With increasing resistance, you’ve got to figure out new creative ways to get rid of them. If unsuccessful, you will eventually have some really smart mice (bacteria) on your hands that you can’t get rid of without nearly destroying the entire house altogether. For obvious reasons, we can’t just destroy the house (your body) in the case of a bacterial infestation.

Therefore, we need to carefully limit any opportunities for the offending bacteria (mice) to gain experience and learn how to avoid our traps. When that happens, things get out of hand quickly as we’re trying to compete in a type of arms race with the bacteria. Regardless of the final outcome, patients suffer. Therefore, we can’t go giving out antibiotics willy nilly. That’s like giving the other team your playbook, showing the enemy where your troops are, or teaching the mouse how the trap works. We can be smarter than that. Antibiotics are incredibly useful but only against bacteria and in moderation. If you cover your entire floor with mouse traps, you can’t walk on it anymore without hurting yourself. 

I hope that helps you better understand what antibiotics are and what they are used for. They are incredibly useful and often help a lot of people get better, but as with any other medication, they have their limits and must be used carefully. Always ask your doctor if antibiotics will help you get better, but know that if they say “no” it’s because they are more likely to harm you than help you or at best they will be completely useless.

Learn more, stay humble.