How to Use Antibiotics and Avoid Resistance

Antibiotics are among the most valuable medicines we have, and they are steadily losing their power because they are used for illnesses they cannot treat. Using them properly is something every household can do.

What is antibiotic resistance?

WHO explains that antimicrobial resistance happens when bacteria, viruses, fungi and parasites stop responding to the medicines meant to kill them. Infections then become harder or impossible to treat, and the risk of serious illness and death goes up. Importantly, it is the germ that becomes resistant, not your body, and resistant germs spread from person to person like any other infection.

The scale is already serious. WHO reports that bacterial resistance was linked to more than 4.7 million deaths worldwide in 2021, and that about one in six laboratory-confirmed bacterial infections worldwide was resistant to antibiotics in 2023. WHO names misuse and overuse of these medicines as the main force driving resistance, alongside poor sanitation and hygiene, weak infection control, and limited access to vaccines and diagnostic tests.

When do antibiotics not work?

Antibiotics act on bacteria. They do nothing at all against viruses. CDC states that antibiotics do not work for:

• Colds and runny noses
• Flu
• Most sore throats
• Most cases of bronchitis

CDC also notes that many bacterial sinus infections and ear infections get better without antibiotics. The NHS says antibiotics are no longer routinely prescribed for chest infections, ear infections in children, or sore throats, and that many mild bacterial infections clear up on their own.

When are antibiotics the right treatment?

CDC gives strep throat, whooping cough and urinary tract infections as examples of infections that do need antibiotics. The decision belongs to a doctor who has examined you, and sometimes to a test. That is the difference between treatment and guesswork.

What does using them correctly look like?

• Only on a doctor's prescription. Not on a friend's advice, and not because a past illness felt similar.
• Follow the instructions exactly on the label or the patient leaflet, at the right times.
• Finish the course you were given, even after you feel better. The NHS also notes you can still be infectious after starting antibiotics, for anywhere between 48 hours and 14 days depending on the infection.
• If you miss a dose, the NHS advice is generally to take it as soon as you remember, unless your next dose is nearly due, in which case skip the missed one. Never take a double dose to catch up.
• Never share antibiotics and never keep leftovers for next time. Both CDC and the NHS say this directly.

Is there a downside to taking them just in case?

Yes. CDC points out that antibiotics can cause side effects even when they cannot help you, from rash, dizziness and nausea to more serious problems. One is infection with C. difficile, which causes diarrhoea that can lead to severe damage to the colon and can be fatal. The NHS lists nausea, vomiting, bloating, indigestion and diarrhoea as common side effects.

What else helps slow resistance?

Anything that prevents infections in the first place means fewer antibiotics are needed. WHO includes poor sanitation and hygiene, weak infection prevention, and limited access to vaccines and diagnostic tests among the drivers of resistance, so washing hands with soap, safe drinking water, food hygiene and keeping vaccinations up to date all play a part.

When to see a doctor

See a doctor instead of treating yourself if:

• An illness is getting worse rather than better
• An infection is not clearing up
• You are already on antibiotics and your symptoms are not improving
• You get severe or lasting diarrhoea while taking or after taking antibiotics

Get emergency help for signs of a severe allergic reaction to any medicine, which the NHS lists as a rash, wheezing, tightness in the throat, difficulty breathing, or swelling of the face: call Rescue 1122 where available, or go to the nearest hospital emergency department.