Do You Always Have To Use Up The Antibiotics You Are Prescribed

Should I take antibiotics that my doctor prescribed if my strep test came back negative?

Disclaimer: DO NOT rely solely on medical advice from the internet (including mine). Consult with your pharmacist or physician.First, it depends on the fever. If you have a fever of <101 F, then it is less likely to be bacterial. Second, it depends on how long you have been sick. If it were me, I would not take an antibiotic for at least 10 days, if my fever remained <101 and I had no cultures to back up a bacterial infection. Finally, it depends on how at risk you are. If you are a person with a suppressed immune system or another condition that requires greater caution, I might be more apt to take the medication.Personally, it infuriates me that your physician gave you an antibiotic in this situation. It’s a case I see played out on a daily basis and it’s the reason we have multi-drug resistant bacteria floating around and killing people. Something like 90% of antibiotics prescribed are unnecessary. I personally see them prescribed for viral infections and allergies on a daily basis. There is no need for it.Simply put, I would give antibiotics to a low-risk individual if one or a combination of these criteria are met:The infection has lasted greater than 10 days.Cultures are positive.There are multiple sick people with proven bacterial infection in the household.Symptoms resemble a possible bacterial infection and the patient has a temp of >101 F.Otherwise, you are probably doing nothing but killing off good bacteria, which can end up causing other health problems and/or creating bacteria that Keflex will no longer be affective against..Moral of the story is that I’m not telling you to skip the antibiotics. That is not my place, as I am not your prescriber. However, my professional opinion is that if I personally wasn’t running a significant fever (>101), had negative cultures, and I hadn’t been sick for AT LEAST a week, then I WOULD NOT take antibiotics. I would take Tylenol, cough drops, and drink plenty of water until I was better. Too many doctors give antibiotics “just in case”.Just for perspective, I have worked in healthcare around sick people for 8 years now and in those 8 years I can recall needing antibiotics one time. Keep in mind that I get as sick as anyone else. I’m pretty much congested with a cold or with allergies for a third of the year. Antibiotics are rarely needed because it’s usually not a bacterial infection.

Why do doctors prescribe antibiotics for viruses/viral infections?

This is an interesting question, and I will discuss further, but the main answer is doctors don't prescribe antibiotics for colds. You are correct, a cold is caused by a virus.Unfortunately, the patient does not come in with a tattoo on his forehead that says, I have a cold.When I was in medical school, I had a severe bronchitis, and probably pneumonia. Dutifully I went to the doctor that treated the med students. Of course, he was our Statistics teacher. Suffice it to say he was not very good at that either.Long story short, he made me culture my sputum 3 times, which took 6 days, before he would give me antibiotics. I literally almost died. Probably survived only because I was young. 3 times the cultures grew out pure H. Influenza (a bacteria).After I recovered, my friend developed my same symptoms. He asked me what I took, got a prescription, and never even got sick.As a resident in OB/Gyn, I noticed when someone was very ill, we got blood cultures before treatment. Cultures took two days. By that time, they were much sicker.Today, doctors do not hesitate to use triple antibiotic therapy for someone with a serious infection. They do not wait for blood cultures.What did I learn from this? When I was practicing medicine, and developed green or yellow sputum, I treated myself. I could not afford to miss days in my practice. If I did not work, I did not get paid. I am amazed that Bob Costas did not get treatment for his conjunctivitis when he was hosting this last winter Olympics. He kept saying, the doctors told me it would go away. It did, but a week later. How much money did he lose? Personally, I would have treated him and it would have gone away in a day.In summary, if I get a cold I don't treat it with antibiotics. But if I am not sure, I treat it. Every day is important to me, and if I don't have to be sick I choose not to do so.One does not have to use the "big guns" of antibiotics that are available for very serious infections. We should save these. But Doxycycline and Erythromycin can be judiciously used. Antibiotics, when used early in an infection, can prevent it from becoming more serious. This is especially true in Mycoplasma infections, where early treatment can knock it out quickly, but if not treated, it can last for months.If you are the CEO of your company, and can't miss work, I would take the antibiotic. Even though most doctors would disagree with this philosophy, you can bet they are treating themselves when they get sick.

Is it ok to miss 2 doses of antibiotics?

No, it is not ok, it is bad.Forgetting two doses out of how many per day?  If only once a day, you miss two whole days, if thrice a day, 2/3 of a day no bacteria inhibiting or killing blood levels of the antibiotic is there, so no effect.  We know that stopping a course of antibiotics prematurely (let's say before 3 to 5 days) is bad, it could cause the bacteria to become resistant to that antibiotic.