Dr. Avanthi Doppalapudi, an infectious disease physician with Medical Associates of North Georgia, recently explained the essentials about antibiotics, their uses and their risks.
What antibiotics are
Dr. Doppalapudi noted, “The term antibiotics is actually a misnomer, meaning ‘anti’ means against, ‘bio’ is life. So antibiotics are not against all life. For example, they don’t kill parasites, they don’t kill fungi, they don’t kill viruses, but only bacteria.” She added, “A better term would be ‘antibacterial.’”
She explained that antibiotics come from different sources: “Some are natural substances, the biggest example is penicillin, which is derived from a mold called Penicillium. Then we have semi-synthetic, where the natural product, like penicillin, is chemically modified to create the final drug. An example is amoxicillin.” Fully synthetic antibiotics, she said, include sulfa antibiotics, azithromycin and doxycycline.”
How they work
Dr. Doppalapudi said antibiotics fight bacteria in several ways:
- Breaking down the bacterial cell wall
- Disrupting the membrane
- Blocking DNA or protein production
- Interfering with bacterial metabolism
Some kill bacteria directly, while others slow their growth. None can tell the difference between good and bad bacteria, which is why side effects occur.
A brief history
Discussing penicillin, she noted, “Alexander Fleming discovered penicillin in 1928. He found that there was a mold that contaminated the bacterial plates, and wherever this mold was, there was a circle around it where bacteria were not growing.”
She highlighted the problem of resistance: “By the 1960s, there was increasing use of penicillin resistance. Resistance means the bacteria is resisting the drug. Methicillin-resistant Staphylococcus aureus, also called MRSA, was documented globally by 1961.”
When antibiotics help — and when they don’t
Dr. Doppalapudi emphasized, “Antibiotics, we know, help 100% when we know that there is a bacterial infection. When we know for sure it is not a bacterial infection — viral, fungal, or parasitic — we know for sure that they are not useful and could in fact be harmful.”
They help when:
- A bacterial infection is confirmed
- A bacterial infection is strongly suspected
They don’t help when:
- You have a viral illness like a cold or flu
- You have most cases of bronchitis
- You have most sinus infections (only 0.5% to 2% are bacterial)
- You have ear pressure without a clear infection
- You have asymptomatic bacteriuria — bacteria in urine with no symptoms
Why this matters
Unnecessary antibiotics can cause side effects such as diarrhea, rash, yeast infections and nausea. Dr. Doppalapudi warned that more serious long-term risks include Clostridioides difficile (C. diff) colitis, organ damage and worsening antibiotic resistance.
Practicing careful antibiotic use — “antibiotic stewardship” — prescribing only when needed and for the right duration, protects your health today and preserves these medications for the future.
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