Antibiotics, Viruses and Bacteria

Q. Do antibiotics ever work for viruses?  What’s the difference between viruses and bacterial illnesses? Strep throat seems to be around a lot as soon as school starts and a lot of parents and doctors seem panicked about the possible complications.

A. Viruses are smaller “animals,” need to use another animal’s cells to survive and are in most ways harder to kill using medication. Fortunately, the immune system does a great job of destroying viruses over a few days. It does this by mobilizing white blood cells and antibodies to attack viruses. Unfortunately, the same techniques used to fight the invaders make us feel sick. This involves fevers and various chemical “poisons” which are produced by white blood cells. These chemicals and the elevated temperature get rid of the virus but can make us feel achy, nauseous, and weak.

Bacteria are pretty independent small “animals” and can survive on their own better. Antibiotics kill them by breaking done the walls of the bacteria’s cells or by interfering with bacterial metabolism. There are a lot of different antibiotics and they each kill different bacteria with varying success. Most parents have had the experience of “antibiotic failure” for an ear infection and the need for a second or even a third drug.

Streptococcus is a relatively common cause of sore throat and most doctors have read about the kidney and heart complications which can occur. Very few of us have actually seen these complications (I’ve only been in practice twenty years) but we still have a healthy respect for the problems which have occurred in the past and could occur. We all treat strep throat with antibiotics and I have no great reason to argue against that tradition. It’s probably safer than not treating with antibiotics.