Antibiotics: Double-Edged Swords

Andrew Siegel MD  4/9/16

…A break from my typical “pelvic health” entries to briefly review these miraculous medications that are of both great benefit and detriment to humans and humankind. Beginning next week, I segue to the topic of “female pelvic health.”


The 19th century –the “century of hygiene”–was marked by improved public health and sanitation, which saved more lives than any other cause.   The 20th century–the “century of medicine”– witnessed the development of antibiotics, vaccines, medications, chemotherapy, etc.  The 21st century could aptly be labeled the “century of resistance,” as overuse/misuse/abuse of antibiotics has resulted in the emergence of highly resistant “superbugs” that are one of the world’s most pressing public health problems. 

Ten Indisputable Facts Regarding Antibiotics

  1. Antibiotics are indispensable assets and essential weapons in the fight against bacterial pathogens, in many cases proving lifesaving.
  2. Antibiotics have dramatically improved human quality and quantity of life.
  3. Antibiotics arguably are the medication class that has been most abused, overused and/or used inappropriately (although pain medications are right up there as well).
  4. When prescribed for non-bacterial infections, e.g., the common cold and other viral upper respiratory infections, antibiotics not only provide absolutely no benefit, but also can be detrimental.
  5. Antibiotics can induce allergic reactions and many other side effects including tendon weakness and rupture associated with the use of Ciprofloxacin and other members of its class.
  6. Antibiotics destroy healthy bacteria along with pathogenic bacteria, causing adverse effects due to the change in the population of the bacterial ecosystem: yeast infections; infection/inflammation of the colon (colitis) caused by overgrowth of Clostridium difficile; and the selection of “superbugs” that are resistant to antibiotic treatment.
  7. Antibiotic overuse in farm animals–the number one consumer of antibiotics– has contributed in a major way to the surge in these “superbugs.”  Resistance is of particular concern in children because they have the highest demand for antibiotic use and fewer choices since some antibiotics cannot be safely used in children.
  8. On an annual basis 2,000,000 Americans acquire antibiotic-resistant infections;            23,000 die from them.
  9. 50% of outpatient antibiotic prescriptions in the USA are considered unnecessary.
  10. Antibiotics are often prescribed inappropriately because patients “demand” them and the “path of least resistance” is often for physicians to prescribe them.

Bottom Line:  Antibiotics are a powerful component of the medical armamentarium against disease, but are double-edged swords that must be used judiciously and appropriately.  (So the next time a patient with a cold asks me to prescribe a Z-Pak, you know what the answer will be!)

Wishing you the best of health,

2014-04-23 20:16:29

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Author of The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health– available on Amazon Kindle as of today:

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Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: 

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Arnold Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: or Amazon.  In the works is the female PelvicRx.

Pelvic Rx can be obtained at, an online store that is home to quality urology products for men and women.  Don’t forget to use code UROLOGY10 at checkout for 10% discount. 

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