Are my antibiotics necessary?

April 16, 2011 11:01 AM

I had a tooth extracted last week and despite being on antibiotics for four days, it's infected, and the infection has spread, making it painful to swallow. The solution: a different antibiotic has been prescribed. I don't like antibiotics, so my question is: what would happen if I just didn't take the damn things, took the painkillers, braved it out and waited for my body to handle it alone? Would that just be stupid? I appreciate that it's probably hard to advise without specific details, but any comments welcome.
posted by Holly to health & fitness (28 answers total)

Yes, that would be very stupid. Listen to your doctor and take the antibiotics.
posted by alaijmw at 11:05 AM on April 16, 2011 [15 favorites]

Maybe your body would handle it. Maybe it wouldn't. Before vaccines and antibiotics, we had a hell of a lot shorter average lifespan than we have today, and we had a lot more situations where infections that are simple in today's terms turned into debilitating injuries.

Take the freakin' antibiotics.
posted by straw at 11:06 AM on April 16, 2011 [5 favorites]

I'm not a doctor, but it's possible to die from infections like that. Take the antibiotics.
posted by drjimmy11 at 11:06 AM on April 16, 2011 [1 favorite]

I don't like antibiotics either, but in this case you do have an infection. There is a possibility your body can't handle it alone. Are you willing to take that chance? Take the antibiotics.
posted by kellyblah at 11:07 AM on April 16, 2011 [1 favorite]

Not taking the antibiotics is a bad idea. You have an infection that is spreading, showing you that your body is not just 'taking care' of it. That infection might run its course and then you're OK, or it might damage your body.

Take the antibiotics.
posted by zippy at 11:07 AM on April 16, 2011 [1 favorite]

If you had a mildly infected scratch on your finger, your body could probably take care of it without much trouble. With an infection in your gums, it can and will (as you have seen) spread easily, and complications can be very bad and very expensive. Take the antibiotics. IANAD.
posted by rtha at 11:09 AM on April 16, 2011 [3 favorites]

You have a post-surgical infection. Your doctor has prescribed antibiotics.

Sepsis is bad.
posted by valkyryn at 11:11 AM on April 16, 2011 [4 favorites]

A friend of the family had a gum infection that spread to her heart and she DIED.

If you worry that taking too many antibiotics will somehow leave you vulnerable to antibiotic resistant bacteria, that's more of a wider societal/evolution issue and has nothing to do with you personally taking/not taking antiobiotics.

Take the antibiotics.
posted by bonobothegreat at 11:12 AM on April 16, 2011 [2 favorites]

valkyryn has it. Not taking the antibiotics can kill you. My mom almost died from dental related septesemia.
posted by procrastination at 11:16 AM on April 16, 2011 [1 favorite]

You don't want to do this. There is no painkiller that has much effect against the pain of a dental abscess. Unrelenting, screaming, crying, blow-your-head-off-with-a-shotgun PAIN. You do not want to be acquainted with this pain.

And that pain when you swallow? Your throat may get so swollen that you CANNOT swallow, even water. And every breath will hurt so bad you want to die. And the infection could set up housekeeping in your jawbone, where it's very, very resistant to treatment. If you skip the nice little antibiotic pills now, you could very easily end up in the hospital on industrial-strength IV antibiotics for weeks, or months, with permanent organ damage to remind you of your folly.

Please, please, don't even think about not taking the antibiotics. Start them AS SOON AS POSSIBLE, and FINISH them. In this situation, it really is important. Good luck!
posted by Corvid at 11:19 AM on April 16, 2011 [7 favorites]

Right now I work in the ICU. Recently we had a patient who had an infection in the back of his throat (which is where yours is if you have pain with swallowing) it got so bad that his airway was blocked and we were afraid he would asphyxiate. We had to put a tube down his throat and he spent the better part of a week on a ventilator. This has a very real possibility of happening to you if you don't take the antibiotics.
posted by genmonster at 11:20 AM on April 16, 2011 [2 favorites]

Everyone - thank you for taking the time to put me straight on this one. I appreciate it. I will, as Straw says, and for a thousand reasons, take the freakin' antibiotics.
posted by Holly at 11:22 AM on April 16, 2011 [1 favorite]

I am a person who is deeply suspicious of antibiotics. I use salt water rinses (and sometimes baking soda) for mild mouth infections, a process recommended to me by a dentist. I have an ENT and GP who are both hesitant to prescribe antibiotics and who suggest alternative approaches where possible. All that aside, when they do prescribe antibiotics, I take the medication as directed until they are gone. Because the alternative is usually very bad.

Take the antibiotics as directed, you will be much happier in the future.
posted by GenjiandProust at 11:27 AM on April 16, 2011

Glad you're taking the antibiotics. Just chiming in to stress the importance of taking the entire prescription and not stopping once you start to feel better.
posted by Homo economicus at 11:51 AM on April 16, 2011 [2 favorites]

One time I didn't want to take antibiotics so I waited for my body to handle a kidney infection on its own and OH DEAR did I ever have to take extra-huge-monster antibiotic pills once I finally dragged my aching, weakened, 104+ degree fevered, idiot self down the block to the doctor, who said he ought to hospitalize me but he wouldn't as long as there was someone to check on me and make sure I took the damn pills. It was the unfunnest thing ever so far.
posted by little cow make small moo at 11:53 AM on April 16, 2011 [1 favorite]

So, I'm glad the OP is going to take the antibiotics, but for anyone in the future who might find this question and be unperturbed by the possibility of heart infection, I add Brain Infection.

I'm sure you're aware of the proximity of tooth to throat and brain. If it's traveled to your throat, the bacteria is also trying (with the help of your bloodstream) to get anywhere it can. This includes your brain.
posted by bilabial at 12:10 PM on April 16, 2011 [2 favorites]

I was going to go where bilabial mentioned -- with the infection's origin right next to your brainpan, all that grey matter is just prime real estate for the infection to set up camp. And that would SUCK SO HARD.

I've only had to take antibiotics once, for a super-disgusting strep infection that was so bad by the time I went to the urgent care center that a nurse looked in my mouth for one second and said 'Holy shit, you have strep.' She ran the test anyway, because she had to, but the culture took two minutes. Ten minutes after walking in the door, I had a prescription for horse-pill penicillin. Bleah.

And oh god, was it worth taking those choke-you-out-if-you-swallow-them-wrong pills. And for the love of pete, take all of them even if you feel better. If you got twenty, take them for twenty days. Don't be lazy and skip a day.

Get better! No dying!
posted by Heretical at 12:52 PM on April 16, 2011

Glad you're going to take the antibiotics. Ludwig's Angina is one of the potential conditions that can occur if you forgo treatment for a dental infection.
posted by gimli at 2:31 PM on April 16, 2011

Thank you, everyone, and thanks, Metafilter. I have to say I'm kind of moved by the interest and concern. My only worry now is that I'm having to break the course of antibiotics that didn't work so that I can take the antibiotics s that hopefully will work. But that's what the dentist said I should do, so I guess that's what I'll do. Any comments? Thanks again to all!
posted by Holly at 2:43 PM on April 16, 2011

I am not a doctor, but the finishing-the-course thing is to kill nearly all of the bacteria responsible for the infection so that they don't rise up from a near-eliminated state. (Possibly having being bred into an antibiotic-resistant strain.)

The thing is here that the first antibiotic isn't working, so it won't kill the culture that's growing in you anyway — but the new antibiotic will hopefully do that.

So the rule is "don't break the cycle of an antibiotic that is working on your infection".

(But I am not a doctor.)
posted by krilli at 2:50 PM on April 16, 2011 [1 favorite]

Nice logic, krilli - I'm guessing that's my only option anyway. Thanks!
posted by Holly at 2:59 PM on April 16, 2011

I had septicemia. It sucked. Hard. I was hospitalized for almost a week. I almost DIED. Take the antibiotics.
posted by PorcineWithMe at 7:45 PM on April 16, 2011

Why don't you like antibiotics? Is it because you have to remember to take a pill? I agree, that can be annoying. Try an alarm if you need help.

Do antibiotics upset your stomach or make you vomit if you don't eat with them? Talk to your doctor/dentist... he/she may be able to switch you to a different drug, or offer you something like Compazine for the side effects.

It's always worth discussing these things with your prescriber.
posted by IndigoRain at 1:34 AM on April 17, 2011

In case one of the reasons you don't like taking antibiotics is what they do to your digestion (IOW, if you react to antibiotics like I do), the best thing to do is to take them while simultaneously boosting the quantity of probiotic and fermented foods in your diet. Yogurt with live cultures is, of course, what you'll hear most about (veer towards the health food, low-sugar or plain end of the spectrum rather than hyperprocessed Yoplait or what have you); there are also beverages like kefir, rejuvelac, and kombucha. (Note, I suggest kombucha not because of the unproven claims like "it cures cancer/eliminates gray hair/gives you perfect pitch", but because it's a fermented drink full of live organisms.) Sauerkraut, kim chi, and fermented (not vinegar-brined) pickles are also full of active cultures — any lactic-acid fermented food will be full of beneficial cultures.

There are also probiotic supplements available at health food stores. I have no personal experience and so can't recommend any particular brands. Go for the refrigerated ones is what I've been told, though, so the cultures will be alive.
posted by Lexica at 12:57 PM on April 17, 2011

Just checking back - thanks for the latest comments. The reason I don't like antibiotics is that our bodies build up resistance to them, and I'd like to feel that they'll still work on me in my declining years, when I'll almost certainly need them. But then again, maybe the pharmaceuticals industry always keeps one step ahead of the resistance...
posted by Holly at 1:29 PM on April 17, 2011

The reason I don't like antibiotics is that our bodies build up resistance to them

I was always under the impression that it was the bacteria strain that was gaining the resistance to antibiotics. This is why it is more a broad issue when antibiotics are used incorrectly -it doesn't just affect the person taking the antibiotics. The strain in that person is transferred to others, and that strain is more resistant to antibiotics. It's awesome that you don't want to contribute to that, and I love seeing people here saying that randomly chucking down antibiotics for a sore throat is bad, but unfortunately, we'll all still be affected by those whom seem to think that a Z-pack is no different than vitamins.
posted by kellyblah at 5:52 PM on April 17, 2011

The reason I don't like antibiotics is that our bodies build up resistance to them
Your body does not build up resistance to antibiotics. Bacteria build up resistance to antibiotics, which is why so many people are telling you to finish the course your doctor prescribes.
posted by HiroProtagonist at 9:29 PM on April 17, 2011 [1 favorite]

Just in case you were wondering, here's a nice (actually, somewhat confusing) picture showing how the blood vessels near the mouth connect to the cavernous sinus of the brain.
posted by ladypants at 1:35 PM on April 18, 2011