Antibiotics
When They Work
- Antibiotics only work against bacteriaⓘ
- Most respiratory infections are viral
- Bacterial infections: strep throat, UTIs, some ear infections, pneumonia (sometimes)
Common Misuse
- In an EU-wide survey, only 43% of citizens correctly identified that antibiotics do not kill viruses, and 20% reported taking antibiotics for colds or flu[1]
- A study of parents in Beirut found that those who believed antibiotics were effective against viruses were twice as likely to misuse them[2]
- In a survey of community pharmacies in Sri Lanka, one in three staff reported dispensing antibiotics without a prescription[3]
- A qualitative study in Spain found that patients often expect antibiotics and doctors sometimes prescribe to satisfy those expectations[4]
Why This Matters
Warning: Antibiotic resistance is a growing global health crisis. Every unnecessary dose contributes to bacteria evolving resistance.
- The traditional advice to "always complete the full course" is now debated[5]. For many common infections, shorter courses are equally effective. Follow your doctor's specific instructions on duration rather than assuming longer is better.
- Never use leftover antibiotics or share them
- Ask your doctor if antibiotics are truly necessary
Painkillers
How They Actually Work
- Paracetamol (acetaminophen)ⓘ
- Ibuprofen/NSAIDsⓘ
- Aspirinⓘ
Common Myths
Myth: Stronger painkillers are always better
Reality: In a clinical trial of acute pain after dental surgery, paracetamol + ibuprofen provided better pain relief than paracetamol + codeine, and adding codeine to the paracetamol/ibuprofen combination provided no extra benefit[6]. Stronger isn't always more effective for your type of pain.
Reality: In a clinical trial of acute pain after dental surgery, paracetamol + ibuprofen provided better pain relief than paracetamol + codeine, and adding codeine to the paracetamol/ibuprofen combination provided no extra benefit[6]. Stronger isn't always more effective for your type of pain.
Myth: You should wait until pain is bad before taking painkillers
Reality: Pain is generally easier to manage earlyⓘ. Taking medication early is often more effective.
Reality: Pain is generally easier to manage earlyⓘ. Taking medication early is often more effective.
Rebound Headaches
- Taking painkillers too often can cause chronic headachesⓘ
Vitamins & Supplements
The Supplement Industry
Myth: Everyone should take a daily multivitamin
Reality: Vitamin D supplementation did not significantly improve most non-skeletal health outcomes in a systematic review covering 54 reviews and 210 clinical trials[7]. However, this does not mean vitamin D is useless — most of these trials studied people who were not deficient. Exceptions where supplements help: pregnant women, people with documented deficiencies, some elderly.
Reality: Vitamin D supplementation did not significantly improve most non-skeletal health outcomes in a systematic review covering 54 reviews and 210 clinical trials[7]. However, this does not mean vitamin D is useless — most of these trials studied people who were not deficient. Exceptions where supplements help: pregnant women, people with documented deficiencies, some elderly.
Specific Vitamins
- Vitamin Dⓘ
- Vitamin Cⓘ
- In an RCT with 440 postmenopausal women with osteopenia, daily vitamin K1 supplementation (5 mg) for 2-4 years did not prevent bone density loss, but fewer women in the vitamin K group had clinical fractures (9 vs 20)[8]. A later meta-analysis of 36 trials found a possible reduction in clinical fractures (OR 0.72), but this became non-significant after excluding studies at high risk of bias[9]
When Supplements Help
- Documented deficiency (confirmed by blood test)
- Pregnancy (folic acid, sometimes iron)
- Strict vegans (B12)
- Specific medical conditions
- NOT as insurance against poor diet
General Principles
Medicine Safety
- Read the label and follow dosage instructions
- Dont mix medications without checking interactions
- Store medicines properly and check expiration dates
- Tell doctors about all medications you're taking
When to See a Doctor
- Symptoms persist or worsen despite self-treatment
- Fever lasting more than a few days
- Severe or unusual pain
- Any concerning symptoms
Red Flags for Quackery
Warning: Be skeptical of products that: claim to cure everything, use testimonials instead of evidence, attack mainstream medicine, are only sold through special channels, or require you to stop regular treatment.
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References
Systematic review / meta-analysis Randomised controlled trial Published study Low quality / unsupported
- European Commission (2018). Special Eurobarometer 478: Antimicrobial Resistance. European Commission. [DOI]
- Hallit S, et al. (2020). Association of knowledge and beliefs with the misuse of antibiotics in parents: A study in Beirut. PLOS ONE. [DOI]
- El-Nimr N, et al. (2019). A cross-sectional national survey of community pharmacy staff: Knowledge and antibiotic provision. PLOS ONE. [DOI]
- Vazquez-Cancela O, Souto-Lopez L, Vazquez-Lago JM, Lopez A, Figueiras A (2021). Factors determining antibiotic use in the general population: A qualitative study in Spain. PLOS ONE. [DOI]
- Langford BJ, et al. (2022). Short-course antibiotics for common infections: what do we know and where do we go from here?. Clinical Microbiology and Infection. [DOI]
- Mehlum MH, et al. (2023). Analgesic effect of oral paracetamol 1000 mg/ibuprofen 400 mg, paracetamol 1000 mg/codeine 60 mg, paracetamol 1000 mg/ibuprofen 400 mg/codeine 60 mg, or placebo on acute postoperative pain. European Journal of Clinical Pharmacology. [DOI]
- Autier P, et al. (2017). Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLOS ONE. [DOI]
- Cheung AM, et al. (2008). Vitamin K Supplementation in Postmenopausal Women with Osteopenia (ECKO Trial). PLOS Medicine. [DOI]
- Mott A, Bradley T, Wright K, Cockayne ES, Shearer MJ, Adamson J, Lanham-New SA, Torgerson DJ (2019). Effect of vitamin K on bone mineral density and fractures in adults: an updated systematic review and meta-analysis of randomised controlled trials. Osteoporosis International. [DOI]