Tag Archives: hospital

Do antibiotics kill viruses?

Definition of antibioticIf you wonder why so many people think antibiotics can treat colds and flu (viruses), perhaps its because sick people are using search engines to figure out what antibiotics are. Below are some examples of what people will find. I’ve included definitions of “microorganism” because so many definitions of “antibiotic” contain that term.


antibiotic: a medicine (such as penicillin or its derivatives) that inhibits the growth of or destroys microorganisms.
microorganism: a microscopic organism, especially a bacterium, virus, or fungus.


antibiotic: any of a large group of chemical substances, as penicillin or streptomycin, produced by various microorganisms and fungi, having the capacity in dilute solutions to inhibit the growth of or to destroy bacteria and other microorganisms, used chiefly in the treatment of infectious diseases.
microorganism: any organism too small to be viewed by the unaided eye, as bacteria,protozoa, and some fungi and algae.


antibiotic: a substance produced by or a semisynthetic substance derived from a microorganism and able in dilute solution to inhibit or kill another microorganism.
microorganism: an extremely small living thing that can only be seen with a microscope.


antibiotic: A substance, such as penicillin or erythromycin, produced by or derived from certain microorganisms, including fungi and bacteria, that can destroy or inhibit the growth of other microorganisms, especially bacteria. Antibiotics are widely used in the prevention and treatment of infectious diseases.
microorganismany organism, such as a bacterium, protozoan, or virus, of microscopic size.

Britannica Library:

antibiotic:  chemical substance produced by a living organism, generally a microorganism, that is detrimental to other microorganisms. Antibiotics commonly are produced by soil microorganisms and probably represent a means by which organisms in a complex environment, such as soil, control the growth of competing microorganisms.
microorganisms: living things that are too small to be seen with the naked eye. They are normally viewed using a microscope. Bacteria, viruses, and some molds are examples of microorganisms.


antibiotic: Any substance that can destroy or inhibit the growth of bacteria and similar microorganisms.
microorganism: An organism that is too small to be seen by the unaided eye, especially a single-celled organism, such as a bacterium.

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A simple name change for antibiotics could save lives

In depressing medical news this week, the World Health Organization reported that 64% of adults believe that antibiotics can be used to treat flu and colds. That’s terrible because those 64% are likely to pressure their doctors for antibiotics when they don’t need them, which in turn will speed the evolution of bacteria resistant to the drugs … and then people die from bacterial infections that used to be treatable.

Cartoon image of Batman slapping robin for thinking antibiotics can treat common coldThere are several beliefs that contribute to this statistic, and I think it’s important to tease them apart so we can better craft outreach strategies. The one that gets the most attention, of course, is when people (e.g., Robin in the popular Batman meme I based on original by Dr Nick Bennett and his wife) think that colds are caused by bacteria. A second reason is that some people think viruses are a kind of bacteria and thus treatable with antibiotics.

But there’s a third, even more important explanation that gets almost no attention: people thinking antibiotics are effective against a wide range of microorganisms (i.e., not just bacteria). Why on Earth would people think this? I think kids are almost certainly to blame. When young kids are sick, they don’t really care about the whole virus-versus-bacteria thing … they just know something is infecting them and that the parents keep chanting “antibiotic” over and over again. So I think it’s unavoidable that kids construct a definition for antibiotics before they even start kindergarten (pollsters: can you ask?). Kids are also genius at figuring out word meanings when they don’t get full information from teachers or parents, so it is probable that many assume that the anti (against) and biotic (living) parts of “antibiotic” mean that the drug kills all life. (This is, indeed, what the word “antibiotic” used to mean before microbiologists commandeered it to mean something else.) Although kids might be told later in life (in high school, college) that antibiotics target only bacteria, the correction might not stick in the average person’s brain. In addition to the above, ignorance about antibiotic efficacy is probably increasingly pulled from the Internet. If you doubt me, just type “antibiotic definition” into Google and read the top five or so definitions: they all say that antibiotics can kill microorganisms.

If “antibiotic” (the word) is the source of so much confusion, replacing it with a better word might cause people to stop asking for it, which could save lives via preserving antibiotics. Luckily, the word “antibacterial” is just waiting there, perfect for the job. The anti and bacterial parts of the word convey its meaning unambiguously, plus it’s an old word (older than antibiotic!), and is already used by the general public. You can even Google the definition if you don’t believe me: all the definitions indicate it is a drug that kills bacteria (and only bacteria). It would join other words such as “antifungal” and “antiviral”, all of which tend to be used and understood by both doctors and patients.

Cartoon image of Batman slapping robin for thinking antibacterials can treat common coldThere would, of course, be a certain amount of work associated with the switch. For example, websites promoting antibiotic awareness would need to run a Search and Replace macro to insert “antibacterial” everywhere instead of “antibiotic”. That might take 10 minutes for a large site. And brochures and cartoonish wall art for waiting rooms would have to reprinted, but the result would be that waiting patients and parents would be measurably less confused on what antibacterials do. And once everything was converted to “antibacterial”, outreach organizations like WHO and CDC could focus on the more important issues such as making people understand what colds are (please see Batman comic #2) and making sure that the full course of antibacterials is taken.

Note that I’m not suggesting everyone stop using “antibiotic” altogether. But in terms of public outreach, discussion with patients, and the names on drug containers, we should give it a try.

What would also be great is if pollsters could replace “antibiotic” with “antibacterial” for half of the survey participants. Currently, most physicians and “antibiotic awareness week” coordinators LOVE the word “antibiotic” and can see no fault in it; they blame ignorance levels on the educated, ignorant masses. But if poll data could show them that ignorance goes down by (say) 50% after adoption of “antibacterial,” they might rethink their opposition to change.

BONUS FACT: Alexander Fleming used the word “antibacterial” 19 times in his paper describing the isolation of penicillin. He used “antibiotic” 0 times. He got a Nobel prize for the work.

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Evidence-based antibiotic usage

Stop prescribing antibioticsIn my ongoing quest to show that “antibiotic” is a word that does more harm than good to public health outreach, I frequently encounter people on the Internet who insist that confusion over antibiotic efficacy is not due, at all, to the word itself.  I value these people’s insight, of course, because their views certainly might be true for the planet they live on. There are probably a lot of habitable planets in the Universe (40 billion just in our galaxy!), and I don’t presume to know what reality is like for those places.

On Earth, however, the belief that antibiotics treat viruses is rampant, generates over-prescription, and is clearly related to the word itself. Here are Exhibit A (from answers.com) and Exhibit B (from Google definitions):

What does antibiotic mean?What is a germ?  Definition from Google.People believe that antibiotics treat viruses because on Earth we regularly use a word’s roots to infer meaning. So for the average person who doesn’t remember any biology from middle school, parsing the meaning of antiviral, antibacterial, antifungal, etc. is easy … as long as he/she knows what anti-, viral, bacterial, and fungal mean.  But that same trick doesn’t work for antibiotic.  And because people don’t realize their inference is incorrect, the misconception becomes forever entrenched in public opinion, and on the internet.  The CDC (and others) waste millions of dollars each year trying to quash the misconception, but such efforts will always fail because the strength of the “antibiotics” misnomer is always truthier to the average Joe than a bunch of patronizing posters on a doctor’s waiting room wall.

[As an aside, misnomers are words (you can probably guess, based on the roots … if you live on Earth) that deliver an incorrect meaning.  “Pencil lead” (two words, of course) is a great example, and there are thousands of parents each year who call their doctors in a panic after Jimmy gets stabbed during math class with a pencil. Or they search the internet for “pencil lead poisoning“.  Luckily, pencil lead is graphite (always has been), a harmless crystal of carbon that is not going to cause Jimmy to be developmentally delayed.]

So how bad a misnomer is “antibiotics”?   How should physicians decide whether to use “antibiotics” or “antibacterials” when discussing treatment of illnesses?  Like any medical question, the decision should be evidence-based.  Here is how to get the evidence (Pew Research Center folks, this means you):

Antibiotic versus antibacterial poll dataResponses for questions #1 and #2 show that approximately 10% and 36% (pdf) of adults are confused about the correct answers, respectively.  That’s a HUGE fraction given the daily importance of bacteria and viruses in our lives and in the news.  Unfortunately, there are no poll data for #3 and #4.  But my guess is that the fraction of incorrect responses for #3 and #4 will be 1% and 5%, respectively.  “Antibacterials” clearly suggests the drug kills bacteria — only people unfamiliar with English might be clueless.  And I’m guessing that 5% of the public think viruses are bacteria (I’ve asked dozens of virologists … and none knew of poll data on classification ignorance).  No matter what the actual numbers, the level of confusion for “antibacterials” is going to be dramatically less than that caused by “antibiotics.”

So if you are a doctor hoping to improve patient understanding and patient care, using “antibacterials” is a no-brainer.  And if you are worried that “antibacterial” is a rare word, stop worrying: it’s from the 1890s (that’s old!) and is found 13,200,000 times on the internet (that’s less than the 23.8 million for “antibiotic”, but still totally respectable).  Don’t wait for the CDC, WHO, AMA, ACP, APA, etc. to recommend the change, because chances are they won’t — they love the word, “antibiotic” (I’ve emailed them all, trust me).  So just tell your colleagues and staff on the floor to get on board.  And then let me know how it goes.

Below are my other posts on the topic, if you need further convincing.  All posts have graphics that you are encouraged to use for your talks on the topic (this week is Antibiotic Awareness Week, after all). Please consider sharing these links with others on Twitter and Facebook if you are on board with my suggestion, and if you can forward to impressionable medical students, you get bonus points.

  1. Curbing the misuse of antibiotics
  2. Antibiotics are antiviral
  3. How doctors can reduce antibiotic demands from patients
  4. Antibiotic Awareness Week poster
  5. Antibiotics work against viruses
  6. How to improve Antibiotic Awareness Week
  7. Seasonal plea for informed antibiotic usage
  8. Antibacterial soap
  9. The Walking Dead need antivirals, not antibacterials (Shopping list for anti-infectives)
  10. Venn guide to pills that kill things

[If you’re curious why I am so interested in this issue, it’s because I witnessed, first-hand, confusion over “antibiotics” when I lectured on antibacterial resistance in my evolution courses at Swarthmore College.  My students were (largely) bright, and were often bound for medical school … yet they frequently made the same incorrect assumptions about efficacy that totally uneducated people make.  Misuse of “antibiotics” became one of my pet peeves.  Because I have a blog, I thought it would be worth a try to effect some change.]

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Antibiotic Awareness Week poster

Ten interesting facts about antibiotics, for Antibiotic Awareness Week (Nov 18 -24, 2013).  Below is an image that can be used for presentations. PDF version for printing: facts-about-antibiotics.pdf.

Antibiotic Awareness Week poster

I’ve tried to craft the above poster with information that is mildly interesting, with the hope that people (people like you?) might pass the link along. There are 100s of posters on the internet … but they seem to be completely ineffective at educating the public (according to an experiment). In my view, the problem is that all of these posters use “antibiotics” instead of the correct term, “antibacterial.” Please see my page, “Curbing the misuse of antibiotics” for details on why antibiotic/antibacterial choice matters for the public, even if it doesn’t matter to you (who probably have a higher degree).

Below are some links that explore some of statements in the PDF above. I’m putting them below the fold because they are probably TMI for 99% of the people who might be interested in the above PDF. If you are that 1%, go crazy.

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Antibacterial soap

Ever wonder why soap companies label their products “antibacterial” instead of “antibiotic”?  OK, probably not.  But this is not just trivia, folks — the explanation can help us address the rather pressing problem of drug-resistant strains of bacteria. So if this post is too boring now, at least consider returning when you are dying in a hospital bed from an untreatable bacterial infection.  It will seem more important then.

colin purrington photography: Blog photos &emdash; antibacterial-soap

So the answer is that I think soap manufacturers have figured out that using “antibacterial” is much clearer than using “antibiotic” — consumers have zero expectation that antibacterial soaps kill fungi, viruses, or protozoans.  That’s because to most people antibiotics have a broad range of action (Google definition; Wikipedia entry).  So soap companies avoid this confusion by specifying “antibacterial,” and their usage has clearly caught on.  As proof, please see the graph below to see how people search for information about such soaps online.  The blue line, which shows the number of people searching Google for “antibacterial soap” is vastly higher than the red line, which shows “antibiotic soap” searches.

Antibiotic soaps on Google Trends

I make the above points not to highlight how great soap companies are, but rather to show pharmaceutical companies, physicians, and health organizations that if they’d adopt “antibacterial” as way to describe antibacterial drugs, the public would fall in line. Currently all these groups love using the word “antibiotic,” and when I’ve suggested to them that they should switch, they respond politely, “You have wasted our valuable time with this crackpot suggestion” (I’m paraphrasing).  They firmly believe the word “antibiotic” is not causing the public confusion.  I think they haven’t really thought about how misnomers work on the brain — they truly do influence people’s perceptions. I also believe that they haven’t searched Google for the definition of “antibiotic”, and that they haven’t looked at the Wikipedia entry (links above).  I fully admit that word “antibiotic” doesn’t confuse microbiologists or physicians, but those people make up a rather small proportion of the world’s population.  The remaining people are justifiably confused about the specificity of “antibiotics,” and that’s why they tend to demand antibacterials from their doctors for viral infections. For example, many people use Google to research specificity of antibiotics; they never search for specificity of antibacterial (see graph in a new window). Getting rid of “antibiotics” should be a no-brainer for anyone concerned with the over-prescription of antibacterials.

So I’m looking for just one medical association, one non-profit, or one pharmaceutical company brave enough to abandon “antibiotic”.  It would be good press, and it would help fight the evolution of drug-resistant bacteria.

Please see, “Curbing the misuse of antibiotics” for further information if you are concerned with evolution of antibacterial-resistant strains of bacteria. My theme, again, is that simply deleting “antibiotic” is an insanely easy thing we could all do.

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