The People's Perspective on Medicine

Show 1172: How Can Antibiotics Affect Your Brain?

Antibiotic overuse is troubling for many reasons. It contributes to bacterial resistance, but in addition certain antibiotics affect your brain negatively.
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How Can Antibiotics Affect Your Brain?

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Antibiotics are crucial for treating serious infections, but the specter of bacterial resistance to antibiotics is scary. Many public health experts have called for more diligent antibiotic stewardship to protect the usefulness of these medication.

How Might Antibiotics Affect Your Brain?

Some physicians point to other, equally compelling reasons to use antibiotics more judiciously. They have potential side effects ranging from diarrhea or rashes to altered mental status, kidney injury or heart rhythm problems. As a result, doctors should prescribe them only when they are necessary. Dr. Sara Cosgrove describes how fluoroquinolones can damage tendons and how such antibiotics can affect your brain. Older people may be especially vulnerable to the cognitive impact. How can we protect them and ourselves?

The Pain of Gout:

When uric acid crystals build up in joints, the result can be swelling, redness and excruciating pain. Gout affects an estimated 4 percent of American adults: roughly 6 million men and 2 million women. Anyone who has experienced a gout attack would rather not have another, but about four-fifths of gout sufferers will have a second attack within three years of the first episode. How is gout treated? What drugs are most helpful? Find out how you can reduce your likelihood of a second attack with diet and lifestyle measures.

How to Treat Incontinence:

If you release urine when you don’t intend to, you have urinary incontinence. Doctors classify common cases of incontinence into two different categories: stress incontinence and urge incontinence. If coughing, sneezing, running, jumping or lifting a heavy object are triggers, that is stress incontinence due to pressure on the bladder. Urge incontinence is caused by contraction of the bladder muscle, with a sense of “gotta go NOW.”

Incontinence is embarrassing. Many women deal with either of these problems by using pads in their underwear, and don’t bring it up with their physicians. However, there are treatments that can be effective. Learn about the pros and cons of surgical treatments and medications used to ease incontinence.

This Week’s Guests:

Sara Cosgrove, MD, MS, is an infectious disease physician, the Director of the Antimicrobial Stewardship Program at The Johns Hopkins Hospital and a Professor of Medicine at the Johns Hopkins University School of Medicine. Her research and practice focus on development of tools and programs to promote appropriate use of antibiotics to improve the safety of patients and prevent antibiotic resistance. Her article on adverse events related to antibiotic use in the hospital was published in JAMA Internal Medicine in September 2017

Chad Deal, MD, is head of the Center for Osteoporosis and Metabolic Bone Disease and a board-certified rheumatologist at the Cleveland Clinic.

Peter C. Jeppson, MD, is Division Director of Urogynecology at University of New Mexico. He is board-certified in both Obstetrics and Gynecology and Female Pelvic Medicine and Reconstructive Surgery. In addition, he is a fellow of the American College of Obstetrics and Gynecology and a fellow of the American College of Surgeons.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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  • Tamma PD et al, "Association of adverse events with antibiotic use in hospitalized patients." JAMA Internal Medicine, Sep. 2017. doi: 10.1001/jamainternmed.2017.1938
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Dr. Deal focused a lot on alcohol use as being the primary cause for gout, with diet being a secondary factor. In my opinion, diet is the bigger culprit, as you have many gout sufferers who don’t drink alcohol but who do consume red meats and other gout-inducing foods. The doctor also downplayed eating cherries to ease gout pain. He half-heartedly acknowledged studies about the benefits of cherries and added that he does not recommend cherries in his practice. What is the harm of a patient trying cherries for gout symptoms? It appears to work for some people. Sadly, Dr. Deal seems to be an old school traditionalist who downplays remedies that don’t involve a prescription medication.

I took an antibiotic, and shortly thereafter my hair started to fall out. I called the pharmacist to see if there was a connection. He said yes. UGH! The things doctors don’t tell you!

My husband had sepsis 10 months after a knee replacement. The doctor replaced the plastic in his irrigated knee replacement. He had IV therapy for seven weeks in a nursing home. He was told to have oral antibiotics every time before dental work. It has been years since then. Wondering if that antibiotic is still necessary twice per year.

I was prescribed Clindamycin for an inflamed root canal. I developed a raging vaginal yeast infection that took 2 weeks of treatment before I could sit comfortably. I wish I had been warned of that side affect.

I am very glad that you’ve had this show, my mom has had serious problems with recurrent urinary tract infections and the biggest fear, that the doctors have, is that she will develop a resistance to all the antibiotics. This is a very serious problem and this is been ongoing for my mom. Also that you would dovetail with the urinary incontinence, it is one of the main reasons that she has these recurrent infections because she consistently cannot control her bladder. I am sending her the show on your podcast just so she can hear about the going to the bathroom according to the clock, which it seems that when the doctors tell her to do prevention ie hourly she resists. Plus the Gout pills she takes too.

Hi Joe and Terry, my question is prompted by the antibiotic discussion with your first guest. Many of your guests have noted the risk of C-Dif after a course of antibiotics. But none of them have explained–since both good and bad bacteria get wiped out from the antibiotic treatment–why C-DIF thrives. You and your guests have described C-Dif as a strain of bacteria, not a yeast. So why does it get to thrive, when both the targeted bad guys, and the non-targeted good guys in the bacterial realm are destroyed by the antibiotic treatment? Please consider bringing someone on your show sometime who can address this anomaly? Many thanks and kind regards, Julie in Virginia

It’s not just wheedling, whining patients who are responsible for over-prescribing antibiotics. My nieces’ pediatrician, in Garrison NY, does nothing but prescribe ABs, even when the problem is clearly something else (viruses, allergies, etc.).

A few years back, my one niece had a sliver in her foot. She needed cleaning and debridement/ extraction of the wood chip – minor surgery. The problem was that this office full of PAs and NPs who see most of the patients either had no authority, no interest, or no ability to do the minor surgery. (Or the insurance would insist on a specialist – who knows?) So we got a pointless, unnecessary, irresponsible prescription for an antibiotic, went home and soaked her foot, and eventually the sliver came out. No help from the pediatrician whatsoever, and a terribly irresponsible prescription.

I’ve taken the kids to this doctor several times and no matter what the problem, all we get is a prescription for antibiotics. This doctor is nothing but a pill-pusher, and I’m guessing he’s not the only one.

There are times where antibiotics are necessary to relieve infections which can cause serious pain. So the real question is once the issue is resolve how does one get the body back to norm? The effects mentioned………….how long were the patients on antibiotics? Also is there any particular antibiotic that is more troubling than others?

Many women I talk to are not aware that many times incontinence can be helped with the use of a pessory. I was having a severe incontinence problem, and the gynecologist suggested an operation (which would have put me out of commission for at least 3 months}. My general physician suggested trying a pessory, of which I had never heard. I talked to another gynecologist and had a pessory inserted. I felt relief immediately and have had it for at least 3 three years. This is a painless procedure. Please make women aware of this procedure so more do not take the operation route or suffer needlessly. Always, your column is of great interest to me.

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