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Are Antibiotics Really Appropriate for What Ails You?

By U.S. News & World Report

The discovery of penicillin in 1928 paved the way for combating infections, which are a leading cause of death. But today we live in an era of antibiotic overuse, in which these drugs are frequently prescribed to treat various infections and conditions. The “bugs” targeted by these medications have, in turn, evolved to become resistant to the very antibiotics that have been protecting us.

We now know that use of antibiotics for bronchitis and upper respiratory infections and prolonged use of antibiotics for treating pneumonia and urinary tract infections has contributed to this epidemic of resistance. This happens because continued exposure of these bugs to the antibiotics kills off the strains that are susceptible, but allows the ones that are not killed to continue to reproduce. Some bacteria are now resistant to even the most powerful antibiotics available. The shift means health providers need to be more careful in their use of antibiotics, saving them only for conditions that truly warrant treatment with these drugs.

[See: 5 Common Preventable Medical Errors.]

One commonly encountered condition treated with antibiotics in older adults is urinary tract infections. UTIs may be diagnosed if a person has a fever (in older adults, 99 degrees Fahrenheit or higher), lower abdominal pain, pain or burning with urination, or a change in urinary habits, such as going more frequently or more often feeling the urge to go. Lab tests may show an elevation in that person’s white blood cells, which is a marker for infection. If these symptoms are accompanied by a urine test or a urine culture that is consistent with a UTI, antibiotics are warranted.

Often, though, antibiotics are given to older persons merely because of a positive urine test or urine culture without any of the above signs or symptoms supporting a diagnosis of urinary tract infection. Studies of urine tests in older nursing home patients suggest that up to 50 percent of residents may have bacteria in their urine. This does not mean they have an infection — it merely means bacteria is present in their urine, but it is not causing any problem. This condition, called asymptomatic bacteriuria, has been shown to be harmless and does not require treatment with antibiotics. Despite this understanding, antibiotics continue to be prescribed for it.

[See: Which Practitioner Do I See, and When?]

Aside from fostering bacterial resistance, overuse of antibiotics has been shown to have other consequences. For older persons, particularly those individuals who have had multiple courses of antibiotics, who are hospitalized, or who reside in long-term care facilities, the use of antibiotics increases their risk of developing an infection of the gut caused by the bacteria Clostridium difficile. C-diff leads to severe diarrhea that could be potentially life-threatening in frailer and older individuals. A person who develops C-diff is at risk for developing it again in the future with any antibiotic exposure, and resistance to antibiotics also makes these individuals more susceptible to infections for which antibiotics may no longer be effective.

Antibiotic stewardship, or the concept of responsibly administering medications only when medical evidence supports their use, is now an important part of medical practice. Aside from physicians, it’s also important for the general public to be aware of when antibiotics should — and should not — be administered.

[See: 10 Questions Doctors Wish Their Patients Would Ask.]

Everyone wants to recover quickly when they are sick. But we have to be sure that the medications prescribed are appropriately used, and don’t do more harm than good.

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Are Antibiotics Really Appropriate for What Ails You? originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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