Dr. BauerCalling Dr. Bauer

Dear Dr. Bauer,

I’ve been hospitalized with two COPD exacerbation events. I was treated with antibiotics. Antibiotics are ineffectual against viral infections, are there no drugs to combat viruses? 

                                                              Jerry D.

You ask a very good question about the cause and treatment of pulmon­ary infections in those with underlying lung disease. The common cold (cough, nasal congestion, clear sputum production) is almost always the result of a viral infection. Drug companies are performing research daily to find a safe, cheap pill that will kill viruses. Viruses are “simple” forms of life that have been around billions of years because of their adaptability and resistance to stresses in the environment. Vaccines to some viruses such as influenza have been developed at great cost but it is just touching the tip of the iceberg since we are exposed to many other viruses every day.

When a patient with lung disease is admitted to the hospital with an “exacerbation,” we have few effective tests that can differentiate between a viral or a bacterial cause. Both result in very similar symptoms of fever, cough, green sputum and shortness of breath. We often order blood cultures and sputum cultures for bacteria, but these can take days to get an answer. Culturing viruses is very hard in a hospital laboratory. Not knowing an exact cause, doctors will frequently start right away with antibiotics with the hope that if it is a bacteria, we can get on top of it right away. Bad viral infections sometimes make us more susceptible to secondary bacterial infections when they weaken our body’s defenses.

Using antibiotics too frequently and for too long a period will make the patient prone to develop a “resistant” infection. This seems to be happening more and more. Patients need to know that antibiotics can be very effective but need to be used only with appropriate indications.

Let me take this opportunity to wish all of our Pulmonary Paper readers a very happy holiday season and a great New Year in 2014!

You ask a very good question about the cause and treatment of pulmon­ary infections in those with underlying lung disease. The common cold (cough, nasal congestion, clear sputum production) is almost always the result of a viral infection. Drug companies are performing research daily to find a safe, cheap pill that will kill viruses. Viruses are “simple” forms of life that have been around billions of years because of their adaptability and resistance to stresses in the environment. Vaccines to some viruses such as influenza have been developed at great cost but it is just touching the tip of the iceberg since we are exposed to many other viruses every day.

When a patient with lung disease is admitted to the hospital with an “exacerbation,” we have few effective tests that can differentiate between a viral or a bacterial cause. Both result in very similar symptoms of fever, cough, green sputum and shortness of breath. We often order blood cultures and sputum cultures for bacteria, but these can take days to get an answer. Culturing viruses is very hard in a hospital laboratory. Not knowing an exact cause, doctors will frequently start right away with antibiotics with the hope that if it is a bacteria, we can get on top of it right away. Bad viral infections sometimes make us more susceptible to secondary bacterial infections when they weaken our body’s defenses.

Using antibiotics too frequently and for too long a period will make the patient prone to develop a “resistant” infection. This seems to be happening more and more. Patients need to know that antibiotics can be very effective but need to be used only with appropriate indications.

Let me take this opportunity to wish all of our Pulmonary Paper readers a very happy holiday season and a great New Year in 2014!

Question for Dr. Bauer? You may write to him at The Pulmonary Paper, PO Box 877, Ormond Beach, FL 32175 or by email at [email protected]