In an earlier entry, I gave you several reasons why you might not want to take an antibiotic if you really don't have to.

There's no doubt, however, that antibiotics are effective, powerful, and sometimes necessary tools to help us survive infections. They are one of the most important reasons we live so much longer today than people did a hundred years ago.

Probably the biggest problem with antibiotics in our war on infection is that the enemy - the germs - turn out to be pretty clever. Bacteria have succeeded in finding ways to become resistant to and to survive just about every antibiotic discovered or invented. And every time you or anyone else takes an antibiotic, the drug helps to create a few more resistant bacteria.

Many people think they become "immune" to certain antibiotics, or that a certain antibiotic is always good for them. But remember that antibiotics don't treat people, they treat bacteria, and it's mainly the bacteria's sensitivity to or resistance to the antibiotic that determines the success or failure of the treatment. (There can also be genetic variations in the way our bodies process antibiotics, but that's usually not a big factor in how effective they are.)

Here are some suggestions for safe treatment of infections, with or without antibiotics:

• Prevent infections. The best defense against infection is also the simplest: Wash your hands frequently. Do this especially before meals and after using the bathroom, and carefully clean any cuts or tears in your skin. No bacterium has ever developed resistance to good old-fashioned soap and water! You don't even need antibacterial soap - in fact, some bacteria are already resistant to the chemicals, like bactroban, in those soaps.
• Take the full prescribed course. If you stop taking an antibiotic before all the bacteria are dead, the survivors will be the ones most resistant to that antibiotic, and it may not work for you in the future.
• Don't use the same antibiotic every time. Choosing a different antibiotic than the last one you took improves the chances that the bacteria making you sick will be sensitive to it.
• Ask your doctor if you really need it. The fewer antibiotics you take, the fewer side effects you'll have, and the fewer resistant bacteria you'll be creating.
• Ask about drug interactions. Check with your doctor or pharmacist about drugs your antibiotic may interact with, especially blood thinners and birth control pills. Don't forget food and alcohol interactions, too.
• Ingest friendly bacteria. While taking an antibiotic, try to maintain normal, healthy bacteria in your system by eating yogurt or taking probiotics.
• Watch for unusual reactions. Tell your doctor about any new symptoms or problems that occur during or after taking an antibiotic, especially rashes or hives, sore throat or painful swallowing, vaginal pain or discharge, or diarrhea.
• Treat stomach side effects. If an antibiotic causes nausea, ask your doctor or pharmacist if you can take it with food. An antacid medication can sometimes help, too.