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.

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?

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.

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.

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.

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