MISUSE OF THE DRUG CAN DO MORE HARM THAN GOOD.

HERE ARE 10 THINGS TO KNOW BEFORE YOUR NEXT VISIT TO THE DOCTOR.

Sure, you know what antibiotics are. They're what you take when you're ill, but what exactly do they do in your body?

What kind of illnesses do they actually treat? Do you know that if overprescribed, they could lead to the emergence of new superbugs that threaten public health? Despite everyone's firsthand experience with antibiotics, this class of medication is widely misunderstood and misused. With help from doctors, we've rounded up the 10 important facts that will keep you informed and protected.

If you think antibiotics are the cure to all your sniffles and coughs, you're in for a disappointment. The truth is antibiotics are only effective against bacterial infections. These may include urinary tract and skin infections, some ear and sinus infections and a small portion of sore throats caused by the strep bacteria.

Whether antibiotics are given depends on the opinion of the doctor or expectations of the patient. While life- or organ-threatening or contagious bacterial infections (such as sexually-transmitted diseases) definitely require antibiotics, there are minor infections that clear up on their own although antibiotics can speed up recovery or prevent these conditions from worsening.

On the other hand, antibiotics will do nothing for the common cold, flu, dengue and most sore throats and coughs because such conditions are brought on by viruses.

These viral infections can be treated with symptom-relieving medication (such as Panadol for fever and lozenges for sore throat) and will usually go away in five to seven days. Antibiotics will neither take away viruses nor speed up recovery.

Experts reckon that over prescription of antibiotics for viral infections is the main reason for the emergence of superbugs - powerful organisms that cannot be killed by any existing antibiotic. Bacteria are a hardy bunch that mutate as they encounter different antibiotics to ensure their survival. This mutation process can cause normal harmless bacteria to become powerful antibiotic-resistant colonies. The result? A longer period of illness, higher cost of treatment, hospitalisation (or quarantine) and even death, according to the World Health Organisation. Superbugs, or any bacteria for that matter, can be spread simply by bodily contact or touching a dirty surface.

Last year, a highly-resilient strain of Clostridium difficile (C. difficile) took at least 49 lives in Britain's hospitals. This bacteria type, which causes serious intestinal conditions, is difficult to fight because it changes its genetic makeup easily to counteract antibiotics.

Hands up, if you've ever chucked unfinished antibiotics after your symptoms cleared up. You're doing a great disservice to yourself because there may be residual bacteria that have not been killed off. The result? Not only may your infection flare up or worsen, you are also helping to create new antibiotic-resistant bacteria that live on in your body.

How does this happen? When you start on antibiotics, the drug races to kill the bacteria before the mutation rate of the bacteria overtakes the former. The longer the bacteria can survive, the more likely they are to develop resistance. It is like a lottery - each bacterium is a ticket and the prize is antibiotic resistance. By missing doses or not finishing your antibiotics, you allow the bacteria to multiply again, giving those thousands to millions more chances to resist the antibiotic.

Don't keep antibiotics for later use either. These pills lose their potency once past their shelf life. Plus, you don't want your family members to self-prescribe the wrong medicine when they're ill!

While you need to finish your course of antibiotics, don't panic if you miss a dose. It is only when you miss several doses that the concentration of each dose becomes insufficient to kill the bacteria. So what should you do if you forget your meds? Common sense applies here, if you miss a dose, you should take it as soon as you remember. If it is close to the timing of the missed dose, if too much time has lapsed, just remember to take the next tablet at the scheduled time and take extra care not to miss subsequent doses. Don't take double the number of pills to "make up for it" because this may increase the risk of side-effects.

A solution for the forgetful: Ask for a longer-acting antibiotic that allows for a once- or twice-daily dosage. This way, the chances of missing a dose are lower. If you miss several doses, go back to your doctor for further advice.

Have there been times when your doctor said he was going to give you a "stronger" antibiotic because your health was not improving? Some antibiotics target more bacteria types than others (broad-spectrum) and this is what doctors usually mean when they say that an antibiotic is "stronger". In reality, antibiotics are not really stronger or weaker relative to each other.

An example: If a patient has a common form of pneumonia caused by the bacteria Streptococcus pneumoniae, penicillin, a narrow-spectrum antibiotic, is effective enough in treating the condition. Broader-spectrum antibiotics, such as levofloxacin, will not do a better job than penicillin.

Since narrow-spectrum antibiotics work, why prescribe broad-spectrum drugs? The latter are given when doctors are unsure about what bacteria is causing the infection, but feel that guessing wrongly or withholding treatment (until a lab test confirms the bacteria) will be disastrous for the patient.

Take pneumonia, for example: There are three to five common bacterial causes of this lung condition, and more than five times that number of unusual bacterial causes. When pneumonia patients are gasping for breath, most doctors will not prescribe narrow-spectrum antibiotics. Of course, after the test results are known, doctors can and should 'step down' to a narrow-spectrum antibiotic regimen that will work just as well.

Before you accept a prescription without question, bear in mind that all antibiotics have side effects, most usually diarrhoea and nausea. Diarrhoea can be caused by the antibiotic killing the normal bacteria in your gut, leading to overgrowth of diarrhoea inducing bacteria. Meanwhile, nausea is brought on by the way the drug reacts with your tummy and the part of your brain that controls vomiting. Other complications which are more serious and rare include the formation of kidney stones, blood-clots and inflammation of the bowel. Always ask your doctor about the potential side effects of an antibiotic he's prescribing. He may hand out other medications to relieve the side effects. If you notice a rash after taking an antibiotic, you're likely to be allergic. Stop the medication and see the doctor immediately.

It may seem strange but killing off one infection may bring on a different infection.

That's because antibiotics can wipe out beneficial bacteria together with the bad ones. These good bacteria help to keep the number of harmful organisms in check. Once the balance is tipped, organisms such as yeast or viruses can multiply and cause infection. A classic example: Women on frequent antibiotic treatment for urinary tract infections are at a higher risk of getting yeast infection. To prevent this, take probiotic supplements to boost the population of good bacteria. A balanced diet and regular exercise will also strengthen your immunity.

Antibiotics, like any other medications, can interact with other pharmaceutical products, and this includes oral contraceptive pills. For example, a broad-spectrum antibiotic such as amoxicillin can compromise the effectiveness of the Pill and you may need barrier methods such as condoms during the antibiotics course and for one week after you've completed it. Always inform your doctor about any drug you're taking so he can prescribe compatible antibiotics.

Most antibiotics should not be mixed with alcohol as it will negate the drug's effectiveness or cause side effects. Metronidazole, which is commonly used to treat infections of the intestine, colon and vagina, can cause nausea, vomiting, headache and stomach pain when it interacts with alcohol. Always ask your doctor if your antibiotic will cause adverse reactions with alcohol. How much you can drink and the types of side effects vary from drug to drug. The same goes for foods like dairy products, fruit juices and soft drinks.

While it is less common these days with better education, there are still some patients who ask for antibiotics even when their condition does not warrant one. Some patients may find it more practical to ask for antibiotics first in case they need the drug later on. It also helps them save on subsequent consultation fees.

However, taking antibiotics unnecessarily may increase your risk of resistance to the particular medication during future bacterial infections. So if you're suffering from a virus, take your doctor's advice when he says you don't need the extra medication. You will thank him later for saving you money, as well as potential complications.

Instead of demanding unnecessary drugs, a better solution is to ask your doctor about symptom-relieving methods, such as saline nose drops for a blocked nose or home-made concoctions to soothe a sore throat.

In general, prevention is better than cure. Rather than relying on antibiotics to get rid of harmful organisms, it is far better to avoid getting an infection in the first place. Get enough rest, drink more than eight glasses of water a day, load up on fruits and vegetables and exercise regularly. Wash your hands thoroughly before eating and handling food, and after visiting the toilet.