Antibiotics: What You Should Know
Antibiotics save lives and are essential for treating a number of common and more serious infections. But overuse leads to antibiotic resistance—that is, the danger that they will not work when needed.
This is particularly alarming in light of a new report released last week by the Centers for Disease Control and Prevention (CDC), which showed that, on average, someone in the U.S. contracts a drug-resistant infection every 11 seconds, and that someone dies from one every 15 minutes. These figures are nearly 50 percent higher than previously thought, accounting for about three million antibiotic-resistant infections every year, and 35,000 deaths.
The World Health Organization (WHO) has designated this week as World Antibiotic Awareness Week, so our family practice doctors at Cohen Medical Associates in Delray Beach want to explore the pros and cons of antibiotics, the ways they are misused, and what you can do about it.
How they work
Antibiotics work by seeking out and destroying bacterial substances harmful to the body. Different types of antibiotics attack bacteria in different ways, depending on their composition.
Antibiotics can be used to treat a wide range of infections, including strep throat, venereal diseases, tuberculosis, ear infections, sinus infections, urinary tract infections, croup, and sepsis, among others. They also are often prescribed before surgery, including some dental work, to prevent infections.
Unfortunately, as with any drug, there are drawbacks.
Antibiotics can cause such side effects as diarrhea when they destroy friendly bacteria, along with the invaders. Other possible side effects include stomach pain, rash, respiratory difficulties, nausea and vomiting, and joint swelling, among others.
Finally, they can cause bacteria to mutate—that is, to “learn” to resist the effects of the antibiotic, evolving into a type of bacteria that is immune to the antibiotic.
According to the CDC, “If even one bacterium becomes resistant to antibiotics, it can then multiply and replace all the bacteria that were killed off. That means that exposure to antibiotics provides selective pressure, making the surviving bacteria more likely to be resistant.”
This last is the most serious problem with the misuse of antibiotics, and is behind the WHO’s efforts to stem this problem. Without effective antibiotics to treat infections, millions of people will die who didn’t have to.
The result of resistant bacteria
A 2017 study published in the Journal of the Pediatric Infectious Diseases Society found that three of five children admitted hospitals already had an antibiotic-resistant infection when they arrived.
The CDC says that examples of the types of bacteria that have already become resistant to antibiotics include the species that cause skin infections, meningitis, sexually transmitted diseases, and respiratory tract infections such as pneumonia.
The new CDC report found that this problem is even more widespread and dangerous than had been seen in its last report, released in 2013.
“A lot of progress has been made, but . . . antibiotic resistance is worse than we previously thought,” said Michael Craig, the CDC’s senior advisor on antibiotic resistance.
“Losing these antibiotics would undermine our ability to treat patients with deadly infections and cancer, provide organ transplants, and save victims of burns and trauma,” explained CDC Director Tom Frieden.
Ways antibiotics are misused
In a report released in 2016, the CDC found that at least a third prescriptions were for conditions that didn’t warrant antibiotics. “An estimated half of antibiotic prescriptions given during pediatric ambulatory care visits are inappropriate,” the report found.
A large portion of these prescriptions were provided at the request of patients, who demand their doctors “do something” for conditions that cannot be cured by antibiotics. These include the flu, colds, coughs, and sore throats not caused by strep. Other conditions for which antibiotics are not indicated include bronchitis, asthma, and allergies.
Patients contribute to the problem in several ways.
First, by insisting on an antibiotic when the doctor has said it won’t fix the problem.
Second, by sharing their leftover or unused antibiotics with friends or family members.
Third, by not taking the full course of an antibiotic when one is prescribed. This is a major contributor to the problem of antibiotic resistance. When a patient begins to feel better after a few days and stops taking the antibiotic, the bacteria may be weakened but not killed; their remaining numbers survive to mutate into a strain that can no longer be killed by the antibiotic.
By animal agriculture
Antibiotics are used to feed livestock to accelerate growth and prevent disease in otherwise healthy animals which are kept in unnaturally confined conditions during their lifecycle.
A 2017 study by the Pew Charitable Trust confirmed that antibiotic use on farms and feedlots leads to the emergence of resistant bacteria, and that these resistant bacteria are infecting humans, either through direct contact with the bacteria, with food produced from the animals, or through the environment.
What you can do
So what can you do to help combat this growing problem? If we prescribe an antibiotic for your illness, be sure to take all of it, even if you begin to feel better, without skipping doses. This is the most effective way to ensure as many of the bacteria as possible are killed.
In addition, never take an antibiotic prescribed for someone else, and never save antibiotics for the next time you get sick. Each bacterial infection requires a specific type of antibiotic. They cannot be used interchangeably.
Avoid meat and animal products that have been treated with antibiotics during their lifecycle.
Finally, it’s important to take steps in your daily life to prevent infections from taking hold in the first place. This includes frequent hand washing, getting all the vaccinations we recommend, and using safe sanitation practices when handling food.