Antibiotic Resistance – A very real danger
The emergence of bacteria that are resistant to various antibiotics has been deemed a major public health threat. This sobering judgment if from an article in the Health and Human Services and Centers for Disease Control’s Morbidity and Mortality Weekly Reports. The article, “Elements of Outpatient Antibiotic Stewardship” by G. Sanchez, et al (MMWR for November 11, 2016, Vol. 65, number 6), was written for prescribers but the message is applicable to everyone.
We are all stakeholders in the use of antibiotics. Health care providers may be tempted to give a patient a prescription for an unnecessary antibiotic course because they are rushed or in an effort to please survey-writing patients. It is much easier to do that than to take the time to explain why an antibiotic isn’t needed and to describe other things that may speed recovery from a viral infection or help the person feel better.
Patients encourage the inappropriate use of antibiotics when they visit a health care provider when they have a cold or allergies, imagining that antibiotics will help. Furthermore, if the provider hedges about prescribing the coveted antibiotic, the patient may ignore the providers experience- and education-based decision and continue to push. It can get to the point where the provider senses a negative and damaging comment from the patient may result, or just feel too tired or rushed to bother with more education.
It may not seem like a big deal, this overuse of antibiotics, but the research and statistics reveal how damaging this situation is. Bacteria that are resistant to many antibiotics contribute to an estimated 23,000 deaths in the U.S. each year. They are also responsible for some 2 million infections every year. Although antibiotics can be life-saving, inappropriate prescribing and use of antibiotics is the major reason why there are disease-causing bacteria that aren’t killed or kept from increasing in number.
Bacteria reproduce so quickly, it isn’t surprising that mutations develop. Mutations are abnormalities in an organism’s genes that develop because of exposure to a mutagen (a vague name for anything that instigates the error in DNA). Usually mutations don’t give the affected cells an advantage. Indeed, mutations usually make for weaker organisms, but because some mutated bacteria aren’t harmed by an antibiotic they were exposed to, they increase in number and spread, causing infections that are hard to treat.
Antibiotic resistance develops when antibiotics kill, or keep from reproducing, some bacteria in the body, but not all bacteria. Those that survive increase in number because the antibiotic has destroyed much of the competition. These bacteria can easily be spread to others and can also spread their mutated genes to other bacteria so that they’ll also be resistant to the same antibiotics.
The best way to stop antibiotic resistance isn’t with new antibiotics but with careful and appropriate use of the ones we have. In a November of 2015 article in Reader’s Digest, “When to Say No To an Antibiotics Prescription,” (reproduced from a Consumer Reports on Health), people are encouraged to not push for antibiotics for viral infections such as influenza, colds, acute bronchitis or sinus infections when there are no serious symptoms. If someone is unsure about what constitutes “serious symptoms” or signs, they should contact their health care provider. As with all information on this website, readers should not substitute it for the advice and care of their health care provider.