The Curse of the Antibiotics- Resistance
You probably think of antibiotics as a magic bullet against
many deadly bacterial diseases. But because of persistent overuse, we have actually
encouraged the growth of difficult-to-treat bacteria that are resistant to antibiotics.
My pediatricians great, a mother boasts. When my daughter gets
a cold, I call him for an antibiotic and he phones in the prescription right away.
Actually, the pediatrician may not be doing this mom any favors. Her daughters
cold is probably a viral infectionnot bacterialso an antibiotic will have no
effect. Whats more, the antibiotic will kill off substantial amounts of normal,
friendly bacteria in the little girls body, encouraging the growth of
antibiotic-resistant bacteria that may wreak havoc later.
Bacteria-enemy or friends, read How Microbes Defend and Define Us in NEW YORK TIMES
Twentieth century lifesavers are wearing out
In the 1940s, penicillinthe first widely used antibioticbegan saving
countless lives from bacterial diseases. Antibiotics have enabled physicians to treat many
of the scourges of humanity, including tuberculosis, pneumonia, meningitis, tetanus,
syphilis and gonorrhea.
But we overdid it. We used antibiotics too casuallyconfident wed always
have another one to try if the first didnt work. We were heedless that bacteria
naturally mutate and eventually become drug-resistant in direct relationship to their
exposure to antibiotics.
Between 20% and 50% of all antibiotics prescribed for human use each year are
unnecessary according to the Centers for Disease Control and Prevention
Patients are demanding antibiotics for conditions that do not require an antibiotic, such
as the common cold, and physicians feel pressured to write prescriptions. This is a waste
of money, and is also lessening the effectiveness of the antibiotics for the times we
really need them.
A worldwide problem
Huge amounts of antibiotics are used in the dairy, poultry and livestock industries,
allowing drug-resistant bacteria to find their way into our kitchens. In developing
countries, antibiotics are available over-the-counter, increasing the likelihood that they
will be used without proper supervision. And jet plane travel makes it possible for
resistant bacteria to travel from continent to continent with ease.
Just give me something to make me feel
In the United States, we like to be proactive. We like a quick fix for our illnesses.
So were likely to ask the doctor for antibiotics to treat viral infections like
colds, the flu and bronchitis.
But viruses and bacteria are different. Antibiotics have no effect on the common cold
or flu, which usually resolve without treatment in a matter of days. The table below shows
viral infections that can be mistaken for those caused by bacteria. Of course, your doctor
should make the actual diagnosis.
(antibiotic probably not needed)
(treatable with antibiotic)
Physicians often write a prescription for an antibiotic even when they believe the
patients condition doesnt warrant it. At a recent seminar, Dr. Stuart B. Levy
of Tufts University School of Medicine in Boston, Massachusetts reported that more
than 80% of the physicians present admitted to having written antibiotic prescriptions on
demand against their better judgment. Time constraints imposed by the current health
care system make it easier for physicians to take 30 seconds to write a prescription than
to spend 10-15 minutes explaining to a patient why an antibiotic isnt needed.
The price of antibiotic overuse: tougher
The human body normally is home to millions of bacteria. These friendly
bacteria found on the skin, in the mouth, lining the digestive tractvirtually all
over our bodiesare harmless and many are necessary for the normal functioning of the
Use of antibiotics disrupts the ecology of your body. Whether an antibiotic is taken
appropriately for a bacterial infection or taken inappropriately for a viral infection,
antibiotics kill off thousands of friendly bacteria. With less competition from the
harmless, friendly bacteria, the newly mutated, antibiotic-resistant
super germs can proliferate more freely. These organisms could make you ill or
hang around to bother you later.
The consumer group, Center for Science in the Public Interest, estimates that 20% of
the U.S. population is at risk for infections because of weakened immune-defense systems.
This population group includes children, the elderly, people on cortisol-like medications,
cancer patients and people with AIDS.
A person infected with an antibiotic resistant super germ will need a stronger antibiotic
that may have unpleasant side effects and may need to be administered intravenously. In
extreme cases, there are no effective antibiotics. You can also pass these super germs on
to classmates and coworkers. No wonder drug-resistant bacteria have become a major public
Birth DefectsSome of the antibiotics used to treat urinary tract infections during pregnancy may increase the risk of several birth defects
if a woman uses them early in pregnancy, a new study in the Archives of Pediatrics & Adolescent Medicine shows.
Researchers found an increased risk for two classes of antibiotics: sulfonamide (example: Bactrim) and nitrofurantoins (example: Macrobid). But the
antibiotics pregnant women are most likely to be prescribed, the penicillins and erythromycins, appeared to be safe.
What you can do
Be smart with antibiotics
When you or your child is sick, tell the doctor that you are not expecting to receive an
antibiotic unless its necessary. Surveys show that doctors often prescribe
antibiotics because they assume you will be disappointed if you dont get one.
Surveys also show that most patients dont want unneeded antibiotics and welcome a
Take antibiotics exactly as prescribed
If you do need a prescription, take all the pills as directed. Even if you feel better,
continue to take the full prescribed dose.
Dont take leftover antibiotics and dont borrow antibiotics or give antibiotics
to another person.
Manage without antibiotics
Your doctor can suggest ways to help manage a viral infection and its symptoms. In most
cases, a viral infection resolves on its own. Of course, always contact your physician if
the illness seems to worsen or has the usual characteristics of a bacterial infection.
Here are some suggestions from Breaking the Antibiotic Habit: A Parents Guide
to Coughs, Colds, Ear Infections and Sore Throats:
- saltwater nose drops
- elevate head while sleeping
- drink adequate fluids
- blow nose as needed
- vitamin C
- chicken soup
- moist air (humidified)
- adequate fluids
- warm liquids (soup, tea)
- cough drops
- saltwater gargles
- cold drinks
- popsicles and ice chips
- medicated throat lozenges
- honey served in warm tea
- analgesics or analgesic spray
Use common sense around food
Reduce the chances of picking up illnesses
through food. Avoid drug-resistant bacteria and residues of antibiotics on food by
following these steps:
- Wash hands, utensils and surfaces with hot, soapy water before and after food
- Wash raw fruits and vegetables thoroughly before eating.
- Separate raw meat, poultry, eggs and seafood from ready-to-eat foods.
- Cook food completely. Cook eggs until both the yolk and white are firm.
- Refrigerate or freeze perishables and leftovers within two hours.
Outlook for antibiotics
World Health Organization warns that "the gap between [microbes']
ability to mutate into drug-resistant strains and man's ability to counter them is
widening fast." Pharmaceutical companies continue to search for newer antibiotics
that will overcome resistance. Scientists are also trying to modify existing antibiotics,
like penicillin, to make them more effective.
Take care of yourself and your family. Treat antibiotics as a precious resource to be
used only when needed.
What is Antibiotic Resistance and Why Is It a Problem?
Get Smart about Antibiotics
Alliance for the Prudent Use of Antibiotics
Resistance to Antibiotics
Centers for Disease Control and Prevention
American College of Physicians
More Info on Antibiotic use and Abuse