Since the advent of antibiotics, doctors have been prescribing them often for a variety of illnesses. For decades, this seemed prudent; after all, sick kids seemed to get healthy faster. However, now we understand antibiotics use has led to a very serious problem: antibiotic resistance.
What is antibiotic resistance? Put simply, my bacteria can survive a prescription of antibiotics that years ago would have killed those same bacteria.
How does this happen? Antibiotics never actually killed all bacteria living in the infected person, they just killed most. That’s all they needed to do. However, the bacteria that survived just happened to be the ones which were less susceptible (for random reasons) to that particular antibiotic. Since these bacteria suddenly constituted the dominant population in the person, all future generations carried whatever traits made them less affected by the drugs. This means with each successive generation of bacteria in a person, the living bacteria are more resistant to whatever antibiotics have been used on that person.
In extreme cases, a person might be carrying an infection that has been exposed to and developed resistance to all known antibiotics. In fact, this has happened. In particular, it is known that there are strains of a microbe known as S. aureus that are resistant to many of the stronger antibiotics currently made. The concern is that dangerous bacteria such as tuberculosis, malaria, ear infections, and gonorrhea might be un-treatable in the future.
So when should you use antibiotics? There is a simple rule of thumb that, if followed, reduces the danger to all of us: antibiotics work on microbes only, not viruses. Have a cold? Don’t use antibiotics. The flu? Don’t use antibiotics. Unless you know your sickness is the result of a bacterial infection, antibiotics are a waste of your money and a hazard to you in the future. Your doctor will tell you the cause of your symptoms; if it is viral, don’t let him prescribe antibiotics to you. Refer him to the CDC links below if he tries to tell you to take them “just in case”.
The second rule that is equally important if you are prescribed antibiotics: take the full dose, even if you feel better. If you are given 10 days’ worth of drugs, take all 10 days, no matter what. By stopping early, you leave a larger number of microbes alive to breed, increasing the likelihood that one with useful traits for surviving a future round of antibiotics is still alive. In any bacterial infection, the symptoms will go away before all the microbes are dead (in most cases, they never all die). Take the full dose, like clockwork, until it is completely used.
Antibiotics are a good thing. Many serious epidemics have been suppressed or avoided as a result of their discovery and use. However, in order to keep them viable as an option for the future, we need to use them responsibly. Do your part, use them responsibly.
Resources:
- Antibiotic Overuse Fuels Drug Resistance [healthlink.mcw.edu].
- Get Smart: Know When Antibiotics Work [www.cdc.gov]
- Antibiotics FAQ [www.cdc.gov]
- The Problem of Antimicrobial Resistance [www.hiaid.nih.org]
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From the editor
For those of you in the United States (probably many of you), tomorrow is Independence Day. Take care, be careful if you’re blowing things up, and have a great time celebrating our country and our freedom!
Healthy thoughts,
Jeff
