Antibiotics are one of the most widely used drugs today. Antibiotics are one of the most important drugs physicians use in their practice of medicine. Many antibiotics are effective in treating bacterial infections and can also prevent the spread of disease. They can also reduce serious complications by diseases.
Unfortunately, some antibiotics that used to be the first line treatment for bacterial infections now don’t work as well. Even more worrisome, some don’t even work at all against some bacteria. When an antibiotic no longer works against some strains of bacteria, those bacteria are said to be antibiotic resistant. Bacteria, not humans or animals, become antibiotic-resistant.
Antimicrobial resistance is an urgent global public health threat, killing at least 1.27 million people worldwide and associated with nearly 5 million deaths in 2019. In the U.S. alone, more than 2.8 million antimicrobial-resistant infections occur each year. Sadly, a wide percentage of the world today are still not aware of the real dangers that antibiotic resistance poses in the population.
The world urgently needs to change the way it prescribes and uses antibiotics. Without behavioral change, antibiotic resistance will remain a major threat to world. In this article, we will go in depth on what antibiotic resistance is, its dangers and how we can combat it now.
WHAT IS ANTIBIOTIC RESISTANCE?
Antibiotic resistance is the ability of bacteria or other microorganisms to resist the effects of antibiotics. This occurs when bacteria change to neutralize the drugs designed to kill them, making it difficult or impossible to kill them or stop their growth and ultimately to treat the infection itself.
Antibiotic resistance is a type of antimicrobial resistance. Fungi, parasites and viruses can also develop drug resistance.
Contrary to some beliefs about antibiotic resistance, it’s not the body that develop antibiotic resistance —it’s the bacteria. When antibiotic resistance happens, fewer antibiotics are effective against a particular bacterium. There are other alternative antibiotics which can help, but with management of infections, it is important to have as many treatment options available as possible.
WHAT CAUSES ANTIBIOTIC RESISTANCE?
There are several factors that often contribute to antibiotic resistance:
- Overuse of antibiotics: It all starts with indiscriminate prescription of antibiotics by physicians to their patients. Patients taking antibiotics when they’re not indicated or needed contributes to antibiotic resistance and can lead to the selection and proliferation of antibiotic-resistant bacteria. For example, most cases of pharyngitis (sore throat) are viral. Antibiotics won’t help.
- Other common viral infections that aren’t helped by the use of antibiotics include:
- Cold or runny nose
- Flu (influenza)
- Most coughs
- Some ear infections
- Some sinus infections
- Stomach flu
- Coronavirus disease 2019 (COVID-19)
- Whooping cough (pertussis)
- Taking an antibiotic for a viral infection:
- Won’t cure the infection
- Won’t keep other people from getting sick
- Won’t help you or your child feel better
- May cause needless and harmful side effects
- Promotes antibiotic resistance
When taking an antibiotic for a viral infection, the antibiotic attacks bacteria in your body. Not all bacteria in the body are harmful or causes disease. This incorrect treatment can then promote antibiotic-resistant properties in harmless bacteria that can be shared with other bacteria. Or it can create an opportunity for potentially harmful bacteria to replace the harmless ones.
- Misuse of antibiotics: Given the right opportunity and in favorable conditions, bacteria will multiply. For instance, if you forget to take a medicine for a day (or several days), stop treatment too soon, or use incorrect antibiotics (such as using someone else’s medicine), bacteria start reproducing. Bad news is, as they multiply, they can mutate or change. Mutated bacteria become increasingly more resistant to a medicine.
- Agricultural use: Antibiotics are used to promote growth and prevent disease in livestock, but this can lead to the development of antibiotic-resistant bacteria in animals, which can then be transmitted to humans through food.
- Spontaneous resistance: Occasionally, the genetic makeup (DNA) of a bacterium change or mutates on its own. In turn, the antibiotic won’t be able to identify this newly mutated bacterium, messing its ability to target it specifically for removal. In addition, the mutation can also help the bacteria fight off the medicine’s effects.
- Transmitted resistance: Unfortunately, like any other bacterial infection, a drug-resistant bacterial infection is contagious and can be passed on to someone else. Once infected, that person now has an infection that’s resistant to an antibiotic. One example of this in multi-drug resistant tuberculosis. Again, there is usually an alternative treatment, even for multi-drug resistant infections, but the question really is, for how long will these alternative treatments work?
WHY IS ANTIBIOTIC RESISTANCE A PROBLEM?
The problem with antibiotic resistance is that its cunning. We won’t know that antibiotic resistance has occurred until we treat someone. First clue would be that the antibiotic that had previously worked suddenly fails or becomes less effective. It takes quite a while to realize what is really happening, and meanwhile, you get sicker. And so, an infection that previously could be successfully managed at home may now require a hospital admission.
WHAT ARE SUPERBBUGS?
In the past few years, various strains of bacteria have been discovered that are resistant to multiple antibiotics. They have adapted and are now able to fight back against the drugs that previously were able to kill them easily. These are called superbugs. Thanks to antibiotic resistance, they can now cause infections that are very difficult to treat and can lead to serious illness or death. In fact, there’s even a chance that if infected with a drug-resistant bacterial infection, no antibiotic will work.
Some bacterial infections with superbug status include:
- C. diff (Clostridioides difficile).
- Staphylococcus (staph) infections, such as methicillin-resistant staphylococcus aureus (MRSA).
WHAT ARE THE COMPLICATIONS OF ANTIBIOTIC RESISTANCE?
When hit by a drug-resistant bacterial infection, healthcare providers are left with only a few and limited options in treatment.
Ultimately, antibiotic resistance can lead to:
- Increased risk of severe, extended illness and death.
- Severe medication side effects.
- Longer hospital stays.
- More medical appointments.
- Increased medical costs.
PREVENTION AND CONTROL OF ANTIBIOTIC RESISTANCE: ANTIBIOTIC STEWARDSHIP
Antibiotic stewardship is the responsible use of antibiotics to help preserve their effectiveness and slow the development of antibiotic-resistant bacteria. The goal of antibiotic stewardship is to ensure that antibiotics continue to be effective for treating bacterial infections in the future. To achieve that goal, the general public, government officials, agricultural sectors, health care providers, and hospitals all can help ensure correct use of the drugs.
To prevent and control the spread of antibiotic resistance, individuals can:
- Avoid self-medication. Only use antibiotics prescribed by a licensed physician.
- Never demand antibiotics. Follow your healthcare provider’s advice to treat your symptoms without antibiotics.
- Avoid missing a dose. Take your medication on time. Setting a reminder on your phone may help you not to miss a dose. If you do forget to take your medicine, ask your doctor what to do.
- Do not discontinue taking your antibiotics unless instructed to. Even if you feel better, complete and take all of the medicine as prescribed. If you stop an antibiotic too soon, bacteria can start to grow again, and they may develop resistance.
- Never share or use leftover antibiotics. Never take antibiotics prescribed for another person or let anyone else take your antibiotics. They may not be the correct antibiotic. And they likely don’t include a full treatment course.
- Practice good hygiene. Prevent infections by regularly washing hands, avoiding close contact with sick people, and practicing safe sex.
- Get vaccinated. Keeping vaccinations up to date.
- Prepare food hygienically. Follow the WHO Five Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials). Also, opt to purchase foods that have been produced without the use of antibiotics for growth promotion or disease prevention in healthy animals.
To prevent and control the spread of antibiotic resistance, policy makers can:
- Ensure a strong national action plan to tackle antibiotic resistance is in place.
- Improve surveillance of antibiotic-resistant infections.
- Strengthen policies, programs, and implementation of infection prevention and control measures.
- Regulate and promote the appropriate use and disposal of quality medicines.
- Make information available on the impact of antibiotic resistance.
To prevent and control the spread of antibiotic resistance, health professionals can:
- Practice good hygiene. Prevent infections by ensuring your hands, instruments, and environment are clean.
- Avoid unnecessary prescription of antibiotics. Only prescribe and dispense antibiotics when they are needed, according to current guidelines.
- Report antibiotic-resistant infections to surveillance teams.
- Educate patients on how to take antibiotics correctly. Explain antibiotic resistance and the dangers of antibiotic misuse.
- Educate patients about prevention of infections. Talk to your patients about preventing infections (for example, vaccination, hand washing, safer sex, and covering nose and mouth when sneezing).
To prevent and control the spread of antibiotic resistance, the health industry can:
- Invest in research and development of new antibiotics, vaccines, diagnostics and other tools.
The impact of antibiotic resistance if allowed to accelerate and ensue is massive and devastation to human lives is almost unimaginable. Antibiotic resistance is a worldwide health problem. To combat its progress, it involves a range of actions and steps that can be taken at all levels of society to reduce the impact and limit the spread of antibiotic resistance. Because at the end of the day, putting an end to antibiotic resistance is all our burden to bear.
About The Author
Dr. Hannah is a highly-skilled and compassionate physician who completed her medical degree at Pamantasan ng Lungsod ng Maynila in 2014. She passed the Physician Licensure Exam in 2015, and has since gained experience working in various hospitals and clinics throughout Metro Manila. For three years, she served as a physician on duty at a dialysis institute, caring for patients with chronic lifestyle diseases.
As a primary care physician, Dr. Hannah is dedicated to providing patient-centered care that takes into account the whole person, not just their illness. She believes in empowering her patients to take an active role in their healthcare, and believes that this type of doctor-patient relationship is key to achieving optimal health.