Antibiotic resistance is not only a future threat, it is present right here and now
10 March 2019| Last updated on 11 March 2019
As a matter of fact, bacterial infections have plagued humans throughout history.
Nevertheless, and ever since the discovery of Penicillin in the year 1928 by Alexander Fleming, Professor of Bacteriology at St. Mary's Hospital in London, antibiotics have revolutionized the world by saving countless lives, thus becoming indispensable and establishing themselves as the undisputed cornerstones of all modern health programs.
However, everything comes with a price and most people are familiar with the potential side effects of antibiotics. These side effects can range from mild nausea & stomach upset to loose bowels & diarrhea, vaginal itching & discharge, allergic skin reactions, etc. and in more severe cases, colon inflammation (due to disruption of the normal balance of bacteria in the large intestine).
And the latest bad news is that more recently, global concerns regarding the emergence of antibiotic-resistant bacteria are increasingly in the news.
This emerging threat of antibiotic resistance is eroding antibiotic efficiency, and the long-established cornerstones, seem to be starting to crumble.
Simply defined, antibiotic resistance is the ability of bacteria to withstand the effects of an antibiotic. It is currently considered a global red flag as it:
- Threatens our ability to cure common diseases such as bacterial bronchitis, pneumonia and urinary tract infections.
- Threatens to thwart complex medical endeavors such as surgeries, treatment of cancer patients and care of intensive care bed-ridden patients.
- Threatens our ability to achieve global health objectives such as reduction of child mortality and quality of life enhancement for senior people.
Where does antibiotic resistance come from?
To clarify, antibiotic resistance is not a characteristic of the sick person. On the contrary, it is a feature of the bacteria which have evolved through certain genetic changes and mutations that made it able to evade the bacteria-killing powers of the antibiotic.
These genetic changes can carry on throughout bacterial strains when the genetic code for these mutations is spread among those strains; that is, those bacteria which acquired a mutation allowing them to survive will live on to reproduce and pass this trait to their offspring, which will be a fully resistant generation!
So what really causes this spread? When antibiotics are prescribed too often or incorrectly or unnecessarily, bacteria can - by time - develop mutations to protect themselves.
Medical prescribing can be rendered improper when an inaccurate diagnosis leads the attending physician to prescribe an antibiotic, or when an antibiotic is used for a medical condition that does not need an antibiotic coverage.
The most common example for the latter scenario is the habit of many physicians to prescribe an antibiotic for an upper respiratory tract infection which mostly is caused by a viral infection. Moreover, it happens, more often than not, that sick people directly seek an over-the- counter antibiotic treatment for their flu (viral in origin) symptoms.
Of equal importance, some patients do not finish the prescribed full course of a necessary antibiotic, and this happens under the excuse that they did feel better!
Regretfully, this is considered a golden opportunity for any lingering bacteria in the body to re-grow and transform in ways that encourage their own resistance to the antibiotic.
Last but never least, the use of broad-spectrum, second line antibiotics (usually reserved to complicated infections or in surgeries) in the outpatient clinics also contributes to the increase in incidence of bacterial resistance.
How to fend off antibiotic resistance?
Preventing the worrisome spread of antibiotic resistance should be the shared responsibility of medical professionals and patients` alike:
Medical professionals entitled to prescribe antibiotics should:
- Accurately determine if a bacterial infection is the cause of a patient’s ailment through proper investigations.
- Adhere to international guidelines on the proper use of antibiotics for specific illnesses and thoroughly explain to the patient the reason for antibiotic use when discussing treatment plan.
- Please understand that not all infections need or benefit from the intake of antibiotics. Viral flu can make you suffer a quite high fever, feel severe body aches and cough a lot... yet it is still viral and antibiotics do not work on viruses, you will get better in a reasonable amount of time simply by symptomatic treatment. It goes without saying that you should be clinically assessed by a medical professional who will accurately diagnose your condition and advise you on the most appropriate plan of treatment.
- Do not pressure your doctor to prescribe you an antibiotic.
- If your medical condition necessitates an antibiotic prescription, it is crucial to take the medication exactly as prescribed, and for the whole course as advised by your treating physician.
- Do not save antibiotics for later or use someone else's prescription even if his/her symptoms are like yours.
Patients can be more impactful in their own health care:
Antibiotics must be reserved for patients who really need them or deemed seriously ill by their attending physicians. This will ensure that our future generations also have helpful medications that are effective against infections.
Dr. Dragana Sarenac
Internal Medicine Specialist, MD
Dubai London Clinic