Antibiotics and Resistance

“If we use antibiotics when not needed, we may not have them when they are most needed.” –Dr. Tom Frieden, Director, US CDC

I’ve been rotating through Internal Medicine for the past two months. And one of the more common reasons we had to admit people was because of infections — whether it was a lung infection, a urinary tract infection, or an infection of their blood. And once the infection was bacterial, they needed antibiotics.
Usually, we would start them off on a broad spectrum antibiotic and send a sample off to the lab to test for which specific antibiotics that particular bacteria was susceptible to. And alarmingly, it turns out that more and more strains of bacteria are becoming resistant to antibiotics that they used to be susceptible to.
And it made me think about growing up in Guyana and about our rather casual approach to antibiotics – in its prescription and usage.
Back in high school, we learnt about microbes like bacteria that cause so many diseases and illnesses. The discovery of these microbes after the invention of the microscope led to the search for an agent, an “anti-biotic” that would destroy them and cure the diseases they caused.
Recently we had a class on ‘Antimicrobial Resistance’. During the class, we learnt that many of the antibiotics that used to be able to kill specific bacteria were no longer effective against those bacteria. Physicians now have to prescribe newer, stronger antibiotics to fight the bacteria that have developed resistance to the old antibiotics.
Antimicrobial resistance is a growing global concern: more and more bacterial species are becoming resistant to the antibiotics we used to use to treat them. In fact, the theme for World Health Day way back in 2011 was “Antimicrobial resistance: no action today, no cure tomorrow.” The theme was a call to action for us to start making changes now, or else we won’t be able to depend on antibiotics to be able to be a cure for deadly diseases in the future. It’s terrifying to think about bacteria so resistant that we won’t have any drugs that are able to kill them.
So what are some of the actions that we as individuals could take? Well, first of all, we could make sure we’re using antibiotics correctly when we’re prescribed them. Doctors don’t usually choose a random course of antibiotics for you to use; there’s a method to their madness, I promise. So make sure you complete the entire course of antibiotics that you’ve been prescribed. Don’t stop the course three-quarters way just because you’re starting to feel better. Finish the course to make sure you’ve zapped all of the bad bacteria out of your system.
There are all sorts of bugs out there that can cause disease: bacteria, viruses, fungi. Not all disease are caused by bacteria. In fact, the flu that we all seem to get yearly is caused by a virus — the influenza virus. Antibiotics don’t work against viruses, so they won’t do anything to cure your bout of influenza. That’s why your doctor won’t give you antibiotics for your flu; instead, the doctor will tell you what to do to manage your symptoms — things like Panadol for the fever, plenty of rest and fluids.
The medical system isn’t the only reason for our problems with antimicrobial resistance though. The agricultural industry actually plays a major part as well. There is a growing concern about the use of antibiotics in the rearing of livestock.
It is natural for bacteria to develop resistance; all living things adapt and evolve to survive in a changing world. But the problem we’re facing is how quickly the bacteria are becoming resistant, and that’s largely in part to the way we’ve been misusing and overusing antibiotics.
Antibiotics are a vital part of our fight against diseases. The discovery of penicillin, the first antibiotic, was a revolutionary turning point. Let’s make sure we’re doing our part to make sure that the antibiotics we have are still effective for many more years to come!