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Using Antibiotics Wisely

What are antibiotics and antibiotic resistance?

Antibiotics are drugs that are used to treat bacterial infections. Officials from the Centers For Disease Control and Prevention tell us that nearly all of the organisms that cause diseases in humans that are treatable with antibiotics have developed some resistance to the drugs. This may mean that the diseases are more difficult to treat or that different drugs are required. Some of the diseases that are showing resistance to commonly used antibiotics are pneumonia, ear infection, gonorrhea, urinary tract infections, meningitis and tuberculosis. Even some foodborne illness organisms such as Campylobacter and Salmonella DT 104 are showing resistance to antibiotics.

Commonly used antibiotics are effective only in the treatment of bacterial illnesses. Diseases caused by viruses do not respond to treatment with these antibiotics. In most cases, viral diseases must simply be allowed to "run their course." There are also anti-fungal drugs and anti-parasitic drugs available. These types of illnesses, however, do not respond to antibiotics which are used to treat bacterial diseases. It is estimated that one-third of all prescriptions given outside hospitals for antibiotics are unnecessary. The widespread use of these miracle drugs means that over time, organisms have had more opportunities to come in contact with the drug and more chances to become resistant to it. There are certain factors that have contributed to antibiotic resistance:

• physicians may overprescribe antibiotics if they are uncertain about the symptoms and natural course of some respiratory illnesses;
• patients often demand that antibiotics be given;
• patients often stop taking the medicine before they have finished all of the antibiotic prescription;
• sub-therapeutic doses of some antibiotics used in animal production over the years to help keep farm animals healthy may also have provided bacteria with the opportunity to acquire resistance;
• antibiotics are available in some countries without prescriptions.

Living things are always changing. Some bacterial cells may be changing by acquiring resistance genes from other organisms. The way that resistance develops is a "survival of the fittest" process. When an antibiotic is given, most bacterial cells will be killed. However, some cells may change to become more resistant to the drug.

What effect will this have on our health and who is most at risk?

Antibiotic resistance may mean that a person's next infection may not respond to the first choice of antibiotic treatment. Doctors may then have to choose an antibiotic that is more expensive or has more potential side effects. Also, resistant bacteria may spread to others so that antibiotics may eventually lose even more of their effectiveness. The people that may be more affected by this trend toward antibiotic resistance are patients in hospitals and in nursing homes.

What can I do to help curb or prevent antibiotic resistance?

There are three simple rules that will help to curb antibiotic resistance. When you are sick, don't demand that your doctor give you an antibiotic unless he or she thinks one is necessary. When your doctor does prescribe an antibiotic, be sure to take the medicine as directed and finish all the medicine that you are given. If you do have access to leftover antibiotics or to medicine that has been prescribed for someone else, do not take it.

What can I do to prevent infections in the first place so that I don't need antibiotics so often?

Handwashing and good hygiene are important steps in preventing many diseases. Wash hands often and thoroughly. Keep kitchen, food storage and food serving areas clean. Store foods at the proper temperatures. Keep perishable foods refrigerated or frozen. Wash fruits and vegetables thoroughly. Keep raw products separate from cooked foods. Cook foods, especially meat and poultry, thoroughly and without interruption. Cool foods quickly when storing them to serve at a later time. Re-heat leftover foods thoroughly before serving (liquids to a rolling boil and solid foods to at least 165oF internally.) Be sure that any water used for drinking or used with food is from a treated or approved source.

References:

1. Nordenberg, Tamar. 1998. Miracle Drugs vs. Superbugs - Preserving The Usefulness of Antibiotics. FDA Consumer 32 (6): 23-25.
   
2. The Alliance for the Prudent Use of Antibiotics Web site, 1999. Patient Information. Tufts University.