Dangers of antibiotic resistance: how did it happen and what can we do about it?

Dangers of antibiotic resistance

Anyone who has followed the health news for a bit, will know there is widespread fear about antibiotic resistance spiralling out of control.
Ever since penicillin, the first mass-produced antibiotic was introduced in the 1940s, bacteria have become resistant against antibiotics at an alarming pace.

Antibiotics are considered one of the greatest advances in medicine because they prevented a lot of casualties after formerly uncontrollable bacterial infections. Unfortunately, many individuals seek this prescription as the first line of defense. Overprescribing them has in turn resulted in the development of resistant bacteria. These bacteria don’t respond to the antibiotics like they might have in the past.

Mode of action

But how do they work? Antibiotics often get uses indiscriminatingly for two entirely different types of germs: bacteria and viruses.
Bacteria and viruses multiply and spread illness differently:
Bacteria are living organisms existing as single cells. Bacteria are everywhere and most don’t cause any harm, and are frequently even beneficial. Lactobacillus, for example, lives in the intestine and help digest food.

However, some bacteria are destructive and cause illness by invading the human body, multiplying, and interfering with normal bodily processes. Antibiotics are effective because they kill these living organisms by stopping their growth and reproduction. Most of the older type antibiotics kill a lot of the beneficial bacteria too, leaving a 'deserted' digestive tract. That's why a course of antibiotics should always be followed up by a course of probiotics.

Viruses, on the other hand, are not alive and cannot exist on their own — they are particles containing genetic material wrapped in a protective protein coat. Viruses 'live', grow, and reproduce only after they’ve invaded other living cells.

It is possible for some viruses to be fought off by the immune system, but others (like colds) have to run their course. Unfortunately, viruses do not respond to antibiotics at all. By contrast, vaccinations can prevent some bacterial infections, such as meningitis which can rapidly kill people.

Why is overuse harmful?

Taking antibiotics for viral infections doesn’t work. It also, over time, helps to create bacteria that are resistant to the treatment altogether.

By frequently using antibiotics, your body can have an increase of bacteria and other microbes that resist antibiotic treatment. This antibiotic resistance, in turn, requires the prescription of higher doses of medicine or stronger antibiotics. Some individuals have noticed resistance to some of the most powerful antibiotics available on today’s market.

This problem is widespread, and the Centers for Disease Control and Prevention (CDC) calls antibiotic resistance “one of the world’s most pressing public health problems.”
Pneumococcal infections, (which cause pneumonia, ear infections, sinus infections, and meningitis), skin infections, bladder infections and tuberculosis are included in the antibiotic resistant bacteria category.

Taking antibiotics safely

So how can you use antibiotics safely? To minimize the risk of bacterial resistance, keep these tips in mind:

Treat only bacterial infections. Seek advice and ask questions. Letting milder illnesses (especially those thought to be caused by viruses) run their course to avoid the development of drug-resistant germs may be a good idea — but it’s still best to leave what constitutes a 'mild illness'up to your doctor. Even if the symptoms don’t worsen but linger, go to the doctor. At the office, ask questions about whether the illness is bacterial or viral, and discuss the risks and benefits of antibiotics.
If it’s a virus, don’t pressure your doctor to prescribe antibiotics, but ask about ways to treat symptoms.

If antibiotics are prescribed, remember the following:
- use antibiotics as prescribed
- don’t save antibiotics for next time
- never use another person’s prescription

Don’t be afraid to ask your doctor questions. Ask about ways that you can treat any symptoms without the use of antibiotics. Open communication with your doctor is important to the health of your family.

Use antibiotics properly. It is pointless to use antibiotics for viral infections. Use them for bacterial infections only and use them for the full amount of time that is prescribed by the doctor, but do not take them for longer.

Other important suggestions are to never use antibiotics that are lying around the house or that are prescribed for another family member.
If you have any remaining antibiotics after you have completed the full course of medication, be sure to bring them back to the pharmacy where you bought them, so they can discard of them in a safe way.
This problem is not new and both doctors the general public and the goverment are becoming more are aware of the issue.

Developments in the future ahead

Fortunately, new and innovative techniques as well as a more liberal approval for rare bacterial diseases allow for the availability of new antibiotics.
While most older bacterial infections were treated with broad spectrum antibiotics killing off a magnitude of bacteria, newer types are more selective.
Selective antibiotics depend on precise detection technique, which are available but still need to be implemented universally.
As an example, it is possible to correctly determine the exact bacterial strain in 90% of cases, while in practice , without advanced determination techniques, less than 10% of the cases are correctly predicted.

Much more needs to be done to prevent antibiotic resistance: we can do a lot individually but there are 2 major causes of antibiotic resistant bacterial infection : hospitals and livestock.

Most life-threatening bacterial infections happen in hospitals, where despite the utmost care that is being taken by health care professionals, people still get infected by the simple hand-to-body transmission of dangerous bacteria, either from staff or by visitors or other patients.
With more attention to hand hygiene, hospital infections are slowly decreasing.

However one of the biggest challenges is to limit the use of antibiotics in livestock, the use is (or was) widespread, not just because crowded farms have a lot of diseases raging through the animals, but also because because antibiotics are known to promote growth, so it is very alluring to abuse antibiotics by adding it to fodder.

To show why overuse of antibiotics in livestock is so is dangerous: among patients suffering from chronic urinary infections by ESBL-bacteria, one out of five are infected by bacteria which are identical to those found in poultry.

Despite the EU-wide ban on the use of antibiotics as a fodder supplement, the actual use of antibiotics still has barely diminished as antibiotics are now being applied in in higher concentrations to treat or prevent bacterial diseases. Unlike with people it is almost impossible to individually treat animals, so entire livestocks are treated at the same time.
The economical incentive to use antibiotics still remain, not just for the farmers, but also for prescribing veterinarian who make more money that way.
Hopefully alternative treatments such as adding more zinc and vitamin D as well as higher quality and health-inducing fodder, will increase.
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