The World Health Organization has declared this week to be “World Antibiotic Awareness Week,” which is dedicated to bringing awareness to the global health epidemic of antibiotic resistance. It’s also “Get Smart About Antibiotics Week” here in the United States. According to the CDC 2 million people in the United States become infected with antibiotic resistant bacteria and 23,000 people die from such infections each year. What’s worse is that antibiotic resistance continues to increase.
“To give you an idea of how high the pressure is to prescribe antibiotics, I didn’t get a job once because during the interview I told the lead physician that I only prescribe antibiotic prescriptions when they are warranted.”
Following Darwin’s theory of the survival of the fittest, bacteria normally evolve in such a way that they evade destruction by antibiotics. However, inappropriate antibiotic use in healthcare settings and increasing antibiotic administration to farm animals is creating a rising number of “superbugs” such as MRSA and drug resistant E. coli. Even simple urinary tract infections are becoming difficult to eradicate. The few effective second line treatments that are available are usually expensive and require hospitalization. Antibiotic resistance is only a part of the problem, as antibiotics are also not free of side effects. Certain antibiotics can cause vomiting and diarrhea, tendon rupture and even heart arrhythmias. Since antibiotics also decrease the beneficial bacteria that live within our bodies, yeast and the bacteria Clostridium difficile, which are normally contained by our body’s “good” bacteria, can overgrow and lead to deadly infections.
“It wasn’t the antibiotic that cured your cold; it was likely a tincture of time and possibly even the placebo effect.”
So why is there an inappropriate use of antibiotics? Ask any doctor and you will find that there are high expectations from patients for antibiotic prescriptions, especially for colds. However, many people do not realize that colds are usually caused by viruses and viruses are not treatable with antibiotics. (It wasn’t the antibiotic that cured your cold; it was likely a tincture of time and possibly even the placebo effect.) Healthcare providers are also at fault. Many providers give into pressure from patients, sometimes writing antibiotic prescriptions and advising patients not to fill them just for patient satisfaction. To give you an idea of how high the pressure is to prescribe antibiotics, I didn’t get a job once because during the interview I told the lead physician that I only prescribe antibiotic prescriptions when they are warranted. I was also threatened once by an asymptomatic patient who wanted antibiotics because her son had a cold.
So what can be done to decrease antibiotic resistance? Prevention is always key to avoiding any disease in the first place. Eating a healthy diet, managing stress, getting adequate sleep and staying physically active are all great ways to boost the immune system and promote overall health. Consistent hand washing is also paramount as our hands are a primary means of spreading germs. It’s also important to take antibiotics exactly as prescribed. This means that the leftover antibiotic originally given for a skin infection, which should have been completed in the first place, may not cover that urinary tract infection.
It’s up to physicians to educate patients on the risks and benefits of antibiotics use. I find that most of my patients feel comfortable when I educate them about their symptoms and reassure them that I will be available to prescribe antibiotics if necessary. As for patients, your involvement and accountability for your health could be the reason you and your family members survive an antibiotic resistant infection in the future. As always, make sure to see a healthcare provider if you think you need antibiotics.