Once a cure-all, antibiotics have been misused and over-prescribed, creating drug-resistant “superbugs” that can put your health at risk.
By Robert Barnett in Grandparents.com
In the wards of Boston City Hospital, circa 1937, doctors couldn’t do much for infectious diseases “beyond bed rest and good nursing care,” wrote Dr. Lewis Thomas in his 1974 classic, Lives of a Cell. “Then came the explosive news of sulfanilamide, and the start of the real revolution in medicine.” Those “sulfa” antibiotics were quickly followed by penicillin, which saved wounded soldiers in World War II—and then millions of civilians.
Since then there have been countless antibiotics created which are used to treat everything from skin rashes to the common cold. But now we are all paying the price. The overuse of antibiotics, both in people and livestock animals, has led to a rising global tide of infectious bacteria that are resistant to many antibiotics. They’re called “superbugs.” Experts from the World Health Organization says it’s a global threat greater than terrorism. And it’s getting worse, increasing the risk of serious illness and even death. The U.S. Congress is considering new legislation that would allow the FDA to rush new antibiotics into use in very ill patients for whom existing antibiotics are useless. “It’s quite a scary problem,” says internist Molly Cooke, MD, president of the American College of Physicians. “We are increasingly seeing superbugs, and some are pretty difficult to treat.”
Consider Staphylococcus aureus (staph), which can cause skin infections. If it gets into the bloodstream—through a cut, for example—it is often treated with oral antibiotics. It used to be that methicillin, an antibiotic in the penicillin class, quickly dispatched it. But overuse of methicillin has caused the staph bacteria to develop resistance. This has caused the development of MRSA, which stands for methicillin-resistant Staphylococcus aureus, an increasingly common and potentially deadly infection. Now a simple skin infection can land you in the hospital, requiring powerful intravenous antibiotics, which also can have serious side effects.
A hospital-acquired intestinal infection, itself caused by antibiotic use, might no longer yield to Vancomycin (that’s VRE – Vancomycin-resistant enterococcus.) Deadlier still: Clostridium difficile (C. difficile), now becoming resistant, too. C. diff is a disease caused by antibiotic use. “When we wipe out all the friendly bacteria in the gut, unfriendly C. difficile proliferates. I’ve taken care of people who’ve died from this,” says Centers for Disease Control and Prevention (CDC) medical epidemiologist Lauri Hicks, DO, medical director of the Get Smart: Know When Antibiotics Work program. While VRE and C. diff are mostly found in hospitals and nursing homes, the rates are growing quickly. Each year, about 337,000 people in hospitals get C. diff; 14,000 die. Antibiotic resistance is also finding its way into less serious conditions but much more common conditions in the community, such as ear infections in children, and urinary tract infections in adults.
Why Don’t Antibiotics Work?
Keeping antibiotics effective is complex. One cause is the global availability of antibiotics, often over-the-counter in many countries. That makes it much easier for them to be overused so that they eventually become less effective. In the U.S., antibiotics valuable for human medicine are also often fed to livestock to promote growth, which breeds resistance. You won’t develop antibiotic resistance from eating the meat, but raising the animals this way does contribute to antibiotic resistance for human medicine. Says Cooke, “If you look to grass-fed beef that is certified free of antibiotics, you can make a personal contribution to preventing antibiotic resistance.”
No New Antibiotics
The other problem? Many drug companies have not been focusing on creating new antibiotics, so there are fewer antibiotics that are effective at treating these “superbugs”. According to a recent report in Medical News Today, the FDA has only approved one new systemic antibiotic since 2010, and there are only seven more new antibiotics in FDA’s pipeline, none of which is guaranteed to be approved.
How to Protect Yourself?
Consider the illness. “Fifty percent of antibiotic use in humans is inappropriate or unnecessary,” says Dr. Hicks. “The more you use antibiotics, the more likely you are to carry around resistant bacteria—and become infected with resistant bacteria.” Some conditions that may not require antibiotics:
- A cold. It’s the cold virus, folks, and antibiotics only kill bacteria. “If you have sneezing, and a runny nose, and a cough, and a mild sore throat, antibiotics will not make it better.” Just a sore throat? See your doctor to rule out strep.
- Sinusitis. If you have it just a few days, it’s just as likely to go away without antibiotics as with them. Got it 10 days or more? Your doctor may prescribe antibiotics.
- Simple skin problems. “Cleaning the wound a couple of times a day, maybe with a little topical antibiotic, is often fine—you don’t have to take an oral antibiotic,” says Dr. Cooke.
- Chronic bronchitis. If it gets worse, it may be because the air quality is poor, or the air is cold. Similarly, your asthma may kick in during housecleaning. “But if you are bringing up a lot of green or yellow phlegm, that’s different,” says Dr. Cooke.
- Urinary pain. It’s not always an infection. “For women after menopause, the external genitalia can become irritated. Don’t assume burning is a bacterial infection.”
Don’t ignore symptoms. See your doctor—and listen. “Don’t walk in expecting an antibiotic,” says Dr. Hicks. “Think about the doctor visit as an opportunity to find out what is best for your illness. Antibiotics are not harmless medications.” If you do need one, it’s your doctor’s responsibility to prescribe the most narrow spectrum antibiotic that will do the job. Your task? Take them as directed, finish the course (even if you feel better), and don’t stockpile or share.
Stay healthy. The best way to avoid overusing antibiotics is not getting sick in the first place. In the big picture, that means a healthy lifestyle so you don’t get, for instance, diabetes, which often brings on complications that require antibiotics. In the short term, it means: Get a flu shot, and encourage your children and grandchildren to get theirs—and all their recommended vaccinations. Wash your hands, especially when your grandkids are around; use alcohol-based sanitizers when soap and water aren’t available. You may want to check out which area hospitals have the best programs to prevent patient-to-patient infection, just in case.
Talk about antibiotics. When you do get sick, find out what’s wrong, but discuss with your doctor whether you really need antibiotics. After all, says Dr. Cooke, “We did survive as a species for a long time without taking antibiotics for every red thing on our skin, or drippy nose.”