Antibiotics are amazing drugs that cure many illnesses, but their overuse and misuse leads to antibiotic resistance, a growing and significant health threat.
Since penicillin became commercially available in 1941, antibiotics have revolutionized health care and the practice of medicine. Penicillin saved thousands of lives during World War II, when it was given to wounded soldiers to prevent and cure infections resulting from battlefield wounds.
Antibiotics have been used for 80 years to treat and cure a wide array of bacterial infections. Illnesses such as earaches, strep throat and urinary tract infections can successfully be treated with a variety of antibiotics available today. Serious, life-threatening diseases like tuberculosis and bacterial pneumonia can also be cured with antibiotics.
“Antibiotics can save lives and shorten illnesses in many cases,” says Dr. Charles Carlton, an internal medicine physician in Fort Worth. “However, antibiotics are not appropriate for every illness.”
How Do Antibiotics Work?
Antibiotics attack bacteria in our bodies. They either kill the bacteria or prevent them from reproducing further, supporting the body’s immune system’s efforts to defeat the harmful invader. Antifungal medications attack fungal infections in a similar manner.
A British scientist, Alexander Fleming, discovered penicillin by accident in 1928. Returning from a trip, he noticed a petri dish in which he had been cultivating bacteria had mold growing in it. Then he realized that the mold was killing the bacteria. It took several more years of research and work, but Fleming’s discovery in that moment paved the way for antibiotics to be produced and deployed to treat bacterial infections.
Is it Bacteria or a Virus?
Bacteria are single-cell microorganisms that can live in a variety of environments. Our bodies contain natural bacteria, many of which are beneficial to us. When foreign bacteria enter our body, they can replicate rapidly and may cause illness.
Viruses are smaller than bacteria. When a virus enters the body, it invades our existing cells, takes over them and uses the cells’ machinery to reproduce itself. Antibiotics do not work against viruses.
While bacteria and viruses are quite different, they both can cause illnesses that produce similar symptoms. Is it bacterial or viral? That question – and the fact that it’s challenging to answer sometimes – is one of the biggest reasons antibiotics are overused.
How are Antibiotics Overused?
The U.S. Centers for Disease Control and Prevention (CDC) estimates that each year, a whopping 47 million antibiotic courses – more than one in four – are prescribed for illnesses that don’t require antibiotics! This is the primary driver of increased antibiotic resistance.
You may be thinking, how can this possibly happen? Well, consider this scenario:
Your throat starts to hurt. You wake up the next day with nasal congestion. Your chest feels tight. Maybe you have a slight fever. You feel terrible.
It’s probably a bad cold, but you’ve got a big week ahead at work. You don’t have time to be sick! So, you’re off to the doctor to get some medicine.
Your doctor diagnoses you with an upper respiratory infection – the common cold, sinusitis or bronchitis. Maybe you have all three. Then the doctor tells you the culprit is more than likely a viral infection and she wants you to take a decongestant, drink plenty of fluids and get some rest.
You’re not happy with this answer – you want an antibiotic! After all, you can’t be sure it is not bacterial – so the antibiotic may work. And if it is viral after all – well, what’s the harm?
“This scenario plays out all the time in our offices,” says Dr. Diana Dickschat, a Frisco pediatrician. “The truth is, there is harm when someone takes an antibiotic they don’t need. Doing so contributes to the creation of antibiotic-resistant bacteria, which are a problem for all of us.”
In addition to doing nothing to cure a viral infection, an antibiotic:
- Will not protect others from getting sick,
- May cause harmful or unpleasant side effects, such as:
- Rash
- Nausea
- Diarrhea
- Yeast infection
- Can kill beneficial bacteria your body needs.
If you are suffering from one of the following common ailments, it is more than likely caused by a virus, not a bacterial infection:
- A cold
- A sore throat
- Bronchitis
- Sinus infection
- Some ear infections
- Stomach bug
A viral infection will clear up on its own within several days. Your physician may advise you to come back if it does not; a lingering illness could be evidence of a bacterial infection.
Antibiotic-Resistant Bacteria
According to the CDC, “antibiotic resistance is one of the biggest public health challenges of our time. Each year in the U.S., at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die” as a result.
Antibiotic resistance does not refer to the human body becoming resistant to the antibiotics; rather, the bacteria themselves are becoming resistant.
When bacteria are exposed to antibiotics, many of them will die or be left unable to reproduce. Some will survive, however. Usually, it’s a minimal number of germs that survive, meaning the person is no longer sick, but will still have some of the bacteria in their bodies. That bacteria, having been exposed to the antibiotic and survived, has now developed some resistance to the drug.
Over time, as these bacteria are repeatedly exposed to the same antibiotics, survive and reproduce, they become increasingly resistant to the medications, making them much more difficult to treat. In fact, both bacteria and fungi have been shown to be capable of several different defense strategies to defeat antibiotics and antifungal medications.
“There are several common infections known to be resistant to antibiotics,” says Dr. Charles Ewoh, a Fort Worth internal medicine doctor. “Some of these infections can become quite serious, leading to extended hospital stays and unpleasant or even dangerous treatments to rid the body of the infection – that’s why antibiotic resistance is such a problem.”
Antibiotics in Food
There has been a lot of focus on the use of antibiotics in farm animals. Antibiotics do have an important role to play in keeping animals healthy, just as they do for humans. Sometimes, antibiotics are used as a preventative measure to stop livestock from getting common illnesses – this type of antibiotic usage is regulated and approved by the Food and Drug Administration. However, if antibiotics are used as a means of promoting growth in the animal, this is an inappropriate use of the drugs, according to the CDC.
There should be no antibiotic residue remaining in a farm animal at the time it is slaughtered. If the drugs are present at the time of slaughter, they may later be ingested by humans. However, even if antibiotics are not present in the meat you purchase at the grocery store, that does not guarantee there is no antibiotic-resistant bacteria.
Finally, it is important to know that the U.S. Department of Agriculture, which regulates meat processing and sales, has no standard by which to label meat “antibiotic free.” So, when you see meat or poultry with this claim, remember there is no telling what that means.
Antibiotics: Not for Every Situation
Antibiotics are truly wonder drugs. We may need them to cure us of a serious illness or save our lives someday. To keep antibiotics as potent and effective as possible, it’s imperative that we stop overusing and misusing them. That means we should not try to get a prescription for an antibiotic every time we have a head cold or stomach bug. Just give it a few days and see if it gets better. Plus, we do not need the collateral damage that results when the antibiotic causes side effects and kills beneficial bacteria in our bodies.
Antibiotic resistance is a global health challenge – one that can only be met by us all doing our part to stop overusing these important drugs. That means patients and doctors working together to resist the urge to use more medicine than what is necessary to treat an illness.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
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