Using antibiotics sensibly : Antibiotics

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General Health : Antibiotics

Last Updated: Oct 6, 2009 - 12:07:30 PM

Using antibiotics sensibly
By General
Mar 31, 2005 - 4:40:00 PM

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You know the feeling — your head throbs, your nose is stuffy and you're too tired to do anything except flop into bed at the end of the day. You're coming down with a bug — maybe a cold or the flu. A visit to your doctor for some antibiotics should help cure your illness, you think.

But think again. If your illness results from a virus — as a cold, the flu and most sore throats do — antibiotics won't do any good. In fact, taking antibiotics when you don't need them can be harmful.

Frequent and inappropriate antibiotic use leads to the development of antibiotic-resistant bacteria. When bacteria outsmart standard antibiotics, you need stronger and more costly medications to treat infections. Because bacteria mutate much more quickly than researchers can develop new antibiotics, the possibility exists that one day soon highly lethal strains of resistant bacteria will evolve — and there won't be effective drugs to kill them.

Improper antibiotic use isn't just a doctor's fault — you share responsibility with your doctor in using antibiotics carefully and correctly. Start by understanding what antibiotics are, when they should and shouldn't be used, and what you can do to combat antibiotic resistance.

What are antibiotics?

Antibiotics are powerful drugs used for treating many serious and life-threatening infectious diseases. Most infections result from either bacteria or viruses.

Bacteria are responsible for:

Most ear infections
Some sinus infections
Strep throat
Urinary tract infections
Viruses are responsible for:

Colds
Influenza
Most sore throats
Most coughs
Antibiotics can help you get better if a bacterial infection causes your illness, but they'll have no effect at all if you have a virus. What's more, taking antibiotics when you don't need them can lead to germs that are antibiotic-resistant.

Superbugs: How antibiotic resistance develops

After the introduction of the first antibiotic (penicillin) in the 1940s, scientists created hundreds of other antibiotics to combat bacterial infections. It took only a few years of using antibiotics before a troubling pattern emerged. Bacteria frequently treated with the same antibiotic would eventually develop resistance to the drug, and a stronger medication would have to be used. The bugs soon learned to resist the stronger drug, too. Thus began a cycle of needing increasingly powerful drugs to treat infections.

When you take penicillin or another antibiotic for an infection, the drug usually kills most of the bacteria. But sometimes a few persistent germs survive. These surviving bacteria can multiply quickly and thrive despite the presence of an antibiotic.

Since bacteria can adapt their cellular structure, they can become resistant to future treatment by the same drug. As a result, the antibiotic-resistant bacteria — also known as superbugs — no longer respond to first- or even second-choice antibiotic therapy. This leaves fewer effective drugs available to treat common but potentially life-threatening illnesses. Unfortunately, superbugs can also exchange survival secrets with other bacteria, even different species, allowing additional resistant organisms to grow.

For years, the potent intravenous antibiotic vancomycin (Vancocin) provided a reliable last defense against some infections, notably those caused by staphylococcus and enterococcus bacteria. But in recent years, some superbugs have even figured out how to resist vancomycin. A strain of vancomycin-resistant enterococci (VRE) first appeared in the late 1980s and has thrived ever since. Scientists worry that VRE not only will continue to multiply but will share its genetic secrets for survival with other bacteria.

Consequences of antibiotic resistance

As antibiotics continue to be overused and misused, more and more resistant strains develop. As a result, most infections caused by these bacteria don’t respond to typical treatments. Illnesses can last longer, and the risk of complications and even death can go up. Also, failure to treat a particular infection leads to longer periods in which a person is contagious and able to spread the resistant strains to others.

Another consequence is the increased costs associated with prolonged illnesses. According to the World Health Organization, these include the direct costs for additional laboratory tests, treatments and hospitalization along with the indirect costs from loss of income or time away from family. When infections become resistant to typical treatments, unconventional agents come into play. These are usually more costly, and they may have to be given by injection rather than by mouth.

Safeguard effective antibiotics: What you can do

Repeated use and improper use of antibiotics are two of the main causes of the increase in resistant bacteria. Here are some things you can do to promote proper use of antibiotics, which in turn ensures that the drugs will be effective when you need them.

Understand when antibiotics will work and when they won't work to treat an illness. Don't expect to take antibiotics every time you're sick. Antibiotics are effective in treating most bacterial infections, but they're not useful in the fight against viral infections, such as colds or the flu. Each year in the United States, doctors write an estimated 50 million antibiotic prescriptions for viral illnesses — for which antibiotics offer no benefit. Sometimes it's hard to tell whether illnesses result from bacteria or viruses — talk with your doctor if you aren't sure.
Take antibiotics exactly as prescribed. Follow your doctor's instructions in taking prescribed medication, including how many times a day and for how long. Don't stop taking the pills a few days early if you start feeling better. Not completing your full course of antibiotics adds to the antibiotic-resistance problem. A complete course of antibiotics is needed to kill all of the harmful bacteria. A shortened course of antibiotics often wipes out only the most vulnerable bacteria, which allows relatively resistant bacteria to survive and thrive.
Never take antibiotics without a prescription. Antibiotics are drugs only available through prescription. However, if you didn't take the full course of antibiotics that were previously prescribed, you might be tempted to take some of that medication the next time you get sick. Or you might give them to a friend or family member who isn't feeling well. The problem with this practice is that the antibiotic might not be necessary in treating the illness, it might not be the right dose or it might not contain the proper active ingredient to fight the bacteria in your system. All of these can contribute to stronger strains of resistant germs.
Don't pressure your doctor for antibiotics if you have a virus. A prescription for antibiotics won't do you any good if you have a cold or the flu. Instead, talk with your doctor about ways to ease the symptoms of your viral illness. For example, taking a decongestant can help clear a stuffy nose. Or taking medicine such as acetaminophen (Tylenol, others) may reduce fever or muscle aches often associated with influenza.
Protect yourself from infection in the first place. You can keep many germs at bay — and avoid infection — by adopting preventive habits, such as cleaning your hands often, handling and preparing food in a safe manner, and keeping up-to-date on immunizations.

Clean your hands: A simple way to prevent infection
Food safety
Why immunize?
Your nose: What to do when it's runny or stuffy

These rules apply to everyone in your family, from your children to an aging parent.

The scope of your responsibility

If you take antibiotics inappropriately, the resistant microorganisms that you create are a threat not only to you, but also to your family and community. With frequent antibiotic use, resistant organisms persist and become widely established over time. These resistant organisms can cause new and hard-to-treat infections — even in people who haven't abused antibiotics.

Your responsibility in using antibiotics — unlike almost any other medicine you might take — extends far beyond your reach. Responsible antibiotic use protects the health of your family, neighbors and community — and ultimately the global community, too.

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