Dr. Marie George: Antibiotic resistance, and what you can do about it
What's troubling about antibiotics is that scientists are discovering fewer antibiotics than ever, and those we have are losing their effect. Bacteria and other microorganisms, which cause infections and disease, use several ways to impede antibiotic action and thus become "resistant" to the antibiotic. They can change themselves by mutating their own DNA, share DNA between different bacteria, change their structure to be less porous for antibiotics to be absorbed, create proteins which inactivate the antibiotic itself, among other ways to evade the action of antibiotic to kill a microorganism. In fact, the time between when a new antibiotic is introduced and when resistance starts to be noticed among bacteria has fallen from 10 years to just 1. These developments have given rise to the "super bugs." These bacteria can be resistant to nearly every antibiotic developed to kill them.
There are about 15 known super bugs. They go by unusual names, like C. Diff., CRE, and MRSA. These super bugs show resistance to the types of antibiotics that would normally kill them and return the infected person to health. When untreated, bacterial infections can cause serious prolonged illness and even death. If we continue on our current path, it is predicted that deaths attributable to antibiotic resistance will surpass those caused by cancer by 2050. The cost of treating a patient with an antibiotic-resistant infection is an estimated $20, 000 - $30,000 more expensive than normal treatment, and hospital stays for those with antibiotic-resistant infections are an extra 6 days long.
This is scary, but we can fight back. The most effective way to fight back is to work together. Medical and pharmaceutical researchers are working to discover and develop new antibiotics. The Infectious Disease Society (www.idsociety.org) has launched a campaign to develop 10 new antibiotics by the year 2020. They have discovered eight so far, and seven have been FDA approved. This effort was initially supported by the Obama administration and so far has been continued with monetary support from Congress. The plan is called the National Action Plan for Combatting Antibiotic Resistant Bacteria and was initiated in 2015.
Local doctors are working to fight antibiotic resistance too. While many of the most common infections are caused by bacteria, and can be helped with an antibiotic, others are viral. And antibiotics do not work on viruses. They don't cure the infection, prevent the spread of the illness, or make you feel any better. Taking an antibiotic for a virus may provide exposure that bacteria can use to develop resistance. Local doctors are working to prescribe antibiotics only for bacterial infections.
In this arena of complex science, the average person might think that there's not much she can do. In this case, there is. In fact, individuals' participation might be the most powerful in reversing this dangerous trend.
The first and easiest thing you can do to is to get vaccinated. You might think at first that getting vaccinated for a viral disease, like the flu, for instance, shouldn't have any effect on antibiotics. But it does. Those who get the viral flu often get bacterial infections like strep or staph as complications, each of which require an antibiotic. With each prescription we save, we decrease the likelihood that resistance will develop. So every person who doesn't get the flu is a win in the fight against antibiotic resistance.
The second thing to do is to practice good hygiene. Wash your hands frequently, cover your coughs and sneezes. If we all followed these rules, we would decrease the instance of both viral and bacterial infections and greatly reduce the demand for antibiotics.
Educate yourself about which infections are related to bacteria and which to viruses. The CDC's Viruses or Bacteria Fact Sheet, available online, is a great resource for this information. Work with your doctor to ensure that you are prescribed an antibiotic only if you are reasonably sure the infection is bacterial. If you do have an illness that requires a prescription, take it exactly as prescribed.
While the widespread adoption of these actions alone would make a tremendous difference, there is more for those who are interested in making a greater impact. You can learn the effects of antibiotics in agriculture and make wise purchasing decisions. You can use social media and the CDC's antibiotic resistance social content to educate others. Finally, you can also visit www.idsociety.org/policy/ to review current legislation and support politicians who take this issue seriously. Together—the researchers, the doctors and associate providers, and patients—can ensure that our antibiotics remain effective and restore us to good health for many, many years to come.
Marie George, MD, is the medical director for Infectious Disease at Southwestern Vermont Medical Center. Her practice is within the SVMC Multispecialty Practice. "Health Matters" is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care. For more columns like this one, visit svhealthcare.org/wellnessconnection.
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