But nothing lasts forever, and that certainly applies to the use of antibiotics. The bacteria that can be killed by them have adapted to their use, developing defenses that allow them to continue to inhabit and damage cells. In many cases, the drugs that formerly defeated them do not work as well or do not work at all to stem their invasion. When that happens, the bacteria are said to become antibiotic resistant, and that leaves patients and the medical community back to searching for new answers to age-old problems.
Some of the blame lies on the human side. Because antibiotics were widely regarded as “miracle drugs” when they were introduced, the tendency to use them skyrocketed. Part of it was patient demand, part of it was busy doctors who prescribed antibiotics based on suspicion of certain conditions before a formal diagnosis, and part was the appearance of antibiotics in the food chain. With such constant exposure, it is little wonder that clever bacteria soon developed ways to protect themselves against antibiotics, and worse, pass along the secrets of that protection as they replicated.
The first strains of antibiotics appeared in the 1940s as a way to prevent infections, and their arrival was greeted with huzzahs by the medical community. Bacteria are everywhere, even inside and on the surface of the body. While many are helpful and some even enhance certain body functions, others are trouble-makers that lead to illness, infections and even death. Killing them eliminated the harm they caused.
But mutations gradually emerged in the bacterial community. After frequent exposure to certain antibiotics, the bacteria can develop defenses. That is bad enough, but the ability to pass knowledge of defeating a particular drug is what makes the antibiotic resistance a major medical issue. While such resistance has been anticipated for some time, the overuse of antibiotics and its presence in the food chain has sped up the immunity cycle.
THERE ARE USES
Despite the problems, there are still infections that are best dealt with by using antibiotics. These are usually conditions that aren’t the run of the mill infections, but are specialized circumstances where the bacteria haven’t been constantly exposed to the antibiotics treatments that can kill them.
Here are a few things that antibiotics can still treat:
1. Pneumonia: This is a serious lung disease, and fortunately, all antibiotics used to treat it have a high success rate, typically more than 80 percent. Vancomycin even works against some bacteria that are resistant to other antibiotics. Treatments for pneumonia usually have a positive effect within three days.
2. Non-cystic fibrosis bronchiectasis - The antibiotic azithromycin (sold under the brand name Zithromax) has improved life for patients with this disorder, which is a rare lung condition that strikes many children in developing countries and an estimated 110,000 adults in the United States.
3. Skin conditions - Tetracyclines are used to treat infections of the chest, pelvis and skin, and also help with rosacea, acne and perioral dermatitis. The tetracycline’s can suppress but not cure the conditions, so the drug needs to be continued for weeks or even months while the disease is present.
4. Urinary tract infections - The first step in treating urinary tract issue is antibiotics. Which drugs are used depends on type of bacteria that are causing the problems. Among the antibiotics used are Fosfomycin, Cephalexin and Azithromycin, among many others.
5. Endocarditis - Certain heart conditions can be deadly if bacteria get into the bloodstream. At-risk patients include people with artificial heart valves or certain congenital heart defects. Thus, before dental work or other procedures that could potentially allow bacteria to enter the bloodstream, some patients with these conditions take preventative antibiotics prior to procedures to ensure that bacteria will be corralled.
NOT VIRUSES
Antibiotics do not work on viruses, and their use in attempted treatments of viral diseases has contributed to antibiotic immunity. In the belief that antibiotics are, indeed, miracle drugs, many patients demand antibiotics for viral illnesses. For example, a sore throat cannot be treated with an antibiotic. However, strep throat, which is caused by a bacterial infection, can be killed with antibiotic treatments.
By taking antibiotics that are not meant for battling a particular condition, the bacteria have an opportunity to develop immunity. Adding to the patient’s potential problems, use of antibiotics may kill the good bacteria and the harmless ones.
Typically, doctors don't recommend the use of antibiotics for the flu, sore throats, the common cold, bronchitis, coughs, some sinus infections, most ear infections, and the stomach flu.
In the classic case of misguided medicine, doctors prescribe antibiotics for upper respiratory infections. But the immunity factor causes children to develop the C. diff strain. This antibiotic-resistant bacterium causes more than 13,000 deaths each year. C.diff gained strength by antibiotics wiping out many strains of gut flora, the good bacteria that support digestion and immunity. That allowed the opportunistic C.diff to develop immunity.
The Centers for Disease Control and Prevention report that many more cases of gonorrhea are emerging, attributing it to antibiotic resistance. Gonorrhea can cause fertility problems, ectopic pregnancies, neonatal eye infections and pelvic inflammation.
HOW PATIENTS CAN HELP
Education on what antibiotics are meant for is a big help in battling resistance. There is pressure on the medical community to prescribe the drugs less often.
Patients should trust that their doctors know when to use antibiotics and when to treat them with conventional methods. Many patients seek grey-market or Internet drug sources for antibiotics, thinking that self-medicating is the path to healing. This overuse again creates resistant strains, making everyone’s treatments riskier.
The Centers for Disease Control and Prevention claim that more than two million people will develop an antibiotic-resistant infection in the next year, a total that means more than 20,000 additional deaths and longer illnesses, potentially longer hospital stays, and larger costs for treatment.
The battle to preserve the remaining antibiotic strains that can fight certain diseases is a task that falls to everyone, not just medical researchers. Do not demand antibiotic treatment and avoid taking them without a doctor’s advice and supervision.