Eventually, that could mean that surgery may revert to the days when a sizable majority of people died from the infections rather than the treatments. It also means diseases like gonorrhea may become untreatable.
It is a major concern and one that the medical community has fretted about for some time. Ironically, it is a problem that has actually been created by physicians and their patients.
WONDER DRUG NO MORE
When they first hit the market, antibiotics were hailed as miracle drugs. Their invention started a new era in medicine, one in which infections by bacteria were no longer potential death sentences. Doctors now had a not-so-secret weapon that could defeat their invasion.
But bacteria weren’t going gently into that good night. The microscopic creatures began adapting defenses to many antibiotics, allowing them to live on and continue damaging cells and other structures.
Now, many of the drugs that formerly defeated harmful bacteria either don’t work or have less effectiveness than they did before. The formal term for that is antibiotic resistant, and that spells trouble for medical professionals who no longer have the tools needed to fight infections.
While bacteria deserve credit for adapting, factors in their surprising resistance include the overuse of antibiotics by medical professionals in treatments, the presence of antibiotics in our food chain (particularly in meat, poultry and fish) and the insistence by some patients that they be treated with antibiotics, even for conditions where they offer little to no benefit.
Scientists and medical researchers developed the first strains of antibiotics in the 1940s as a way to prevent infections. Bacteria are found everywhere on and inside the body, and while many are helpful and enhance body functions, some are deadly and can lead to infections that may increase illnesses or even cause death. By using antibiotics, bacteria are eliminated and their ability to reproduce halted.
RESISTANCE IS GRADUAL
Mutations in bacteria are responsible for the immunity. After frequent exposure, bacteria develop defenses against the way certain drugs attack them, in some cases neutralizing the effects. What is potentially devastating is the bacteria’s ability to pass along its knowledge of defeating a particular drug. By transferring that knowledge and by reproducing the defense, it creates a new strain of bacteria that can’t be eradicated by that drug.
While the development is unfortunate, such resistance is not unexpected. The pharmaceutical community has kept pace by developing new antibiotics. However, the use of antibiotics and its presence in the food chain has sped up the immunity cycle.
ANTIBIOTICS: ONE SIZE DOES NOT FIT ALL
While antibiotics can defeat bacteria, they do not work on viruses. That is one of the reasons why immunity has been sped up. Many patients demand antibiotics for conditions caused by viruses. In the classic example, developing a sore throat is not cause for taking an antibiotic, but strep throat, which is caused by a bacterial infection, is susceptible to antibiotic treatments.
By taking an antibiotic that’s not useful in battling a particular condition, patients give the bacteria an opportunity to further develop immunity. Worse, use of antibiotics may take out the good bacteria and harmless bacteria, as well as the bacteria that promote infections.
Antibiotics will do no good for the flu, the common cold, sore throats, bronchitis, coughs, some sinus infections, many types of ear infections, and the stomach flu. Many doctors prescribe antibiotics for upper respiratory infections picked up during a cold, but studies have shown they do not work, and children can develop the C. diff strain as a result. This is an antibiotic resistant bacterium that can cause severe diarrhea and leads to more than 13,000 deaths each year.
C.diff’s resistance is used by researchers as a prime example of antibiotics leading to resistance. It is believed C.diff gained strength by the antibiotics wiping out gut flora, the good bacteria that support digestion and immunity. That allowed the opportunistic C.diff to develop immunity, having less good bacteria to battle.
Another antibiotic resistant bacteria strain that is gaining attention is gonorrhea. The Centers for Disease Control and Prevention report that many more cases of gonorrhea are emerging because of antibiotic resistance. Untreated gonorrhea can cause fertility problems, ectopic pregnancies, neonatal eye infections and pelvic inflammation.
In addition to those problems, the Centers for Disease Control and Prevention have identified the carbapenem-resistant Enterobacteriaceae (CRE) as a problem. That bacteria is fatal in 50 percent of cases.
ANTIBIOTICS STILL IN THE GAME
Despite some bacteria developing resistance, antibiotics still work to fight lung disease, pneumonia, skin infections and urinary tract infections. The antibiotic treatments are used for a short period of time in those cases.
Because antibiotics are still working in many of those cases, there is pressure on the medical community to use them in treatment. Many patients clamor for the drugs and some doctors prescribe them even before lab tests confirm the actual cause of the illness.
So-called gray market drugs, which are shipped from overseas locations, are also becoming a bigger problem. Many Internet pharmacies require little verification of a patient’s condition, and some patients feel they are getting over on the system by self-diagnosing.
Another issue in the development of resistance is the use of older medications. Some patients stop taking their prescribed drugs before they are finished, making the meds available for future illnesses. This violates two principles - always take all of your medication, as the absence of symptoms does not mean the bacteria are eradicated. It’s also contributing to bacterial resistance because the illness may be viral rather than bacteria-based.
WHAT WILL BECOME OF ANTIBIOTICS
As the strains of antibiotic resistant bacteria increase, the medical community faces the loss of a vital tool in its arsenal. That may lead to a reluctance to recommend surgery in some cases, fearing that the infection may be worse than the condition.
Meanwhile, the medical research community is working to develop new strains. That is a long and arduous process, and not every promising antibiotic will make it all the way through the approval process. Worse, not every resource at pharmaceutical companies is being devoted to antibiotic development, as profit potential may not be as great as other drugs.
As of 2013, the Centers for Disease Control and Prevention claimed that two million people will develop an antibiotic-resistant infection. They estimate that will create more than 20,000 additional deaths and prolong illness, potentially adding complications to the original problem. That increases overall costs for hospitalizations and could potentially lead to more invasive treatments, medical office visits, and overall expenses.
WHAT YOU CAN DO
Everyone has a stake in the battle against antibiotic-resistant bacteria. Many hospitals have instituted new ways to minimize antibiotic use, hoping to preserve the last remnants of effectiveness in certain drugs.
Patients can help. If you have leftover antibiotics, don’t flush them down the toilet. That can allow them to enter the potable water system, which builds resistance in the wider community each time people drink water.
One other way that patients can help is to avoid taking antibiotics that were prescribed for another person’s illness. Self-diagnosis is never a good idea, and with antibiotics becoming less effective, this practice hurts everyone battling disease.
Of course, one way to prevent overuse of antibiotics is to practice good hygiene. That helps in the fight against disease. Thoroughly wash hands for two minutes using hot, soapy water, and thoroughly wash fruits and vegetables before consuming them. Keep kitchen surfaces clean and make sure foods are properly chilled and heated before consumption.
Vaccinations are also important. Many childhood diseases are bacteria-based, and getting vaccinated helps prevent their spread. Particularly as more parents opt out of the vaccination system and new immigrants appear without vaccinations, it is important to opt in for vaccinations to prevent the spread of whooping cough and other bacterial diseases.
If you believe you may have an allergy to certain antibiotics, request a skin test. This will prevent unnecessary prescriptions and help doctors make a more accurate diagnosis.