{"id":17645,"date":"2018-08-21T12:37:55","date_gmt":"2018-08-21T17:37:55","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=17645"},"modified":"2023-03-03T15:13:46","modified_gmt":"2023-03-03T20:13:46","slug":"antibiotic-resistance","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/antibiotic-resistance\/","title":{"rendered":"What to Know About Antibiotic Resistance"},"content":{"rendered":"

Sir Alexander Fleming might be one of the reasons you\u2019re alive today. In 1928, the Scottish scientist noticed that an overgrowth of mold inside a petri dish was harming neighboring bacteria. Fleming isolated the specific mold, <\/span>Penicillium notatum<\/span><\/i>, and <\/span>named<\/span><\/a> his antibiotic discovery penicillin. <\/span><\/p>\n

Penicillin made it into human drug trials by 1940 and earned Fleming a Nobel Prize in 1945. While his medical breakthrough would go on to save countless lives from deadly and advancing bacterial infections, Fleming readily acknowledged the need to limit its use. He even issued a stern warning to anyone who saw penicillin as a cure-all: \u201cThe thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism.\u201d<\/span><\/p>\n

Decades later, Fleming\u2019s warning has taken on a chilling relevance. Each year, according to the Centers for Disease Control and Prevention, 2 million people <\/span>develop<\/span><\/a> bacterial infections that are resistant to penicillin and other antibiotics. Of those people, 23,000 die from their infections or resulting complications. The reason why is exactly as Fleming explained it: We\u2019ve been using antibiotics too often, in dosages too large or potent, even when they\u2019re not necessary. <\/span><\/p>\n

The result is an increasingly stubborn wave of illnesses and bacterial strains, including<\/span> gonorrhea<\/span><\/a>, pneumonia, blood infections and foodborne germs (<\/span>E. coli<\/span><\/i>), that no longer respond to conventional treatment with antibiotic drugs in the bactericidal penicillin and cephalosporin families. These illnesses aren\u2019t rare either: According to the CDC, <\/span>30 percent<\/span><\/a> of the bacteria that can cause pneumonia are potentially antibiotic-resistant. <\/span><\/p>\n

\u201cWe\u2019re now seeing essentially \u2018superbugs\u2019 that are pretty much resistant to most every drug we have,\u201d said Dr. <\/span>Cindy Liu<\/span><\/a>, chief medical officer of the George Washington University\u2019s <\/span>Antibiotic Resistance Action Center<\/span><\/a>. \u201cThere\u2019s been a huge rise in the number and types of antibiotic-resistant infections in the U.S. and abroad.\u201d<\/span><\/p>\n

Worldwide consumption of antibiotics <\/span>soared<\/span><\/a> 39 percent between 2000 and 2015. Some of this uptick can be explained by the increased availability of antibiotics in developing nations, but overuse everywhere is a major culprit too. Antibiotics are handed out more liberally when patients go to urgent-care facilities or emergency rooms instead of seeing their primary care physicians. Just 7 percent of primary care visits yield prescriptions for antibiotics, according to a 2018 CDC <\/span>analysis<\/span><\/a>, compared to 39 percent of those at urgent care. Of those prescriptions, 45 percent were found to be unnecessary.<\/span><\/p>\n

\u201cPatients will come into an emergency room expecting a prescription,\u201d Liu says, \u201cand the easiest way to manage that is to give it to them.\u201d<\/span><\/p>\n

How overuse breeds resistance <\/b><\/h3>\n

When our bodies are continually exposed to antibiotics, bacteria have more opportunities to <\/span>mount<\/span><\/a> an effective defense against the medication \u2014 a \u201cknow thine enemy\u201d adaptation that bacteria use in order to thrive. <\/span><\/p>\n

Say you develop a sore throat. You go to the doctor, say \u201cah\u201d and kvetch about the pain. Your doctor promptly prescribes an antibiotic, without waiting to see if a swab sample comes back positive for bacteria \u2014 even though <\/span>sore throats are more likely to be caused by viruses<\/span><\/a>, which antibiotics can\u2019t treat. <\/span><\/p>\n

Worse, your doctor might prescribe a broad-spectrum antibiotic,<\/span> which kills a wide variety of bacteria beyond those responsible for any single infection. As you follow this unneeded course of treatment for seven to 10 days, the bacteria in your system learn to tolerate the medication, finding ways to neutralize it or to create a barrier in the bacterial wall. The next time you actually need antibiotics for a bacterial infection, you\u2019re up against a strengthened enemy. Bacteria can also develop immunity to multiple antibiotics, sending doctors on a chase for an effective solution as the infection spreads. <\/span><\/p>\n

While overprescribing plays a large and undeniable role in antibiotic resistance, doctors say they don\u2019t deserve all the blame. \u201cThe human body is a very complicated system,\u201d says Dr. <\/span>Audrey Schuetz<\/span><\/a>, associate professor of laboratory medicine and pathology and co-director of bacteriology at the Mayo Clinic in Rochester, Minnesota. \u201cPatient disease symptoms can be nonspecific, and it can sometimes be difficult for doctors to know whether a disease is due to bacteria or not. Doctors may not know because of limitations in diagnostic tests currently available, or the patient may have several issues going on at once, which confuses the picture.\u201d <\/span><\/p>\n

In those situations, antibiotics become a \u201csee what sticks\u201d solution \u2014 something to take just in case it ends up working. Multiply this scenario by the millions and it gets easier to understand how diseases evolve to fend off drugs that once knocked them out. <\/span><\/p>\n

An infection doesn\u2019t need to be serious at first to become potentially life-threatening later on. One common infection that\u2019s vulnerable to antibiotic resistance is a urinary tract infection. \u201cThere are 10 million cases a year, most caused by <\/span>E. coli<\/span><\/i>,\u201d Liu says. \u201cIf you can\u2019t treat it with an antibiotic, it can travel from the bladder to the kidney and then the blood.\u201d Increasingly, Liu says, UTIs aren\u2019t responding to first-line drugs that worked well for years. <\/span><\/p>\n

The evolution of fortified, antibiotic-resistant infections also stems from agricultural practices. Food suppliers pump poultry, cows and other animals full of antibiotics to ward off illness, inadvertently making bacteria tougher. Food-borne germs, from contact with animals and raw meat, is the source of about one in five resistant infections, <\/span>according to the CDC<\/span><\/a>. The government is taking measures to curb misuse of antibiotics on farms, but <\/span>as the <\/span>New York <\/span>Times<\/span><\/i> reported<\/span><\/a>, experts say these policies are weakened by loopholes. In 2017, for instance, The FDA banned the use of antibiotics for the purpose of fattening up animals. But ranchers and farmers can still administer the drugs to prevent disease, a reason they can cite even if animals don’t show symptoms of illness.\u00a0<\/span><\/p>\n

The patient\u2019s role <\/b><\/h3>\n

Across the board, it\u2019s getting harder to kill previously treatable bugs. While this sounds like a job for medicine and food safety regulators, Liu says patients can do their part too. Among the steps you can take:<\/span><\/p>\n

Don\u2019t push for antibiotics<\/i><\/b>.<\/span><\/i> If your doctor says you don\u2019t need them or that it\u2019s better to wait out an infection for a few days, listen to the expert and stick to over-the-counter remedies. <\/span><\/p>\n

Don\u2019t treat yourself. <\/i><\/b>Some people use leftover antibiotics to self-treat new illnesses, reasoning that if they have similar enough symptoms, they can use the same drugs. Without confirming an infection is bacterial, you risk filling your body with antibiotics for no reason. If it is bacterial, only a medical professional can determine the proper type, dosage and course of drug treatment. It\u2019s <\/span>best<\/span><\/a> to use as narrow a spectrum of antibiotics as possible, to avoid targeting other bacteria in the body. Antibiotics do also carry some health risks beyond potential resistance and ineffectiveness, such as diarrhea.<\/span><\/p>\n

Protect yourself against unnecessary antibiotics.<\/i><\/b> If you\u2019re healthy, the simple act of washing your hands can help <\/span>ward off<\/span><\/a> bacterial infections. If you\u2019re hospitalized, you might <\/span>benefit<\/span><\/a> from a stewardship program that works with physicians to make sure antibiotics are warranted and then monitors their use for effectiveness. <\/span>(Several institutions, including the Mayo Clinic, will be participating in an Antibiotic Awareness Week from Nov. 12 to 18.) <\/span><\/p>\n

No matter what state of health you\u2019re in, seeking out food suppliers that minimize\u00a0antibiotic use communicates public concern over the drugs entering the food supply. But watch out for misleading food labels. \u201cAntibiotic-free\u201d is an empty term, as explained in <\/span>this <\/span>New Food Economy<\/span><\/i> story<\/span><\/a>. Meat labeled \u201ccertified organic\u201d is the only type legally guaranteed not to come from animals treated with antibiotics. \u00a0<\/span><\/p>\n

What happens if antibiotics don\u2019t work?<\/b><\/h3>\n

If you develop an infection that doesn\u2019t respond to conventional<\/span> treatment with antibiotics, physicians can try a number of other therapies. They might lengthen the course of treatment or combine different antibiotics. In the case of wounds or chronic skin infections, they might tackle the problem with topical antibiotics that only get absorbed into your system in very small amounts. They might even steer clear of antibiotics altogether. In women, for example, the diuretic drug spironolactone has shown <\/span>promise<\/span><\/a> fighting acne, an issue often treated with prolonged use of antibiotics.<\/span><\/p>\n

In the future, we may not have to rely solely on antibiotics to treat bacterial infections. Some researchers are looking into <\/span>plant-based<\/span><\/a> compounds with naturally occurring antibacterial properties. Probiotics, for example, may be able to help us <\/span>stave<\/span><\/a> off infections before they start. And both peptides (tiny proteins produced by plants, animals and fungi) and phages (viruses that attack singular strains of bacteria) are <\/span>demonstrating<\/span><\/a> bacteria-killing properties in clinical studies. <\/span><\/p>\n

\u201cThere are newer antibiotics on the market which have activity against multidrug-resistant bacteria,\u201d Schuetz says. \u201cSome antibiotics are in development, and some are currently available. However, there is a concerning trend right now towards fewer antibiotics being developed to fight these superbugs.\u201d<\/span><\/p>\n

Still, \u201cmore drugs\u201d isn\u2019t the ultimate answer. Even with research efforts underway, it will be a long time before new antibiotics or alternatives can defeat infectious diseases. More antibiotics also mean more bacteria learning to survive our drugs. In addition to hoping for a better mousetrap, we need to use the traps we already have more carefully.<\/span><\/p>\n

The best thing the general public can do, Liu says, is stop thinking of antibiotics like a consequence-free fix. \u201cIt\u2019s not a benign drug,\u201d she says. \u201cJust don\u2019t take it unless you need it.”<\/span><\/p>\n

\n

Ready to book a doctor’s appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

So-called \u201csuperbugs\u201d are getting harder and harder to treat. Here’s how patients can protect themselves and promote public health.<\/p>\n","protected":false},"author":24,"featured_media":17849,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[227],"tags":[81,93,129],"class_list":["post-17645","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guides","tag-preventive-care","tag-public-health","tag-rx","reviewer-dr-nassim-assefi"],"yoast_head":"\nWhat to Know About Antibiotic Resistance<\/title>\n<meta name=\"description\" content=\"So-called \u201csuperbugs\u201d are getting harder to treat. 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