The term “antibiotic” means, literally, opposing life. Their medical intent is to destroy invading bacteria, but they can be far more indiscriminate killers. Sometimes, their target is us.
Since the beginning, antibiotics have been a double-edged sword. Antimicrobials are probably one of the greatest success stories in the history of medicine, saving countless lives and controlling infectious diseases that have plagued us since the dawn of time. But they also are ticking time bombs. Along with the ability to cure, antibiotics have the power to spawn resistance in patients and kick-start super strains of drug-resistant bacteria never before known to man.
Every year, at least 2 million Americans become infected with bacteria that are resistant to antibiotics. An estimated 23,000 of them will die; even more succumb to other conditions complicated by those initial infections. This is not a natural scourge, but a man-made one. Some diseases, such as C-diff colitis, are specifically caused by overuse of antibiotics. We let this particular monster out of the box. How we will get it back in is another question.
Antibiotics first gained popular use during the 1940s; penicillin was the miracle drug of World War II. But by the mid ’50s, a troubling glitch appeared. Penicillin resistance became so widespread that it threatened to erase the initial advances it created. Pharmaceutical researchers rallied and began turning out new antibiotics that attacked bacteria with fresh vigor. At first it seemed the enemy was conquered, but the bacteria fought back. Within that same decade, antibiotic-resistant staph infections made their debut. This was to prove a continuing, and vicious, cycle.
The main problem with antibiotic therapy is that after any new antibiotic is introduced, resistance is inevitable. During almost four billion years of evolution, microbes have accumulated an impressive arsenal of defense mechanisms. There is a constant race between the discovery of new antibiotics and microbial resistance against them. Add that to the fact that no new classes of antibiotics have been discovered since the 1980s, and you have the makings of an apocalyptic pandemic.
Fact: Antibiotics can only treat conditions caused by bacteria. Viral infections, such as the common cold and flu, are impervious to their charms. So, how did antibiotics come to be so overprescribed? Twenty years ago, doctors didn’t know any better. Back then, patients who came in with even a scratchy throat would be automatically dosed with erythromycin. Over the years, much of the medical community realized the enormity of that error, but their patients had been trained to expect medication. The majority of patients will listen when told they don’t need antibiotics, but there are some who just won’t accept that answer. If one doc won’t prescribe antibiotics, the patient will find someone who will.
The overuse of antibiotics has even spread to the agricultural industry. It is common practice to indiscriminately dispense low doses to livestock, both as a preventative measure and because it causes animals to rapidly gain weight. Other countries already realize the dangers of this practice. In Denmark, the government has cracked down on antibiotics sold to farmers much as the US has clamped down on opioids. There, antibiotics are a carefully monitored, controlled substance. In the United States, you can buy tetracycline in a pet store.
Fortunately, the CDC understands the gravity of the situation. They established an annual Get Smart About Antibiotics Week in 2015, and currently mandate antibiotic stewardship programs in hospitals that effectively reduce their use. But outpatient facilities and nursing homes have few regulations. At urgent care clinics, prescriptions for the slightest sniffle are still par for the course. Patients want a result and they want it now. They feel short-changed if they leave with nothing but sensible advice.
Naturopathic physicians have long known that antibiotics are seldom needed for recovery; but even they admit that with some conditions, such as bacterial pneumonia, antibiotics can be the ONLY option. Then it takes a great deal of skill on the part of the doctor to understand exactly when and what to prescribe. There is an entire spectrum of treatments between all or nothing. The overall health and age of the patient has to be considered, and sometimes a quandary presents itself. Is it better to risk the threat of disease without treatment … or risk an adverse reaction to the drug itself?
This is a fine line we walk between hope and Armageddon. It is entirely possible that any of us, at any time, could become infected with a microbe that resists treatment. Bacteria circulates freely through the population — in our food, from our grocer’s hands and through locker rooms at school. Recovered patients carry bacteria back from the hospital. Unless we live in a bubble, we cannot escape the problem, but we can all be part of the solution. For information visit cdc.gov/getsmart/week
