Right now we are facing a public health issue both nationally and globally called antibiotic resistance. Bacteria are everywhere, existing unseen, and while some are completely harmless, some are not. They are usually reduced by drugs called antibiotics that attack a part of their functioning system and either make them ineffective or kill them outright.
However, antibiotic overuse and misuse has led to antibiotic resistance, which is when disease-causing microorganisms cannot be killed by the usual antibiotics that are meant to eliminate them.
Exposure to antibiotics at a low level or for too short a time can lead to bacteria being able to survive and multiply and ultimately become resistant. To understand how this happens, please see the Centers for Disease Control and Prevention’s (CDC) image below. This selective survival could lead to more harm because antibiotic-resistant bacteria require more expensive antibiotics that may have more side effects.
To combat this problem, healthcare facilities are committed to “antibiotic stewardship.” Antibiotic stewardship is the effort to measure and improve the appropriate prescribing of antibiotics by clinicians and appropriate use by patients. Improving antibiotic prescribing in all healthcare settings is critical to avoid creating more antibiotic-resistant bacteria.
How Great a Problem has Antibiotic Resistance Become? Well, did you know that:
- Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics.
- This figure is expected to rise to as high as 10 million by 2050.
- Resistant infections already cost the American healthcare system about $20 billion a year.
- Antibiotic-resistant infections can lead to increased healthcare costs and, most importantly, to infections that last longer, cause more severe illness, require more doctor visits or longer hospital stays, and involve more expensive and toxic medications.
What can you do?
1. Question the Need for Antibiotics
The fact that a friend was prescribed antibiotics for her cough does not necessarily mean you must have antibiotics for your cough, too, despite how bad your cough sounds. Be open to what your clinician has to say, especially if he or she is following the evidence-based guidelines for antibiotic prescribing. The CDC and other groups have established protocols for when antibiotics should be prescribed based on various diagnoses, especially upper respiratory illnesses, and they may be quite different from what you might expect.
You shouldn’t hesitate to ask your clinician about whether you need the antibiotic he or she is prescribing. A number of respiratory illnesses like simple bronchitis, some types of sore throat, and the flu are caused by viruses rather than bacteria, and viruses (unlike bacteria) do not respond to antibiotics. Unless your clinician tells you that you have a bacterial infection, antibiotics are not necessary. Viral infections have a way of clearing up with time because your immune system (your body’s natural soldiers) is well-equipped to fight against them. For a simple guide of what kinds of conditions should lead to treatment with antibiotics, please refer to the CDC image below.
Viruses or Bacteria – What’s got you Sick?
2. Finish up
There has been a lot of research about how to treat infections with antibiotics – the best type of antibiotic for a particular infection as well as the length of the course of treatment to determine the shortest possible time needed to completely kill all bacteria.
If you get prescribed an antibiotic for any condition, it is important to finish your course for the number of days stipulated by your clinician (unless you develop concerning side effects, then you should hold off on further doses until you can promptly discuss these side effects with your clinician.)
It is important to finish up the course of antibiotics because it allows your body’s natural defenses to eliminate harmful bacteria, avoid promoting resistant bacteria, and clear the infection.
3. Travel Smartly
Travelling, especially to a different country, gives you the opportunity to explore new places, cultures, people and food. However, as a note of caution, you should be careful about exposure to microbes when traveling. Plan ahead for your trip by receiving recommended immunizations to prevent serious diseases that are present at your destination. You should also pay attention to food and drink precautions and protect yourself from insect bites that could potentially transmit serious diseases.
Bacteria have different strains that are present in different geographical locations. When travelers unknowingly transport that different strain across international borders, it could become a public health problem, especially if the different strain does not respond to common antibiotics.
Overall, antibiotic resistance is a major global public health concern that needs to be addressed. By avoiding antibiotics when they are unnecessary, completing the course of antibiotics when they are needed, and travelling smartly, we can all play our part to stop it.
This article was written by Olohirere Ezomo, an intern in our Infection Control department, who is working on an Antibiotic Stewardship project with Atrius Health during her final semester as an MPH candidate at Tufts University School of Medicine.