Antibiotic Resistance: What Is It and Why Should It Matter to Me?
In the modern era of medicine, antibiotics have played a pivotal role in treating bacterial infections and saving countless lives. However, the widespread and sweeping use of these drugs has led to the emergence of a significant global health concern: antibiotic resistance. In this blog, infectious disease expert Dr. Ari Frenkel will share the concept of antibiotic resistance, understand its implications, and explore the steps clinicians and patients can take to improve antibiotic stewardship.
Understanding Antibiotics and their Value
Antibiotics are powerful medications designed to fight bacterial infections. They work by either killing bacteria or inhibiting their growth, thus allowing our immune system to effectively combat the infection. These drugs have been instrumental in treating various ailments, from common respiratory infections to life-threatening conditions like sepsis.
“Antibiotics are considered one of the most important medical discoveries of all time! Putting it in perspective, the average lifespan prior to the use of penicillin was only 47 years old,” Dr. Fenkel points out. “Unfortunately, over the years of use, antibiotics lost the ability to work effectively leading the race to develop newer antibiotics”
One crucial aspect of antibiotics is their classification as either narrow or broad spectrum.
Narrow spectrum antibiotics are effective against a specific group of bacteria, while broad spectrum antibiotics can target a wide range of good and bad bacteria. Broad spectrum antibiotics are often prescribed when the exact cause, or bad bacteria, from a common infection is unknown or when the infection is severe.
The Downstream Effects of Wide Utilization
While broad spectrum antibiotics can be lifesaving in certain situations, their overuse has significant consequences. One of the primary concerns is the development of antibiotic resistance. When bacteria are exposed to antibiotics, they may undergo genetic mutations or acquire resistance genes from other bacteria. This leads to the survival and proliferation of resistant strains, rendering the antibiotics ineffective against them.
The repercussions of antibiotic resistance are far-reaching. It not only limits the treatment options for common infections but also poses a threat to public health and medical procedures that rely on antibiotics, such as surgeries and cancer treatments. Furthermore, the rise of antibiotic-resistant infections increases healthcare costs, prolongs hospital stays, and increases the risk of complications and mortality.
The CDC estimated that the cost of antimicrobial resistance is $55 billion every year in the United States, $20 billion for health care and about $35 billion for loss of productivity.
Improving Antibiotic Stewardship
Antibiotic stewardship refers to a set of strategies and practices aimed at optimizing antibiotic use to preserve their effectiveness.
Ari Frenkel, MD, MPH
“We now live in a world where guess work is not needed, there are tools to support proper antibiotic selection and utilization. We don't rely on approximations to diagnose torn ligaments or broken bones,we use advanced technology such as CT and MRI. Same is true with microbiology and infectious disease. Newer technologies allow for the rapid and accurate testing of bacterial infections so the right antibiotic, if any at all, can be prescribed.”
Clinicians and patients both play a crucial role in improving antibiotic stewardship.
Here are some steps that can be taken:
Accurate Testing: Proper diagnosis is essential to ensure antibiotics are prescribed only when necessary. Clinicians should utilize diagnostic tests, such as cultures and drug sensitivity testing, to identify the causative bacteria and determine the most effective treatment options.
Completing the Full Course: Patients should follow prescriptions as prescribed and complete the full course, even if they start feeling better. Stopping the medication early can lead to the survival of bacteria and the development of resistance.
Educating Patients: Clinicians should educate their patients about the proper use of antibiotics, avoiding sharing or reusing antibiotics, and understanding the difference between viral and bacterial infections.
Preventing Infections: Implementing preventive measures, such as vaccination, and proper hand hygiene can help reduce the incidence of infections and, consequently, the need for antibiotics.
Collaboration: Healthcare providers, researchers, policymakers, and the public must collaborate to raise awareness about antibiotic resistance, advocate for responsible antibiotic use, and support research and development of new antibiotics.
It Begins With Us (And knowledge)
Antibiotic resistance poses a significant threat to public health, jeopardizing the effectiveness of one of modern medicine's most valuable tools.
Dr. Frenkel reiterates the role we all play in combating antibiotic resistance, “one of the driving forces of antibiotic overutilization is that patients expect antibiotics, and in some cases, demand them from their doctors. However, it's important to note, that in majority of cases, such as respiratory infections and GI illnesses, antibiotics may not be needed, and if given, can lead to more harm than good.”
It is crucial for clinicians, patients, and society as a whole to prioritize antibiotic stewardship. By improving diagnosis accuracy, completing full courses of antibiotics, and implementing preventive measures, we can preserve the efficacy of these life-saving drugs and safeguard the health of current and future generations.
Let us take a collective stand against antibiotic resistance and protect the power of antibiotics for years to come.
