Ask an expert: Why are superbugs outsmarting antibiotics?
“Antibiotics have saved far more lives than all other medical advances since their introduction,” says James Leggett, MD - a Providence infectious disease specialist. Today, however, antibiotics are overprescribed and overconsumed. As a result of rampant antibiotic usage, bacteria are developing resistance to these medications, depriving doctors of options for treating infected patients. In the US, antimicrobial-resistant infections are linked to 2 million illnesses and 23,000 deaths each year, according to the Centers for Disease Control and Prevention.
Nearly every antibiotic used in medicine originally was gathered from nature, says Dr. Leggett. For millions of years, bacteria and fungi have battled each other to survive. Scientists have collected these defensive antimicrobial compounds, purifying them in the form of a pill or solution. “We are using their own weapons against them [bacteria and fungi],” says Dr. Leggett. “It’s only a matter of time before the shields ramp up and bacteria become resistant. It’s a constant fight of our brains against their brawn.”
Resistance occurs in nature when one force encounters another. Dr. Leggett says there are two kinds of pressure related to antibiotic resistance: intense and low. Intense pressure occurs in places like the ICU, where a doctor may prescribe an antibiotic to treat infection over the course of, say, two weeks. This type of high-pressure force results in the rapid emergence of antibiotic resistance. What he describes as low pressure is the chronic use of antibiotics that’s become all too common in modern society. In this scenario, resistance emerges slowly in the bacteria exposed to the antibiotic. The risk is that the bacteria transmit resistance to bacteria in other parts of the body.
Some doctors prescribe antibiotics unnecessarily. A study in the New England Journal of Medicine found that half of antibiotic prescriptions may be unnecessary, with the highest prescribing rates affecting patients younger than 9 and older than 64. If the exact cause of an illness is unknown, a doctor may take preventative measures in case the culprit turns out to be bacteria. For instance, the common cold and bronchitis (typically caused by virus) may produce symptoms similar to pneumonia (typically caused by bacteria). Additionally, some doctors have admitted to caving when patients demand antibiotics.
The doctor’s office is not the only place where humans are getting more than their fair share of antibiotics. For instance, an estimated 80 percent of antibiotics are given to animals, many of which include livestock raised for human consumption. While some drugs actually are used to treat sick animals, antibiotics in the meat industry often are intended to promote growth and prevent disease. “That is a big driver of resistance,” says Dr. Leggett, “because bacteria in other animals may not cause infections in people but resistance does pass over to people.”
Protect yourself from antimicrobial resistance
- Don’t use antibiotics unless you truly need them
Know the difference between viruses and bacteria. Remember, the common cold and flu are caused by viruses, not bacteria. “Use antibiotics only when you need to, for the shortest amount of time,” says Dr. Leggett. “Prolong the inevitable resistance of bacteria.” - Wash your hands
Scrub your hands with soap for 20 seconds before rinsing them under clean water. Don’t waste your money on antibacterial soap when regular soap works just as well, says Dr. Leggett. Alcohol-based hand sanitizer is fine and doesn’t promote antibiotic resistance, he adds. - Wash your meat
Rinse raw meat. Use separate cutting boards for meat and vegetables. Don’t undercook your meat.
If you have questions about antibiotics, contact a Providence provider near you.