By Rajinder Bajwa, M.D.
We are living through exciting times of modern medicine where we can get treatment for many diseases which were considered incurable in past.
Antibiotics and vaccines have played a major role in that success. Diseases considered a scourge in past like smallpox have been eradicated because of successful implementation of effective vaccine. Antibiotics have greatly reduced illness and death from infectious diseases. This seems very exhilarating, but reality is something else.
Physicians, scientists and public health administrators are worried a lot about antibiotic resistance (ABR). ABR happens when bacteria change after they are exposed to antibiotics. Bacteria that develop antibiotic resistance are sometimes referred to as “superbugs.” As a result, the antibiotics become ineffective and infections persist in the body, increasing the risk of spread to others.
World Health Organization data from 129 member states show extensive antimicrobial resistance in every region of the world. The overuse of antibiotics in hospitals and in agriculture leads to selection and proliferation of drug resistant bacteria. According to the Centers for Disease Control and Prevention, more than two million people in the United States become infected with resistant bacteria each year – and 23,000 of them die.
This is scary data. In my opinion ABR is a far more serious threat than conditions such as Zika and Ebola, which receive extensive media coverage. If we fail to tackle this problem we may soon be in the post-antibiotic era, where simple infections will be able to kill because we won’t have antibiotics to treat them. The gains we have made in modern medicine will vanish.
There is hope. We can combat ABR. However, everyone has to play their role seriously and sincerely. Stakeholders include not only hospitals, physicians and public health bodies. All of us can help in a number of ways to prevent the development of ABR.
Prevent infections: Preventing infections in the first place will reduce the amount of antibiotics that have to be used. Less use of antibiotics means less chance of development of ABR.
Handwashing is do-it-yourself vaccine. Clean hands often with soap and water. This is the biggest and sometimes underutilized strategy to prevent infections. Another way of preventing disease is getting all your vaccines. Vaccines not only protect you but others who come in contact with you.
Prevent food-borne illnesses: Always cook food to the right temperature, wash hands while cooking or serving, clean table tops and other surfaces where food is kept or cut, refrigerate food promptly and don’t cross contaminate. Keep meat, poultry, seafood, and eggs separate from all other foods at the grocery and in the refrigerator.
These simple steps will improve your health and you are less likely to get sick and less likely to be prescribed antibiotics.
A common misconception is: “I need antibiotics now as I am sick.” Most common illnesses like colds, flu, sore throat and bronchitis are caused by viruses. Antibiotics will not help treat them but definitely will lead to the development of drug resistant bacteria. Unnecessary use of antibiotics not only leads to ABR but can cause many other complications and adverse effects such as Clostridium difficile diarrhea.
Antibiotics are responsible for 1 of 5 emergency room visits for adverse drug reactions. Listen to your doctor’s advice. If she is not prescribing antibiotics, more than likely you don’t need them. However, if they are prescribed for bacterial infection take them as prescribed. Finish the complete course and don’t stop before, even if you feel better. Stopping antibiotics prematurely promotes antibiotic resistance.
On the other side of the fence, hospitals and physicians have a huge responsibility to prevent this problem from getting out of control. An estimate shows that up to 50 percent of the time antibiotics are not optimally prescribed – either they were not needed at all, incorrect antibiotics was prescribed, or dose and duration were not correct. This needs to change.
Proper tests should be ordered to confirm infection. If needed, antibiotics must be used in correct dose and duration.
In hospitals I believe we have more control over this. Antibiotic stewardship programs and infection prevention policies are vital. Area hospitals are taking the lead in implementing antibiotic stewardship programs that provide necessary oversight for correct use of antibiotics.
At our hospital we take this seriously and have implemented a program for the past two years. Restricting certain antibiotics, daily audits, timely review of patients receiving antibiotics and ordering diagnostic tests are key steps we have taken to ensure the safe use of antibiotics.
Again, I will emphasize that staying healthy and proper use of antibiotics will minimize the emergence of antibiotic resistance, thus preventing us from entering a post-antibiotic era.
Rajinder Bajwa, M.D., is Chief of the Infectious Diseases Division at Niagara Falls Memorial Medical Center. He is board certified in Infectious Diseases and Internal Medicine and holds professional membership in the American College of Physicians, Infectious Disease Society of America, Society of Healthcare Epidemiology of America, American Society for Microbiology and the Medical Council of India. His research has been published in several peer reviewed journals.