Antibiotic Overuse And Its Role In Drug Resistant Infections

We are in the midst of cold and flu season, and I have recently seen an uptick in clinic visits for upper respiratory infections. Common complaints include sore throat, cough, nasal congestion, and low-grade fever, and I often feel pressure by patients to prescribe antibiotics for their symptoms. However, most upper respiratory infections are caused by viruses and are not improved by a course of antibiotics.

Antibiotics treat bacterial infections like strep throat, certain kinds of pneumonia, skin infections, and urinary tract infections. Antibiotics are vital to modern medicine and have led to a dramatic reduction in illness and death from infectious diseases. However, very few new antimicrobial drugs have been introduced over the last thirty years and taking antibiotics unnecessarily can lead to an increase in strains of bacteria that are resistant to most or all current antibiotics.

Almost all bacteria have the ability to change or mutate to become less susceptible to drug threats, but the more that antibiotics are used, the more opportunities bacteria have to evolve to resist them. The Center for Disease Control (CDC) estimates that half of all prescribed antibiotics are unnecessary or inappropriate as written. If an antibiotic is prescribed for a viral infection, otherwise harmless bacteria in the body may develop resistance and later transfer it to more dangerous bacteria when a true bacterial infection does occur.

The misuse of properly prescribed antibiotics can also contribute to drug resistance. For example, when patients fail to complete their drug regimens at home, they may allow some bacteria to survive the treatment and develop resistance in the process.

Antibiotic-resistant infections affect 2 million people and are associated with 23,000 deaths annually in the United States. Antibiotic resistance is a major public health concern that limits available treatments and increases costs because of the need for more expensive drugs and longer treatment courses. Some antibiotic-resistant infections cannot be treated by any current medications. Examples of antibiotic-resistant infections include Methycillin-resistant Staph aureus (MRSA), Clostridium difficile, drug-resistant tuberculosis, and drug-resistant gonorrhea.

It is important to note that antibiotic overuse occurs not just in medicine but also in food production. In fact, agricultural usage accounts for 80 percent of all antibiotic use in the U.S. and is a major source of human antibiotic consumption.

Almost 21 million pounds of antibiotics are administered to livestock in the U.S. every year for growth promotion, weight gain, and disease prevention. The antibiotics in meat and dairy, as well as the resistant bacteria, are potentially passed on to humans in undercooked foods. According to the CDC, 1 in 5 antibiotic-resistant illnesses in humans is linked to food. An analysis of supermarket samples by the non-profit Environmental Working Group (EWG) found that the majority of the ground beef, ground turkey, and pork chops sold in the typical American grocery store contains antibiotic-resistant bacteria. Drug-resistant bacteria can also spread from farms through agricultural workers, flies, and trucks that haul livestock and can accumulate in manure that is spread on fields and enter waterways.

So what can you do to reduce the incidence of antibiotic-resistant infections? Here are some tips to promote proper use of antibiotics and reduce resistance:

  • Complete the full course of an antibiotic. It’s important to take all of the medication, even if you are feeling better. If treatment stops too soon, the drug may not kill all the bacteria, and the remaining bacteria may become resistant to the antibiotic that you’ve taken.
  • Do not skip doses. Antibiotics are most effective when they are taken regularly.
  • Do not save antibiotics. You might think that you can save an antibiotic for the next time you get sick, but an antibiotic is meant for your particular infection at the time. Never take leftover medicine.
  • Do not take antibiotics prescribed for someone else. These may not be appropriate for your illness, may delay correct treatment, and may allow your condition to worsen.
  • Practice good hygiene. Wash your hands regularly with soap and water, especially after using the toilet, before eating, before preparing food and after handling fresh meat. Wash fruits and vegetables thoroughly, and keep kitchen work surfaces clean.
  • Don’t push your health provider to prescribe antibiotics. Ask your doctor if they think your illness is viral, and if you can fight it off on your own.
  • Avoid infection by getting vaccines, including the flu vaccine.
  • Use antibiotic ointments sparingly.
  • Avoid antibacterial hand soaps and cleaners.
  • Practice food safety at home. If possible, purchase meat and dairy that have been raised without antibiotics.

By: Dr. Shanna Ndong