Health News
Health News
July 10, 2020
Antibiotics: Overuse and Misuse

Antibiotics are amazing drugs.  Since penicillin became commercially available in 1941, antibiotics have revolutionized health care and the practice of medicine.  Penicillin saved thousands of lives during World War II – it was given to wounded soldiers to prevent and cure infections resulting from battlefield wounds.  Before antibiotics, many more soldiers would die due to infection rather than the wound itself. 

Antibiotics have now been widely used for 80 years to treat and cure a wide array of bacterial infections.  Illnesses such as earaches, strep throat and urinary tract infections can successfully be treated with a variety of antibiotics available today.  Serious, life-threatening diseases like tuberculosis and bacterial pneumonia can be cured with antibiotics. 

“Antibiotics are amazing drugs that have saved millions of lives across the world,” says Dr. Gregory Bratton, a family practice and sports medicine doctor.  “But antibiotics are not appropriate for every illness – as with anything, too much of a good thing isn’t good.” 

How Antibiotics Work

Antibiotics work by attacking bacteria in our bodies.  They either kill the bacteria or prevent the bacteria from reproducing further.  Often by simply stopping the growth of the bacteria, the drugs will have given the body’s natural immune system the advantage it needs to defeat the harmful bacteria.  Antifungal medications work in a similar manner, attacking fungal infections in our body. 

A British scientist, Alexander Fleming, discovered penicillin by accident in 1928. Returning from a trip, he noticed a petri dish in which he had been cultivating bacteria had mold growing in it.  Then he realized that the mold was killing the bacteria.  It took several more years of research and work, but Fleming’s discovery in that moment paved the way for antibiotics to be produced and deployed to treat bacterial infections. 

Is it Bacteria or a Virus?

Bacteria are single-cell microorganisms that can live in a variety of environments.  Our bodies contain natural bacteria, many of which are beneficial to us.  When foreign bacteria enter our body, they can replicate rapidly and may cause illness. 

Viruses are smaller than bacteria.  When a virus enters the body, it invades our existing cells, takes over them and commandeers the cells’ machinery to reproduce itself. 

Antibiotics do not work against viruses.  Some viruses can be prevented through vaccinations, such as the flu and chickenpox, but others, such as the coronavirus that causes COVID-19, have yet to see a vaccine that is effective. 

Is it bacterial or viral?  That question, and the often-elusive answer, is a key reason antibiotics are overused.

Antibiotic Overuse

You may be familiar with this scenario:  one day, your throat starts to hurt.  You wake up the next day with nasal congestion.  Your chest may feel tight.  Maybe you have slight fever.  You feel terrible.

You know it’s probably a bad cold, but you’ve got a big week ahead at work.  You don’t have time to be sick!  So, you’re off to the doctor to get some medicine.

Your doctor examines you and lets you know you have an upper respiratory infection – the common cold, sinusitis or bronchitis.  Maybe you have all three.  Then the doctor tells you it is more than likely a viral infection and she is going to prescribe you a decongestant, plenty of fluids and some rest. 

You’re not happy with this answer – you want an antibiotic! After all, you cannot be sure it is not bacterial – so the antibiotic may work.  And if it is viral after all – well, what’s the harm?

“This scenario plays out all the time in our offices,” says Dr. Laura Baker, a primary care physician.  “The truth is, there is harm when someone takes an antibiotic they don’t need. Doing so contributes to the creation of antibiotic-resistant bacteria, which are a problem for all us.”

In addition to doing nothing to cure a viral infection, an antibiotic:

  • Will not protect others from getting sick
  • May cause harmful or unpleasant side effects
  • Can kill beneficial bacteria your body needs.

If you are suffering from one of these common ailments, it is more than likely caused by a virus and not a bacterial infection:

  • A cold
  • A sore throat
  • Bronchitis
  • Sinus infection
  • Some ear infections
  • Stomach bug

A viral infection will clear up on its own within several days.  Your physician may advise you to come back if it does not; a lingering illness could be evidence of a bacterial infection. 

Antibiotic-Resistant Bacteria

According to the U.S. Centers for Disease Control and Prevention (CDC), “antibiotic resistance is one of the biggest public health challenges of our time. Each year in the U.S., at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die” as a result.

Antibiotic resistance does not refer to the human body becoming resistant to the antibiotics; rather, the bacteria themselves are becoming resistant. 

When bacteria are exposed to antibiotics, many of them will die or be left unable to reproduce.  Some will survive, however.  Usually it’s a minimal number of germs that survive, meaning the person is no longer sick, but will still have some of the bacteria in their bodies.  That bacteria, having been exposed to the antibiotic and survived, has now developed some resistance to the drug. 

Over time, as these bacteria are repeatedly exposed to the same antibiotics, survive and reproduce, they become increasingly resistant to the medications, making them much more difficult to treat.  In fact, both bacteria and fungi have been shown to be capable of several different defense strategies to defeat antibiotics and antifungal medications. 

“There are several common infections known to be resistant to antibiotics,” says Dr. Joseph Saucedo, a family medicine doctor.  “Some of these infections can become quite serious, leading to extended hospital stays and unpleasant or even dangerous treatments to rid the body of the infection – that’s why antibiotic resistance is such a problem.”

Antibiotics in Food

There has been a lot of discussion over the last few years about the use of antibiotics in farm animals.  Antibiotics do have an important role to play in keeping animals healthy, just as they do for humans.  Sometimes, antibiotics are used as a preventative measure to stop livestock from getting common illnesses – this type of antibiotic usage is regulated and approved by the Food and Drug Administration.  However, if antibiotics are used as a means of promoting growth in the animal, this is an inappropriate use of the drugs, according to the CDC. 

There should be no antibiotic residue remaining in a farm animal at the time it is slaughtered.  If the drugs are present at the time of slaughter, they may later be ingested by humans.  However, even if antibiotics are not present in the meat you purchase at the grocery store, that does not guarantee there is no antibiotic-resistant bacteria. 

Finally, it is important to know that the U.S. Department of Agriculture, which regulates meat processing and sales, has no standard by which to label meat “antibiotic free.”  So, when you see meat or poultry with this claim, remember there is no telling what that means. 

Antibiotics: Not for Every Situation

Antibiotics are truly wonder drugs.   We may well need them to cure us of a serious illness or save our lives someday – perhaps they already have.  To keep antibiotics as potent and effective as possible, it’s imperative that we stop overusing and misusing them.  That means we should not try to get a prescription for an antibiotic every time we have a head cold or stomach bug.  Just give it a few days and see if it gets better.  Plus, we do not need the collateral damage that results when the antibiotic causes side effects and kills beneficial bacteria in our bodies. 

Antibiotic resistance is a global health challenge – one that can only be met by us all doing our part to stop overusing these important drugs.  That means patients and doctors working together to resist the urge to use more medicine than what is necessary to treat an illness. 

This article contains information sourced from:

The U.S. Centers for Disease Control and Prevention

The Mayo Clinic