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It’s a growing problem that affects all of us
Antibiotics are drugs that can stop bacteria from growing and reproducing, and their use has saved countless lives from all types of infections. In fact, the scientists who discovered and purified the first antibiotic – penicillin – were awarded the Opens in new tab 1945 Nobel Prize in Physiology or Medicine thanks to its ability to treat previously deadly infections.
But even a wonder drug like penicillin is no match for bacterial strains that are constantly evolving. Though penicillin was very effective, it started to become less so soon after it was released thanks to new strains of antibiotic-resistant bacteria. That’s a reality that infectious diseases physician Eric Young, MD, with LVPG Infectious Diseases, is acutely aware of, particularly as antibiotic resistance continues to grow as a worldwide issue.
“When antibiotics first became available, a relatively small number of medications could be used to treat the majority of infections,” Dr. Young says. “Over time, these older antibiotics have become less useful and new antibiotics have had to be developed. At present, antibiotic resistance is developing faster than the invention of new antibiotics to treat them.”
It’s important to be aware that there are many bacteria that have developed resistance to commonly-used antibiotics, such as methicillin-resistant Staphylococcus aureus or MRSA. Dr. Young says as greater numbers of bacteria become resistant to existing antibiotics, it limits what is available to treat you, and in some cases you may need to have antibiotics given intravenously.
And antibiotic-resistant infections affect not just thousands of people, but millions. “More than 2.8 million antibiotic-resistant infections occur in the United States each year, and more than 35,000 people die as a result,” Dr. Young says.
First a lesson in how antibiotics work: Antibiotics work by preventing bacteria from reproducing or from producing what they need to grow, such as proteins. By limiting bacterial growth, your immune system can fight and kill the bacteria.
Bacteria become resistant to antibiotics thanks to random mutations that affect the way bacteria produce the things they need to grow. Bacteria may also produce chemicals that destroy the antibiotic molecule before it can damage the bacterial cell.
“Over time, the original susceptible bacteria may be completely replaced with a resistant strain of the same bacteria, and then an antibiotic is no longer useful to treat infections with the bacteria in question,” Dr. Young says.
Dr. Young says antibiotics are appropriate in the treatment of bacterial infections such as urinary tract infections, pneumonia and skin infections. “But they are not appropriate in diseases that are not an infection or infections that don’t respond to antibiotics, such as viral infections,” he says.
If you are seeing your health care professional about an infection, allow that person to help determine whether an antibiotic is really right for you. “Sometimes it is not clear whether your infection is caused by bacteria or a virus, and in those cases, it is often best to wait to see if you get better without taking an antibiotic,” Dr. Young says.
According to Dr. Young, the best way to avoid antibiotic use is to not get a bacterial infection. Some ways to help avoid getting sick are tried-and-true tips:
“In fact, influenza vaccination has been shown to decrease a person’s risk for developing bacterial pneumonia, because viruses such as the flu can weaken the defenses in the lung and lead to bacterial pneumonia,” Dr. Young says.
Probiotics may be helpful at preventing or decreasing antibiotic-associated diarrhea but are generally not necessary. People with weakened immune systems because of certain illnesses or medications should generally not take probiotics because they can occasionally cause serious infections in these individuals.
Clostridioides difficile (C. diff) is a serious infection that occurs most frequently during or after a course of antibiotics. The risk is seven to 10 times greater in people who have taken an antibiotic than in those who haven’t.
“C. diff bacteria may be present in a small amount in a healthy person’s intestine, especially after they have been in a hospital or nursing home,” Dr. Young says. “Antibiotics upset the balance of bacteria in the gastrointestinal tract and allow C. diff to multiply.”
When there is enough C. diff, the bacteria can produce a toxin that causes the symptoms of C. diff. Risk is greatest in people who are over 65 years old, have been admitted to a hospital or nursing home recently, have a weakened immune system or who have had C. diff in the past. About one in 6 people with C. diff will experience a relapse within the next two months.
Dr. Young says the main symptom of C. diff is diarrhea. “It is usually at least three watery bowel movements per day, although it may be far more than that. There may be abdominal pain and occasionally nausea. Fever may or may not be present,” he says.
If you have these symptoms, especially after taking an antibiotic, you should notify your doctor or clinician. Let them know if you have been on antibiotics because that is an important detail in diagnosis. Confirming that you have C. diff. is done using a stool sample.
Antibiotics are powerful medications that have helped humans (and animals) thrive even after a serious infection. But they are not without risk, Dr. Young says. “If you don’t need the antibiotic, the risk for side effects, no matter how small, isn’t worth taking,” he says.
