Antibiotic Resistance

Why your doctor may be resistant to prescribe antibiotics
By Paula Aucoin, MD

As the winter months approach, so do the colds, flus and other common illnesses that send you or your children to the doctor’s office in search of a cure.  Whatever the ailment, many patients or their parents may expect the doctor to simply prescribe an antibiotic, thinking that will surely “kill the bugs” and restore the patient to health.

But that’s not how it usually works, and there are very good reasons why your doctor will only prescribe antibiotics when they are effective and absolutely necessary.

It’s important that patients everywhere understand when antibiotics are appropriate – and when they are not.  If a condition is viral, which is true of the common cold, the flu, bronchitis and most types of sore throats, antibiotics have zero effect.  Patients also need to realize that the needless prescribing or over-prescribing of antibiotics is feeding a global crisis in modern medicine. Powerful strains of antibiotic-resistant bacteria – some call them “superbugs” – are constantly evolving,  infecting two million people and causing 23,000 deaths in the U.S. alone each year.

To build that understanding, a quick review of the great benefits and serious limitations of antibiotics, along with a few eye-opening facts about the growing problem of antibiotic resistance, can be helpful.

What are antibiotics? Antibiotics are medications used to treat bacterial infections. Bacteria, sometimes called germs, are frequent causes of infections in children and adults. Prior to the 1940’s, treatment of bacterial infections like pneumonia was often unsuccessful because no specific therapy was available to kill the organisms causing them.  In 1928, Alexander Fleming discovered penicillin – the first antibiotic –considered a “miracle drug” when it was first used for treatment of infections in Allied troops during World War II.  In 1945, penicillin was introduced for use in the general population.  Even in those early days, the first strains of antibiotic resistant bacteria began to emerge.

What are some common bacterial infections treated by antibiotics? Lung infections such as pneumonia, urinary tract infections, kidney infections, sexually transmitted diseases, strep throat and certain ear infections in children are some of the most common infections caused by bacteria. They respond to antibiotic treatment. The full course and proper doses of the antibiotic must be taken.

What are some common viral infections for which antibiotics are ineffective? Viral illness such as the common cold, flu, sinus infections, bronchitis and sore throats (with the exception of strep, which is a bacterial infection) are unresponsive to antibiotics. Using antibiotics to treat viral infections not only won’t cure your ailment or relieve symptoms, it will create side effects and foster new strains of drug-resistant bacteria your body can’t fight. 

What exactly is antibiotic resistance and how did it become such a problem? Even though antibiotics have revolutionized medicine and saved countless lives over the past 70 years, they have been used so widely and for so long that the infectious organisms they were designed to kill have adapted to them, in some cases making those drugs impotent or far less effective. Bacteria inevitably find ways of resisting the antibiotics developed by science. While the more sensitive or susceptible bacteria are killed by the antibiotic treatment, the resistant bacteria multiply. These resistant bacteria can spread from person to person, from food sources contaminated with bacteria and from any environment where bacteria flourish.

What can the average person do to avoid infection by drug-resistant bacteria?  The best strategy is to prevent infections from happening in the first place.  Vaccinations are key. Vaccination of children and adults against common bacteria such as Streptococcus pneumonia or meningococcal infection has decreased the frequency of these diseases.   Influenza vaccination can decrease both influenza itself and bacterial infections which often accompany serious influenza infections.  Good hand washing, safe preparation of food and avoiding meat from animals raised with growth-inducing antibiotics are other tools to avoid infection with drug-resistant bacteria.

Paula Aucoin, MD, is an Infectious Disease consultant and Medical Director of Infection Control and Prevention at Berkshire Medical Center.