Use of antibiotics comes at a cost
ANTIBIOTICS, also known as antibacterials, are types of drugs that destroy or slow down the growth of bacteria.
They are used to treat infections caused by bacteria, which are microscopic organisms, some of which could cause illness.
Before bacteria can multiply and lead to symptoms, the body’s immune system usually destroys them.
But if the white blood cells fail to fight off the infection, antibiotics can help.
The first antibiotic was penicillin, which was discovered in 1928 by Scottish professor Alexander Fleming.
The discovery revolutionised medicine, allowing doctors to treat hundreds of millions of people suffering from illnesses that had been considered terminal for centuries.
Many people consider antibiotics to be one of the greatest creations.
There’s no doubt that antibiotics have helped us out a lot. Many lives would have been lost had it not been for them.
What we failed to realise, though, when we first started bombarding our world with antibiotics some decades ago, was that their use came with a cost. The cost is greater than most people realise.
Why is prescribing antibiotics unnecessarily a problem? ● Antimicrobial resistance:
Antibiotics are not harmless drugs that physicians should be allowed to prescribe to whomever wants them.
Rather, they are powerful compounds that have caused a major change in human biology.
Not only have the widespread use of drugs, creams and sprays with antimicrobial properties over the most recent decades triggered the evolution and spread of antibioticresistant “superbugs”, but it has also altered the microbial communities that surround us.
Antimicrobial resistance means that due to overuse and misuse of antibiotics, previously easily treatable infections have become untreatable.
This applies to both hospital and community-acquired infections.
Examples of communityacquired infections that have become increasingly difficult to treat include TB, typhoid fever and sexually transmissible infections such as gonorrhoea.
“We’ve reached the end of antibiotics,” said Centers for Disease Control and Prevention expert Dr Arjun Srinivasan, who declared that “miracle drugs” that had saved millions were no match against “superbugs” because people had overmedicated themselves.
● Effect on Human Microbiome:
In 2010, more than 70 billion individual doses of antibiotics were consumed worldwide.
Broad-spectrum antibiotics can impact up to 30% of the bacteria among the human microbiota, resulting in severe loss of taxonomic and functional diversity.
The dramatic shift in the microbiota can develop immediately following antibiotic administration, and can sometimes last for years after its cessation.
The perturbation of the endogenous flora has been linked to many disease states, including obesity and autoimmunity.
● Antibiotic side-effects:
Many patients expect and sometimes demand antibiotics from their healthcare practitioners.
Given the many side-effects of antibiotics and the emergence of untreatable infections because of the overuse, misuse and abuse of antibiotics, patients should be questioning whether an antibiotic is really needed rather than demanding them.
Antibiotics have been linked to a number of sideeffects, including miscarriage during pregnancy, mental status changes, increased risk of cardiovascular events, kidney injury, hypo- and hyperglycaemia in diabetic patients, and severe diarrhoea requiring hospitalisation.
In the US, antibiotics are responsible for almost one in five emergency department visits for treatment of the sideeffects of their use.
And in children under the age of 18 years antibiotics are the commonest cause of emergency department visits.
Minimising unnecessary antibiotic use by even a small percentage could significantly reduce the immediate and direct risks of drug-related adverse events in individual patients.
In its recent annual report on global risks, the World Economic Forum concluded that “arguably the greatest risk… to human health comes in the form of antibioticresistant bacteria (Howell L, ed. Global risks 2013, eighth edition: An Initiative of the Risk Response Network. World Economic Forum).
We shouldn’t stop using antimicrobial drugs. However, we should definitely be more careful about how and when we use them.
And patients should ask the prescribing healthcare practitioners about the need for an antibiotic rather than demanding an antibiotic.