Pros and cons of antibiotics
Experts warn that the overuse of antibiotics is leading to a drug resistance that poses a threat to our health
WHEN the first antibiotic was discovered almost 90 years ago it seemed like a miracle. Here was a compound that could kill bacteria that caused serious – and often fatal – infections. It was a discovery that changed the face of medicine, and since then numerous other antibiotics have been discovered and developed. They’re used to treat a wide variety of infections and diseases caused by bacteria.
But experts are increasingly warning against overuse, saying that far too many antibiotics are being used for infections that would otherwise have cleared up on their own.
As with most things in life, too much of a good thing isn’t necessarily good, says the University of Cape Town’s Dr Sean Wasserman, who specialises in infectious diseases.
“Because bacteria are constantly changing and become drug-resistant due to excessive use of antibiotics, the medication can become ineffectual for certain infections,” he says.
“Antibiotics also attack the good bacteria in your body – and once nonresistant bacteria have been killed off, the resistant bacteria take over.”
Part of the problem is that sometimes people want to treat any and all illnesses and conditions with antibiotics, even demanding a prescription for antibiotics from their doctor. This is a bad idea, says Dr Francois Retief, a gastroenterologist from Mossel Bay in the Western Cape.
“Antibiotics are effective only against bacterial infections – they have no effect whatsoever on viral infections. Yet antibiotics are being prescribed for viral infections, allergies and problems that have nothing to do with bacterial infections.” There’s a long list of ailments that can be treated effectively with antibiotics, including infections of the urinary tract, throat, ear and vagina – but only if these infections are caused by bacteria, which is something your doctor needs to establish. Even bronchitis often doesn’t need antibiotics as in most cases it’s viral and not bacterial.
As antibiotics work only on bacteria and fungi and have no effect on viruses, you shouldn’t be prescribed antibiotics for common illnesses such as colds, flu, measles and mumps, says Johannesburgbased Dr Karen Koch – not unless there’s a secondary infection.
Before writing a script, your doctor should examine you and perform the necessary tests to ensure antibiotics are really needed as well as to establish the type and dosage of antibiotics to prescribe.
It’s often difficult to establish what type of bacteria is causing the problem, Retief says. He believes it’s not necessary for a patient to complete the course of antibiotics and that they should be administered only until the patient’s symptoms improve.
“That means the patient’s own resistance has improved to the extent their body is helping to clear the infection.
“It depends on how the patient’s body reacts to the medication. If the reaction is positive, treatment should be stopped as soon as possible [to cut down on antibiotic use].”
If a patient is slow to respond to an antibiotic it means the infection-causing organism is resistant to the medication and another type of antibiotic should be prescribed.
Why drug resistance is such a problem
The overuse and unnecessary use of antibiotics could lead to a public health crisis because it results in bacteria becoming increasingly resistant to these medications (see graphic above) – in other words, the antibiotics no longer kill them. This could eventually lead to a situation where we have no means of treating bacterial infections. This isn’t a problem only in hospitals, where “superbugs” (multidrug-resistant bacteria) have become a major concern. A recent study published in the journal Clinical Infectious Diseases found antibiotic resistance has important consequences for patients with common infections usually treated by GPs, such as urinary tract infections (UTIs) and respiratory tract infections.
The study found that as these infections became more antibiotic-resistant in patients treated by GPs, the patients not only had more severe symptoms, they also had them for longer.