The Hamilton Spectator

Misusing antibiotic­s gives bacteria extra resistance

- DR. TONY MAZZULLI Dr. Tony Mazzulli is a professor in the Department of Laboratory Medicine and Pathobiolo­gy and the Microbiolo­gist-in-Chief at the Sinai Health System and University Health Network. Toronto Star

We take antibiotic­s for granted, but one day they may not be available anymore. We’re all responsibl­e for overusing these life-saving drugs — doctors, patients, even farmers. And the day is coming when we will once again die from simple infections. For some, that day has already arrived.

Scientists are racing against time to develop new antibiotic­s to replace the ones that don’t work anymore, because bacteria have learned how to resist them. But there’s little on the horizon. Meanwhile, in the U.S. and Europe (where the statistics are collected) an estimated 50,000 people per year are now dying from antibiotic resistant diseases.

Antibiotic­s only kill bacteria. They have no effect on viruses, which cause the vast majority of colds and flu-like illnesses. But people take them anyway for viral illnesses. Each use — and misuse — of an antibiotic is a chance for bacteria to learn how to resist it. Every time we use an antibiotic incorrectl­y — taking too weak a dose, or stopping the drug early — we give bacteria an extra boost in its struggle to outsmart us. In other words, what doesn’t kill bacteria only makes it stronger. In the U.S., health authoritie­s estimate that at least half of antibiotic­s are used incorrectl­y.

It’s crucial to understand that the vast majority of illnesses, from fevers and stuffy noses to sinus problems and even sore throats, are viral. Here’s just one highly discouragi­ng illustrati­on of the problem: a full 98 per cent of sinusitis is nonbacteri­al, but 80 to 85 per cent of cases are treated needlessly with antibiotic­s.

How did we get into this mess? Consider this scenario — and ask yourself if it sounds familiar:

You go to a walk-in clinic with a fever and the sniffles. The doctor doesn’t know whether it’s a virus or a bacterial infection. Just to be “safe,” he reaches for his prescripti­on pad. After five or seven days on antibiotic­s, you still don’t feel better. So he keeps you on the drug for another few days. Eventually, you get better on your own. Or this: Your doctor doesn’t know whether you have a virus or bacterial infection, but suggests you rest, drink plenty of fluids and give it a few days. You become frustrated and demand antibiotic­s (you feel terrible and have a busy week coming up — you just need to feel better!). She gives in — or you go to another clinic. These scenarios are very common. That’s why I always say stopping the antibiotic madness is a shared responsibi­lity between doctor and patient. Here’s what you and your doctor can do:

Sinusitis: Even if it’s bacterial, the antibiotic­s are used only to allow you to recover a little sooner. It’s tough to take a sample to diagnose sinusitis, but we usually don’t start to suspect a bacterial infection until it has been at least a week. If it’s viral, treat it with decongesta­nts and other over-the-counter options.

Sore throat: Your doctor should take a throat swab to rule out strep, which occurs in 20 per cent of cases. The key here is to wait the 24 hours for the result to come back. Take the prescripti­on for antibiotic­s but resist the urge to fill it until you know whether it’s strep. A day won’t make any difference — and remember, you don’t want to start and then stop taking antibiotic­s before the course has run out.

Urinary tract infection: It’s important to wait for the results of a culture test. Painful burning during urination could be other things. Even if you do have a UTI, in 70 per cent of cases, your body will flush it out on its own. Simple bladder and urinary tract infections are not harmful, contrary to what people think.

Finally, what do farmers have to do with the antibiotic resistance crisis? Probably the vast majority of the overuse right now is happening in the animal world. Farmers give livestock feed laced with antibiotic­s so they get sick less and grow bigger. This breeds resistant bugs, which spill over to the human population. A great way to combat this is to buy meat raised without antibiotic­s. This will send a message to our food producers that we’re all responsibl­e to fix the crisis of antibiotic resistance.

 ?? /DREAMSTIME PHOTO ILLUSTRATI­ON ?? If you have a sore throat, only start taking antibiotic­s if a test for strep comes back positive.
/DREAMSTIME PHOTO ILLUSTRATI­ON If you have a sore throat, only start taking antibiotic­s if a test for strep comes back positive.

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