GO EASY ON an­tibi­otics

An­tibi­otics are our go-to pills when we are sick. But, in ex­treme cases, im­mune sys­tems can be­come re­sis­tant, pre­vent­ing us from en­joy­ing their full ben­e­fits


When you’re feel­ing sick, chances are you’ll con­sult a GP and ask for an­tibi­otics so you can get back to work as soon as pos­si­ble. But, de­pend­ing on your ill­ness, an­tibi­otics may not al­ways be nec­es­sary, and if not used cor­rectly, can make them less ef­fec­tive the next time you need them. So what are an­tibi­otics, what role do they play in our health sys­tems, do they al­ways work or can our bod­ies learn to re­sist them over time? An­tibi­otics are sub­stances that are used to either de­stroy bac­te­ria or hin­der their growth through var­i­ous mech­a­nisms. “They are ef­fec­tive for bac­te­rial in­fec­tions and should not be used for vi­ral in­fec­tions,” says Dr Fezile Mkhize, a Joburg-based med­i­cal doc­tor. He ex­plains that an­tibi­otics work by stop­ping the bac­te­ria from grow­ing and mul­ti­ply­ing. Some of the more com­mon in­fec­tions that are treated with an­tibi­otics in­clude bron­chi­tis, pneu­mo­nia, and uri­nary tract in­fec­tions.

“An­tibi­otics are our means of fight­ing back against bac­te­rial in­fec­tions that could po­ten­tially cause wide­spread deaths; the best ex­am­ple of this is the bubonic plague (the black plague), which re­sulted in the deaths of mil­lions of peo­ple (in the 14th cen­tury),” Dr Mkhize ex­plains. He con­tin­ues: “To­day there are an­tibi­otics that are able to treat and pre­vent the oc­cur­rence of this dev­as­tat­ing event. How­ever, with the grow­ing prob­lem of an­tibi­otic re­sis­tance, there’s the loom­ing pos­si­bil­ity of an­other pan­demic. It then be­comes im­por­tant to en­sure that these piv­otal tools for fight­ing against these po­ten­tial catas­tro­phes are used only when re­quired to pre­vent them be­com­ing in­ef­fec­tive.”

So, now the added prob­lem of an­tibi­otic re­sis­tance. The Cen­ters for Dis­ease Con­trol and Preven­tion in the USA de­scribes it as “one of the most ur­gent threats to the pub­lic’s health.” The or­gan­i­sa­tion con­tin­ues: “An­tibi­otic re­sis­tant bac­te­ria can cause ill­nesses that were once eas­ily treat­able with an­tibi­otics to be­come un­treat­able, lead­ing to danger­ous in­fec­tions. An­tibi­oti­cre­sis­tant bac­te­ria are of­ten more dif­fi­cult to kill and more ex­pen­sive to treat.”

What causes this po­ten­tially lifethreat­en­ing mat­ter? The World Health Or­gan­i­sa­tion (WHO) says: “An­tibi­otic re­sis­tance is ac­cel­er­ated by the mis­use and overuse of an­tibi­otics, as well as poor in­fec­tion preven­tion and con­trol,” it states on its web­site, stress­ing that it can af­fect any­one, re­gard­less of age or na­tion­al­ity.

“A grow­ing list of in­fec­tions – such as pneu­mo­nia, tu­ber­cu­lo­sis, blood poi­son­ing, gon­or­rhoea, and food­borne dis­eases – are be­com­ing harder, and some­times im­pos­si­ble, to treat, as an­tibi­otics be­come less ef­fec­tive,” the global health body warns.


Even though WHO says this can hap­pen nat­u­rally, the mis­use of an­tibi­otics is usu­ally one of the lead­ing causes of re­sis­tance. “An­tibi­otic re­sis­tance is when bac­te­ria adapt to these medicines, which they were once sus­cep­ti­ble to. The over-pre­scrip­tion of an­tibi­otics is also an­other fac­tor,” says Dr Mkhize. “These are all points that al­low for an­tibi­otics to be in­ef­fec­tive when treat­ing in­fected or­gan­isms. This, in turn, ex­poses the bac­te­ria to the an­tibi­otic over re­peated or pro­longed pe­ri­ods and can re­sult in the per­son’s even­tual re­sis­tance to that an­tibi­otic,” he adds.


Pop­ping an­tibi­otics un­necce­sar­ily does lead to re­sis­tance, Dr Mkhize warns. “The ob­vi­ous ben­e­fit of an­tibi­otics is that they tar­get bac­te­rial in­fec­tions and pre­vent po­ten­tially dev­as­tat­ing out­comes, but the is­sue comes in that these are very pow­er­ful medicines and can at times tar­get the ben­e­fi­cial or­gan­isms (bac­te­ria and yeasts) in your body,” he says. “It’s very im­por­tant to take them only when nec­es­sary, and even then, en­sure you are in­formed of any side ef­fects that could oc­cur,” he cau­tions.

Not com­plet­ing the full course

As tempt­ing as it is to stop tak­ing med­i­ca­tion as soon as you feel bet­ter, Dr Pule Hlung­wane, a GP, urges in­di­vid­u­als to com­plete the full pre­scribed an­tibi­otic course. “It’s nec­es­sary to take full treat­ment as this helps kill the dis­ease-caus­ing bac­te­ria. Fail­ure to take an an­tibi­otic as pre­scribed can re­sult in the need to re­sume treat­ment later and may pro­mote the spread of an­tibi­otic-re­sis­tant prop­er­ties among harm­ful bac­te­ria,” he cau­tions. “If you fail to com­plete a course of an­tibi­otics, some of the bac­te­ria caus­ing the in­fec­tion may sur­vive and these will be the ones with the great­est re­sis­tance to the an­tibi­otic. As the sur­viv­ing bac­te­ria re­pro­duce, the re­sult­ing in­fec­tion would not be treat­able with the same an­tibi­otic,” Dr Hlung­wane ex­plains.


An­tibi­otics should not be the only so­lu­tion to all your health prob­lems. Have a thor­ough con­ver­sa­tion with your doc­tor about other ways of pre­vent­ing ill­nesses and in­fec­tions, Dr Mkhize urges. “Dis­cuss al­ter­na­tives that can work for you,” he adds. ■

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