When Antibiotics Stop Working

When Antibiotics Stop Working

Ontario Medical Association, Ontario Medical Review March 2013

Antibiotic resistance refers to the ability of bacteria to resist the effects of antibiotics that had previously been successful used to obliterate them. This resistance allows bacteria to survive, thrive and multiply, contributing to increasingly harmful effects on our health, such as more devastating infections and infections that do not respond at all to antibiotic treatment.

We must embrace the idea that with increasing antibiotic resistance we have to change the way we think about antibiotics and the bacteria we are trying to annihilate.

For instance, if you have a bacterial infection that will clear on its own without antibiotic intervention, then why seek antibiotic treatment at all? The simple act of taking antibiotics increases the chances that bacteria may find a way to defend itself, increasing its resistance to the antibiotic effect.

There is no doubt that some antibiotics of have stopped working and it all started with frivolously treating infections with antibiotics in the human population, and delivery of antibiotics to livestock in the agriculture industry.

The most infamous resistant bacteria is MRSA (methicillin-resistant staphylococcus aureus) which has an even more devastating effect on already ill patients whose immune systems are already compromised.

There have been reported patient experiences where the treatment of a self-limiting asymptomatic bacterial infection allowed another more dangerous bacteria (ie.e Clostridium Difficile) to cause a more serious illness in the same patient.   There are many examples, including types of pneumonia now resistant to penicillin and amoxicillin, that now require more harmful, less effective antibiotics that have serious side-effects.

The results of antibiotic resistance are

(1) doctors now need to use unfamiliar antibiotics to treat patients

(2) patients are sicker longer – obviously impacting our congested hospitals,

(3) these antibiotics are often more toxic

(4) patients are now dying from infections that were previously treatable

Physicians and Dentists are rethinking the antibiotics they select and when to prescribe them, such as choosing to not provide a prescription for patient complaints that are often due to viruses or infections that resolve without treatment (e.g. sinusitis, ear and upper respiratory tract infections).

In veterinary medicine and the farm industry, antibiotics are provided as illness preventers (“prophylactics”) or growth promoters. This “seriously compromises preserving the effectiveness of antibiotics.”

There is no doubt that infections with resistant bacteria are becoming more frequent, more difficult to treat, and more deadly. Patients are sicker longer and at a greater cost to the health of the patient and to the health-care system. What happens when antibiotics stop working completely?

As a patient, you must understand that

(1)    Not every infection should be treated with an antibiotics. Infections can be viral and therefore resistant to antibiotic effects anyways (because antibiotics destroy bacteria only). And some infections clear on their own without medicinal intervention.

(2)    Antibiotics should be taken as prescribed, both when it is taken and for how long.

(3)    Patients should never share with another. Antibiotics are tailored to each patient, in terms of dose, frequency and type of antibiotic chosen.

(4)    Always take the full course of antibiotics – partial completion only enhances the resistance of bacteria.

(5)    All left over medications should be disposed of properly and returned to the pharmacist. Do NOT place them in the garbage or down the toilet as this will only expose billions of bacteria and allow them to gain resistance.