Antibiotics: Too much of a good thing

Antibiotics are important medications that save countless lives. Because of misuse and overuse, many of these drugs have become ineffective against an increasing number of virulent, bacteria-induced infections. These antibiotic-resistant afflictions are a growing public health concern. It is a case of too much of a good thing creating harm.

In the United States, 270 million prescriptions for antibiotics are written annually. When used properly to treat disorders caused by bacteria, these pharmaceuticals cure the malady, prevent the spread of the illness and reduce severity.

Antibiotics do not work against viruses that induce the common cold, flu, acute bronchitis, allergies and other everyday illnesses. According to the Centers for Disease Control and Prevention, greater than 30 percent of antibiotic prescriptions are inappropriately used for non-bacterial contagions. In these cases, antibiotic drugs will not help one feel better nor cure or stop the spread of the ailment.

When taken too frequently or for the wrong reasons, antibiotics can have pervasive long-term deleterious consequences. Under these circumstances, the medication enables the transformation of many of the body’s common, healthy bacteria into more virulent organisms.

Normal benign bacteria can become harmful. As they replicate, these newly mutated, stronger strains of superbugs may expand to different populations and produce dangerous illnesses. Because they are often resistant to routine antibiotic therapy, these contagions are difficult to cure. One report estimates that in the United States, nearly 2 million antibiotic-resistant infections causing 23,000 deaths occur every year.

Bacterial diseases that are unresponsive to antibiotics are not new. It happened after the introduction of the first wonder drug.

In 1928 Scottish biologist and pharmacologist Alexander Fleming serendipitously discovered a mold producing a substance that destroyed most known types of detrimental bacteria. He called it penicillin. Because it was highly unstable and difficult to make, the medical community at the time ignored his research. Penicillin remained a laboratory curiosity for a decade.

The approach of war in 1938 motivated scientists to investigate naturally occurring antibacterial substances. Two Oxford researchers found Fleming’s early report and began to study penicillin. They traveled to the United States to further analyze the drug’s potential. After several years of inquiry, American pharmaceutical companies started to produce significant quantities of the medication. The infected wounds of the allied troops could now be successfully treated.

Following the conflict, penicillin was established as part of civilian clinical practices. Shortly thereafter scientists found a bacterial enzyme that inactivated penicillin’s effect. No one predicted then that in the years ahead the overuse of medications like penicillin would foster dangerous strains of antibiotic-resistant bacteria.

For decades after penicillin’s initial debut, the development of multiple new antibacterial products kept antibiotic resistant illnesses at bay. But now, innovative pharmaceuticals agents are struggling to overcome the increasingly resistant infections brought on by the onslaught of antibiotic overuse.

The medical community is fully aware of its pivotal role to correct the problem of over-prescribing antibiotics. Evidence-based guidelines to ensure that appropriate use of antibacterial medications are well known by healthcare professionals. Defensive medicine used to forestall potential malpractice suits, less experienced ancillary medical providers and patients themselves can be stumbling blocks to fully implement these recommendations and achieve results.

But the public can help in the process.

Patients should not pressure their physicians to provide an antibiotic prescription when it is medically unnecessary for the illness that they are suffering. Unfortunately, sometimes when the patient’s expectations are not met, the practitioner’s reputation may suffer.

A disgruntled patient may give their healthcare professional an unfavorable grade on an internet site. In some instances a doctors’ concern for a potentially adverse patient evaluation score may subtly influence the decision on whether to prescribe antibiotics.

Stopping — or at least slowing — the inappropriate use of antibiotics will reduce deadly superbug infections, help perpetuate present day drugs’ effectiveness and lengthen the timeline of current medications. Working together, physicians and their patients can reverse the unintended consequences of too much of a good thing.

Stolz is a retired physician and author of the book “Medicine from Cave Dwellers to Millennials.”

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