Whether you’ve had a sinus infection or ear infection, a UTI or a cut that turned oozy and red, chances are you’ve taken antibiotics.
In fact, most of us are so familiar with antibiotics that we can tick off the names of common ones—amoxicillin, ampicillin, cyclosporine, erythromycin, penicillin and tetracycline, to name a few. Face it: Plenty of us wouldn’t be here if it weren’t for antibiotics, which revolutionized medicine.
But precisely because antibiotics are the go-to drug for doctors and patients alike, the medications are in danger of losing their ability to kill bacteria. And that has experts concerned.
“We have not been able to keep up with the resistance developing in these microbes,” says Kavita K. Trivedi, M.D., chair of the education committee for The Society for Healthcare Epidemiology of America (SHEA).
According to the Centers for Disease Control and Prevention (CDC), more than two million Americans develop antibiotic-resistant infections every year and at least 23,000 die. The problem of infections not responding to drugs that once were effective is so serious that recently the World Health Organization (WHO) released a report calling antimicrobial resistance in bacteria—as well as fungi, viruses and parasites— “an increasingly serious threat to global public health.”
Here’s what you need to know about antibiotic resistance and how to prevent it.
What causes antibiotic resistance?
Bacteria are clever little organisms that multiply—fast. “Over a quick period of time, in the presence of antibiotics, they can learn to survive,” says Dr. Trivedi. Bacteria can also transmit this resistance to bacteria within and outside their species. So not only could the bacterium causing your infection outsmart the antibiotic you’re taking, but also you could transmit it to someone who isn’t even taking an antibiotic.
For decades, pharmaceutical companies routinely developed new antibiotics that enabled us to stay one step ahead of antibiotic resistant bacteria. But that pipeline has slowed, says Dr. Trivedi.
Who is at risk?
If you are young and healthy, your risk of developing a resistant infection is low. “But we have seen resistant pathogens in normal healthy patients,” says Dr. Trivedi.Most at risk are those with weak immune systems such as the elderly and people with chronic health problems. “They have a hard time fighting off these resistant infections,” says Dr. Trivedi. People who are hospitalized or who live in nursing homes are vulnerable, too, because they are more likely to be exposed to others who have resistant infections.
I only take antibiotics a few times per year. Why should I worry about this problem?
Because the more you or a family member or friend use antibiotics, the greater the likelihood bacteria will become resistant to one or more of the drugs.
The truth is we are overusing antibiotics—a lot. In 2010, report CDC researchers, healthcare providers prescribed 258 million courses of antibiotics, or 833 prescriptions per 1000 people. And according to the CDC an estimated 50 percent of antibiotic prescriptions may not be needed. One possible reason: Doctors routinely write an RX for antibiotics even if they aren’t sure a patient has a bacterial infection. That’s because lots of patients demand an antibiotic, convinced it’s the only thing that will help them feel better. What’s more, some people don’t finish their course of antibiotics once they feel better. When that happens, the infection can recur, prompting the doctor to prescribe another antibiotic to knock it out.
Antibiotics are also given to food-producing animals help them grow and stay healthy, which adds to the problem.
Why should I worry?
As more and more bacteria develop resistance, it’ll be harder to treat many infections. Currently, three common bacterial infections have been outsmarting antibiotics so regularly that they have made the CDC’s urgent list—Clostridium difficile (C. d iff); carbapenem-resistant Enterobacteriaceae; and drug-resistant Neisseria gonorrhoeae. A dozen other infections have experts seriously worried including Shigella; Salmonella; Streptococcus Pneumoniae; tuberculosis; and methicillin-resistant Staphylococcus Aureus (MRSA). Three more are a concern—vancomycin-resistant Staphylococcus Aureus; erythromycin-resistant Group A Streptococcus and clindamycin-resistant Group B Streptococcus.
Does this mean many infections can’t be treated?
In some cases, yes. According to WHO, antibiotic resistance to bacteria that cause life-threatening infections such as pneumonia, bloodstream infections and infections in newborns and ICU patients has spread to all regions of the world. WHO has also found that fluoroquinolones, a routine treatment for urinary tract infections, don’t work in more than half of patients in some countries.
Without effective antibiotics, people don’t recover as quickly and have a higher risk of dying. According to WHO, people with MRSA are 64 percent more likely to die than people whose infection responds to antibiotics.
While doctors can try older antibiotics that are rarely used, these drugs may cause serious side effects, such as kidney failure and deafness.
What can I do?
Minimize your use of antibiotics. First, don’t insist on or accept antibiotics without asking your doctor to confirm that you have a bacterial infection, advises Dr. Trivedi. “Give your doctor an opportunity to do testing to make sure you are only exposed to antibiotics if you need them,” she adds.
Be patient. It can take a week or more for a viral infection to ease. What you need to do is “get plenty of rest,” says Dr. Trivedi. “An antibiotic may not help symptoms at all.”
Speak up. Sometimes a viral infection can turn into a bacterial infection. Ask your doctor what the symptoms of a bacterial infection are. If you develop them, let her know.She can then confirm the diagnosis and prescribe an an appropriate antibiotic.
Finish your antibiotic prescription. “Usually people feel better before their course is finished and stop taking the drug,” says Dr. Trivedi.“Doing that gives organisms that have not yet been killed off to an opportunity to develop resistance.”
Don’t share antibiotics. It’s not going to make you feel better and will up your risk of developing a resistant infection.
Get an annual flu shot. Yes, the flu is a virus. But if you come down with it, you’re at risk for getting a secondary bacterial infection, or ending up in the hospital where you’ll be fair game for resistant infections. And if you catch the flu, you can transmit it to people who haven’t been vaccinated, putting them at risk for infection.
Get the pneumonia vaccine if you are 65 or older. Called the pneumococcal polysaccharide vaccine 23, it protects against 23 strains of bacteria that cause pneumonia. People ages 2 through 64 who have health problems also need the vaccine, so check with your doctor. Little ones younger than two need a different pneumococcal vaccine.
Wash your hands regularly.Whether you use soap and water or hand sanitizers, clean hands will reduce your risk of getting sick. Wash kids’ hands after daycare; wash your hands after visiting people in the hospital or nursing home or touching common surfaces such as ATM machines or grocery store carts
Buy antibiotic-free meats and poultry. Experts don’t know what percentage of antibiotic-resistance in humans is linked to the food supply, but “it does contribute in some way,” says Dr. Trivedi. So whenever possible, buy meats and poultry that are labeled antibiotic-free.