Invented in 1928 by Alexander Fleming, antibiotics have been saving countless lives, turning deadly infections into treatable conditions. Antibiotics opened the possibility for surgeons to perform major surgery, for cancer patients to undergo heavy chemotherapy and for transplant patients to take drugs that suppress the immune system. All these therapies would be dangerous if we did not have antibiotics as a powerful tool available to treat infections.
But this powerful tool is under threat from a silent, growing pandemic called antimicrobial resistance (AMR). All over the world, bacteria are building up defenses against the medicines we designed to kill them.
Bacteria
Antibiotics are designed to kill or stop the growth of bacteria. However, our misuse of these drugs is making more resistant and more difficult (and more expensive) to treat. When antibiotics stop working, simple infections can once again become life-threatening.
One of the biggest misunderstandings is that antibiotics cure infections or ‘a fever’. In truth, they are useless against the common cold, the flu, or most sore throats and most middle ear infections in children, as these infections are often caused by viruses, not bacteria.
Taking antibiotics for a viral infection won’t help you get better, but it does give the bacteria in your intestine and on your skin (the so called ‘microbiome’) a chance to encounter the drug and learn how to resist it and it can cause side effects such as diarree and cramps from killing the ‘good bacteria’ in your gut.
Furthermore, many bacterial infections are mild and are not treated with pills of antibiotics. An example is a toenail infection which is treated with local woundcare and antiseptic ointments. So, not every bacterial infection requires antibiotics and It is up to a doctor to make that decision if a course of antibitiocs is indicated.
Each antibiotic has a specific range of bacteria for which it works and for which it never works.. This is typical knowledge trained to undergraduate medical students, and doctors have very clear guidelines (think of it as a cookery book with all recipes in it) to follow.
On the other side, bacteria might develop resistance to certain antibiotics and in some circumstances, only lab testing can determine if an antibiotic in a sick patient will work or not. Using the wrong antibiotic, or the wrong dose, can be ineffective and unnecessarily exposes bacteria to the drug, encouraging resistance.
Antibiotics in the environment
When taking antibiotics, human bodies don’t break them down completely. The remnants of these drugs, along with any resistant bacteria we might be carrying, are flushed down the toilet after urination, entering the sewer system. While our wastewater treatment plants are advanced, they aren’t designed to filter out these drugs and resistant germs. This causes significant amounts of antibiotic residue and drug-resistant bacteria are released into rivers, lakes, and oceans.
Once in the environment, these antibiotic residues act as a «training ground» for naturally occurring bacteria. They are constantly exposed to these drugs, encouraging them to develop resistance. This resistance can then be shared with other bacteria and this will affect plants, fish and birds. Larger animals often eat these and so the resistance spreads to larger animals. Eventually, these resistant bacteria can find their way back to us through the water we swim in, the crops we eat and the animals that live around us, completing a dangerous cycle.
Tips to stop AMR
Protecting antibiotics is a shared responsibility. Here are five golden rules to follow:
- Only take antibiotics that have been prescribed by a dcotor specifically for you and your current illness.
- Discard antibiotics if a blister pack or a bottle is not finished during a course of antibiotics.
- Return the leftover antibiotics to the pharmacy.
- Never use antibiotics ‘from a previous infection’ and never share antibiotics with a family member or friend.
- Never flush old or unused antibiotics down the toilet or sink.
By handling these precious medicines with care, we can help ensure they remain effective for ourselves, our children, and future generations and we keep our own bodies healthy.