Antibiotic Overuse & Abuse/March 2010
Is
prevalent especially during the season of acute respiratory infections and may have
dangerous consequences.
Ever
since their inception in the early part of the last century, antibiotics have been
overused and abused all over the world.
However, antibiotic abuse has become more prevalent with time and is
increasingly causing serious personal and ecological health-related problems.
Antibiotics
are agents that kill or inactivate bacteria but lack activity against viruses
and fungi. When used
appropriately, these anti-bacterial
agents can be life saving but when used indiscriminately they can endanger life
and the ecology.
The
commonest disorders that invite antibiotic abuse and overuse are the acute
respiratory infections that present as head and chest colds. These combination syndromes, (which
encompass head congestion, runny nose, cough, sore throat, discolored sputum,
discolored nasal discharge, and mild fever) are caused by viruses and do not
respond to antibiotics. With very
few exceptions, bacteria, which primarily cause localizing infections such as
sinusitis or pneumonia, are incapable of the rapid, widespread invasion of the
entire respiratory tree that viruses seem to accomplish so effortlessly.
Nevertheless,
secondary bacterial infections, which are bacterial infections that develop on
top of the primary viral illness, can occur in vulnerable individuals such as
smokers, asthmatics, or those who have seasonal allergies, chronic lung diseases,
or otherwise weak lungs or sinuses.
Such antibiotic-responsive infections should be suspected in these
individuals but appropriate medical evaluations should be undertaken before
antibiotics are prescribed.
Situations that might be caused by secondary bacterial infections
include the following:
a)
High fever and shortness of breath—suggest bacterial pneumonia.
b)
Yellow nasal discharge or yellow sputum beyond the second or third week of the
viral respiratory illness—suggest bacterial bronchitis or sinusitis.
c)
Severe sore throat that occurs in isolation with no associated nasal or
bronchial symptoms—suggests streptococcal infection.
d)
Cough that persists beyond the third week of a respiratory viral
illness—suggests smoldering bacterial sinusitis or bronchitis.
e)
Ear ache, especially if unilateral and severe—suggests bacterial ear or eardrum
infection.
Some
of the serious consequences of antibiotic overuse and abuse include the
following:
a)
Bacterial resistance, which means that the bacteria, because of repeated
antibiotic exposures, have evolved defenses that protect them form the deadly
actions of antibiotics. Such
evolved, antibiotic-resistant bacteria often cause life-threatening treatment
failures. A patient with pneumonia
who should promptly respond to penicillin deteriorates while on treatment, ends
up on the respirator, and may die because no antibiotic can be found that can
cure the infection. Another
patient who has a staphylococcal skin infection may become septic while on
treatment because the skin bacteria manage to invade the blood and cannot be
stopped. Etc…
b)
Bacterial epidemics, which mean that bacteria that used to attack one person at
a time have become so immune to the antibiotics that they now attack many persons
at the same time. Such epidemics
in hospitals and intensive care units have caused many deaths and are hard to
stop unless the contaminated hospital wards or intensive care units are closed
and antibiotic use is temporarily suspended.
c)
Antibiotic colitis is a condition where the protective, normal bacterial flora
of the colon is displaced by aggressive bacteria that invade the colon,
contaminate the environment, and spread to others who are not taking
antibiotics. If untreated,
antibiotic colitis may destroy the colon and cause death.
Under
mounting antibiotic pressure, displacement of our environmentally friendly
bacteria by unfriendly, destructive bacteria has been occurring globally over
the past one hundred years. These
unfriendly bacteria have spread through sewage to underground waters and have
contaminated our entire ecosystem.
The consequences of this ongoing, antibiotic coup d'état are yet to be fully understood.
Bacteria,
because of their ability to multiply rapidly, are capable of evolving
resistance to our antibiotics at a much faster rate than we can develop new
antibiotics against them. This race between
bacteria and man is nearing its end and, from all indications, bacteria will be the
sure winners unless we learn to use antibiotics more responsibly.