Modern medicine has given us antibiotics, our go-to-first line of defense. They are not for viruses like common cold or a flu but when you are down with something serious like pneumonia, bronchitis, etc, there is a need for something serious; something potent to kill of the bacteria and get well.
The problem is that bacteria have become increasingly resistant to antibiotics, making the antibiotics that you readily get from your doctor less effective. Antibiotic resistance occurs when targeted bacteria show resistance to an antibiotic, continuing to thrive and multiply, even in the presence of an antibiotic’s therapeutic levels.
What is selective pressure in antibiotic resistance?
Selective pressure is an antibiotic influence on natural selection where susceptible bacteria, or those having low chance of survival, are killed or inhibited by the antibiotic while the resistant strains of bacteria are allowed to survive. However, sometimes, the natural selection to promote resistance to antibiotics is influenced at a low level without human action – bacteria have the ability to produce and use antibiotics against other bacteria.
Nonetheless, today’s higher level of antibiotic resistance is solely due to antibiotic abuse or overuse. It’s common in some countries to purchase antibiotics over the counter or take unnecessary dosages to treat viral illnesses, such as the common cold.
A matter of concern
Whether it is about protecting people from different classes of bacteria or saving countless number of lives since the first antibiotic (penicillin) was clinically used in the 1940s, antibiotics have a significant attribution in the human health history. However, their efficacy has become vulnerable, giving rise to drug-resistant bacteria.
Much of the effectiveness of antibiotics is threatened in the modern food animal industry by the use of low doses of antimicrobials for faster growth of livestock and poultry animals, and to compensate for unhygienic environments they are raised in. This encourages bacteria to resist drugs, and such drug-resistant bacteria come in contact with the general public, either through food, animal or human carriers.
1 death every 3 seconds all around the world
This is a dangerous statistic which will soon become a reality by 2050 if countries don’t take immediate action to control antibiotic resistance. ResistanceMap, a highly visual and interactive online platform, shows the current trends in antibiotic resistance around the globe, including the USA, Europe, and low & middle income countries (LMICs):
- USA: 2 million serious illnesses, 23,000 deaths, $20 billion additional annual medical costs
- Europe: 25,000 deaths, €1.5 billion direct and indirect annual costs (EMA and ECDC 2009)
- India: 58,000 neonatal sepsis deaths (Laxminarayan et al. 2013)
- Tanzania and Mozambique: Increasing deaths of neonates and children under 5 (Kayange et al. 2010; Roca et al. 2008)
- Worldwide: 935,000 deaths of children under 5 due to pneumonia (2013)
The 2000-10 data of 71 countries reveals that global antibiotic consumption has grown from 50 billion to nearly 70 billion standard units, which is more than a 30% increase. Eighty percent of antibiotics are used in the community of most nations, whether prescribed by healthcare providers or not, and 20% are used in hospitals and other facilities (Kotwani and Holloway 2011).
The Journal of the American Medical Association’s new report concludes that doctor’s offices, clinics and emergency rooms in the USA prescribe 30% unnecessary antibiotics.
Rare antibiotic resistant E. coli “superbug” detected for the first time
“The medicine cabinet is empty for some patients,” said Dr. Tom Frieden, director of Centers for Disease Control and Prevention (CDC). “It is the end of the road unless we act urgently.”
Frieden recently signaled a warning sign for the USA when rare mutant Colistin-resistent E. coli was found in a 49-year-old Pennsylvania woman at Walter Reed National Military Medical Center. Colistin is a last resort antibiotic most physicians use when all other antibiotics don’t work against a bacteria. A similar strain of the antibiotic resistant bacteria was found in a pig intestine by the U.S. Department of Agriculture (USDA).
There is the danger of a potentially unstoppable superbug being produced if Colistin-resistent E. coli interacts with other bacteria that only respond to Colistin.
The CDC reports a minimum 2 million cases of infection from other antibiotic resistant bacteria each year and 23,000 consequent deaths to say the least. World Health Organization (WHO) warns about one of the biggest threats to global health due to antibiotic resistance.
10 superbugs which can cause 10 million deaths each year
- Gonorrhea 350,000 cases in the USA in 2014, shows resistance to 5 common antibiotics. The sexually transmitted disease now shows resistance to the only two antibiotics left to treat it, i.e. azithromycin and ceftriaxone, according to CDC. There is an overall increase in sexually transmitted diseases in the USA according to a report.
- Enterococcus: An ESKAPE pathogen which resists vancomycin antibiotic.
- Staphylococcus Aureus: Multidrug resistant Staphylococcus aureus (MRSA) causes 64% more deaths than its non-resistant form.
- Klebsiella: A high level of Carbapenem-resistant bacteria.
- Acinetobacter: Commonly infects patients in intensive care unit (ICU) and other healthcare settings.
- Pseudomonas: Responsible for around 51,000 healthcare associated infections (HAIs) in the USA each year.
- E. coli: Now shows resistance to fluoroquinolones, common oral antimicrobial drugs for urinary tract infections (UTIs).
- Mycobacterium Tuberculosis (TB): India reported total resistance to all TB drugs. 480,000 MDR-TB (multidrug resistant) cases worldwide and XDR-TB (extensively-drug resistant) cases in 100 nations in 2014.
- Influenza: Type A and B influenza cause 250,000 to 500,000 deaths and 3 to 5 million cases of serious illness each year.
- Typhoid Fever: Affects 21 million worldwide population and causes 222,000 deaths (mostly children) each year.
Your part to playing antibiotic stewardship to avoid antibiotic resistance
Did you know? Antibiotics are prescribed by 95% of doctors in clinics without being absolutely sure if they are really required. Does that blame only the clinicians? Or do you also shoulder some responsibility as an antibiotic consumer? Well, a surveys says antibiotics are misunderstood as effective viral infection treatment by 36% of Americans while another reveals the U.S. as 46% of worldwide antibiotic market.
Take no shortcuts to heal
Right from our ancestors to doctors, they all think “rest” is the best remedy to speed up the healing process or stay fit. But we never take the time to see ourselves out of sickness, which is actually the ideal way. Most of us rely on antibiotics to clear up faster. However, the deal is: pay now in time or later with chronic problems.
Be your own advocate at doctor’s office
1 in 10 doctors would definitely prescribe you an antibiotic. At least of 10% of physicians don’t think it’s a big deal to give antibiotics even if they’re not required. With such scary numbers to tell, you ought to be your own health advocate these days! Ask if your illness is really bacterial, tell them you don’t preferably demand antibiotics, and choose a hospital which practices antibiotic stewardship.
Use antibacterial cleaning products at minimum
“For routine day in and day out use, at my house I use a nice soap that smells like flowers. That’s fine. You don’t need anything special,” said deputy director Dr. Michael Bell from CDC.
Don’t become obsessed with antibacterial products! Most regular soaps or alcohol-based sanitizers are natural antibiotics and suffice the need to keep you safe from bacteria.
Check the meat you shop at grocery stores
The bacteria on raw meat can be life-threatening. CDC reports approximately 48 million Americans food poisoned every year. Protect yourself and the community by choosing only “antibiotic-free” meats. Avoid cross-contamination of other foods when handling or cooking meat by washing your hands thoroughly during and after preparing food.
Stick to alternatives whenever possible
Sometimes, even chronic or acute infections can be dealt with natural remedies instead of antibiotics, provided you are observed by a skilled herbalist or integrative MD. Viral and bacterial infections also respond to diet change and natural supplements.
Get on Get Smart
It’s a great resource made available by CDC to avoid unnecessary doctor visits or premature consulting, and eventually taking unnecessary antibiotics.
Featured photo credit: Mkcassidy75 via flickr.com