Antibiotics were one of the greatest medical discoveries of the 20th Century. Untold numbers of lives were saved by the use of these medications. And they have greatly evolved to be effective across a broad spectrum of infections, some that we previously thought incurable. Soon, however, we may lose this valuable weapon we have in the battle against infectious diseases. One of the main culprits in the failure is the use of these medications when they are not warranted. When patients are sick, they want a pill to feel better. Doctors want their patients to be satisfied. What happens is that patients often insist in a prescription for antibiotics for things like viral infections. And doctors often give in to these requests when they should stand their ground and say no.
Superbugs are being seen more commonly these days. Bacteria that used to be easily killed with single antibiotics are now requiring 2 or even more to be effective. We are seeing many organisms now resistant to multiple different medications.
How is antibiotic resistance and superbug evolution dangerous?
– When a person takes an antibiotic without having a true infection that is being targeted, other normal micro-organisms develop a resistance to that antibiotic.
– When patients don’t complete a course of a prescribed antibiotic, they are not killing off all the microbes. Therefore, the remaining ones develop a resistance to the treating antibiotic.
– When resistance develops, the antibiotic no longer works to kill the infection. We are seeing a rapid rise in antibiotics that no longer work for a multitude of diseases.
– When these superbugs arise, we need to prescribe stronger antibiotics. The more we use these heavy hitters, the more we are increasing the possibility of resistance even with our strongest anti-microbials.
There have not been many new antibiotics developed over the past decade. The fact that superbugs are increasing and new tools are not being developed is a very dangerous interface. We will soon have superbugs that will overpower our ability to treat them if this trend does not change. Every parent wants the best for their child. When they take their child to the doctor, they feel reassured by the prescription for the antibiotic. However, this is actually much more harmful than doing nothing at all for the reasons mentioned above. Most infections that we see are viral infections, such as the common cold. There is no treatment for this. The only treatment for a virus is to just let it run its course and supportive care like bed rest and fluids. Patients need to understand that we are not withholding treatment from them when we do not prescribe an antibiotic. Rather, we are providing the best medical care we can and trying to curb the risk of bacterial resistance.
That being said, doctors need to step up and halt this trend. We are the prescribers, the healers. We are the most aware of the dangers this battle poses. We need to be able to stand our ground and say no when warranted. People may not be happy with us but we are not working in a customer service industry. We are tasked with curing diseases and saving lives. If we need to be seen as bad guys sometimes to do that, so must it be done. Because the alternative is much more fearsome.
Copyright secured by Digiprove © 2014 Linda Girgis, MD, FAAFP
