What does antibiotic resistance mean for the future?

DEAR DOCTOR K:

I’ve been hearing a lot about “antibiotic resistance.” What does it mean?

DEAR READER:

When penicillin was discovered, many people (including doctors) thought bacterial infections would become a thing of the past. Unfortunately, penicillin and other early antibiotics didn’t successfully treat all kinds of bacteria that make us sick.

Even worse, bacteria adapted to fight antibiotics. All they had to do was the thing they do best: Keep multiplying. Bacteria multiply so fast that one bacterium becomes millions in 24 hours.

When bacteria (and other cells) divide, mutations (changes in their genes) can occur. Sometimes these mutations allow the bacteria to resist antibiotics. And when they divide, they pass that antibiotic resistance on to their offspring. Now there are millions of antibiotic-resistant bacteria.

Let’s say that you get strep throat and your doctor prescribes penicillin. Strep throat is a sore throat caused by the bacteria called streptococci. The antibiotic (penicillin) will kill off most of the strep bacteria, but a few strep bacteria might develop resistance to penicillin, survive and multiply. They often remain alive in your throat. At first, there are not enough of them to cause trouble. But down the road they can cause another case of strep throat. This time, you might not respond to penicillin.

Antibiotic resistance is a serious problem, causing millions of illnesses and more than 20,000 deaths in the United States each year. Over time, if antibiotic use doesn’t change, antibiotics will become less able to treat common infections. We may be left with no drugs in our arsenal that can kill certain bacteria.

Overuse of antibiotics is the most common cause of drug-resistant bacteria. Many people demand antibiotics to treat viral infections. But antibiotics treat only bacterial infections. Viruses cause a sore throat more often than streptococci bacteria. Therefore, if you take penicillin for every sore throat, most of the time it won’t help you. And if taking penicillin causes penicillin-resistant bacteria to grow in your body, taking it could hurt you.

In the past, doctors routinely treated ear infections, bronchitis and other infections with antibiotics. But we now know that many cases of sore throat (those not caused by strep), bronchitis, and sinus and ear infections will get better on their own. (Though when you really have a strep throat, you need to take penicillin.)

We can all take steps to help slow the growth of antibiotic resistance — or even turn it around:

DECREASE EXCESS USE OF ANTIBIOTICS:

  • Don’t demand antibiotics. If your doctor says you don’t need an antibiotic, ask what else you can do to decrease your symptoms.
  • Don’t save antibiotics and start them again without specific instructions from your doctor.
  • Don’t share antibiotics with your friends and family.

PREVENT INFECTIONS:

  • Wash your hands regularly (with regular, not antibacterial, soap).
  • Sneeze into your elbow, not your hand.
  • Stay home from work or school if you are sick.
  • Stay up-to-date with your vaccinations.