Antibiotics, Hero or Villain?

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It is very common to hear patients demanding for antibiotics (especially for common cold or cough) even for illnesses that do not require antibiotics at all (eg. viral infections). One of the most common misconceptions is that antibiotics are able to fight almost all kinds of infections. Patients should understand that antibiotics are INTENDED TO TREAT BACTERIAL INFECTIONS ONLY and NOT VIRAL INFECTIONS!

When antibiotics are frequently prescribed for viral infections, it will not act against the virus. Prescribed wrongly for bacteria infections on the other hand will result in the bacteria developing strategies to overpower it. Subsequently, antibiotic becomes less effective against the bacteria that they are intended to treat, thus contributing to antibiotic resistance.

While other types of drugs such as Aspirin work with the same efficiency today when compared to its initial launch in 1897, antibiotics lose their potency because of resistance by the antibiotic-resistant bacteria (otherwise known as “superbugs,”). This happens due to the natural selection in nature. Whenever micro-organisms are put under selective pressure (such as exposure to drugs), occasional mutant forms that are less susceptible to the drug survive and thrive. This reflects Darwin's theory of the "survival of the fittest". These bacteria are also informally called “superbugs” because they have developed the ability to inactivate antibiotics.

History tells us that in 1946, about 2 decades after his serendipitous discovery of the Penicillin (the first antibiotic) in September 1928, Alexander Fleming wrote that “the administration of too small doses (of penicillin) leads to the production of resistant strains of bacteria.”

Again, history tells us that mere few years after pharmaceuticals started mass-producing penicillin in 1943, resistant micro-organisms also started appearing. It is now 2012 and we have yet to learn the lessons from the pages of history. We still do all the things that contribute to antibiotics resistance. The simple act of over-prescribing practice (used in livestock feed, by medical professionals and by consumers merely to treat common cold!, not heeding the advice from pharmacists to finish the prescribed course of antibiotics, not being compliant to the prescribed doses are some of the reasons why "superbugs" continue to thrive!

In developing countries for example, less than 60% of children with acute diarrhoea receive necessary oral rehydration therapy, but more than 40% receive unnecessary antibiotics! We can see that allopathic doctors are becoming more generous these days in prescribing antibiotics even for minor cases!

In 2008, new resistance mechanism termed 'New Delhi Metallo-beta-lactamase-1' (NDM-1) was discovered among several gram-negative bacilli. (e.g. Escherichia coli and Klebsiella pneumonia). This bacteria strain is highly resistant to almost all antibiotics. There are only two last resort antibiotics that can help with this infection though it is not guaranteed. Furthermore, it has been discovered that the gene for NDM-1 is able to spread from one type of bacteria to another type of bacteria! For now, it has been a host to two types of bacteria (i.e. the gut bug E.coli which can cause urinary tract infections, and another that can invade the lungs called Klebsiella pneumonia); both can lead to urinary tract infections and blood poisoning.

While intially NDM-1-producing bacteria were limited to critical care units in hospitals, it has been discovered in drinking water in India some months later! A research by Dr. Timothy Walsh (the first person to discover the NDM-1 mutation in 2008) has suggested that about 10% of the people in New Delhi carry NDM-1 in normal flora in their guts! NDM strain has spread apparently from India to every single continent except South America and the Antarctic thanks to air travel!

Another type of resistant bacteria, Klebsiella pneumoniae carbapenemase (KPC), which had only one reported case in 2007 jumped to 259 new cases in the UK in the year 2011! Just this year, cases of totally antibiotic-resistant-TB were reported for the first time in Mumbai, India!

The numbers of these resistant micro-organisms are growing into a worrying trend. It is not surprising to know that the World Health Organisation (WHO) has highlighted antibiotic resistance as a major threat to public health in the 21st century. Center for Disease Control and Prevention (CDC) says that “almost every type of bacteria has become stronger and less responsive to antibiotic treatment when it is really needed.”

Over the past 60 years, 10 classes of antibiotics have been developed. Only two were developed over the last 40 years. It is very costly and time consuming to develop new antibiotics and there are only two pharmaceutical giants in the world that have extensive Research and Development to actively develop new antibiotics. We are racing against time to fight these "superbugs"!

History will be repeated if we continue to take antibiotics for granted. In the 14th century, antibiotics were inexistent to fight Yersinia pestis, the bacterium that caused the bubonic plague a.k.a the “Black Death” that wiped out almost a third of the European population! If we do not curb antibiotic resistance, it is only a matter of time before our people will not have antibiotics to treat various diseases. Many surgical procedures and cancer therapies are not possible without antibiotics to fight these infections. Resistance prolongs illnesses and leads to greater risk of death as well as escalation of cost.

Diseases that are now dominated by "superbugs" include staphylococcus infection, tuberculosis, influenza, candida infection and malaria. Names of some of the multiple antibiotic-resistant strains of bacteria include methicillin-resistant Staphylococcus aureus (MRSA) which causes a high percentage of hospital-acquired infections, Carbapenem-resistant Enterobacteriaceae (CRE), multi-drug resistant Mycobacterium tuberculosis (MDR-TB), Multi-Resistant Acinetobacter which causes hospital-acquired pneumonia, KPC, Pseudomonas aeruginosa (causes hospital-acquired pneumonia, urinary tract infection and blood infection), Streptococcus pneumoniae (causes community-acquired pneumonia) and Clostridium difficile (causes antibiotic-associated colitis).

Unfortunately in some countries, antibiotics are also misused to fatten livestock (non-therapeutic use) which are then fed to humans, thus aggravating the growth of "superbugs". In the United States, 80% of antibiotics are fed to livestock!

Some countries have stringent rules on the usage of antibiotics on livestock. There are also some countries that ban antibiotics from being used for non-therapeutic purposes. For example, Malaysian farmers are advised to wait for the antibiotic to be excreted (after treating the chicken with antibiotics for therapeutic purposes) before the chicken is sold.

If you think antibiotics-resistance is scary enough, let me tell you that bacteria are not the only ones that can turn to "superbugs". Even parasites, fungi, and viruses, can turn into "superbugs" leaving anti-fungals, anti-virals, and anti-malarials, which are used to treat them ineffective!

There is already growing resistance in the Plasmodium falciparum parasite (that causes malaria) to artemisinin-based drugs which is used for malaria treatment (almost half of those are infected with the resistant strain!) on the Thailand-Cambodia border.

There are some steps that we can take to prevent infections. One of them is surprisingly simple and is known to all (though not many may bother with it seriously!). This can simply be done through practising proper hand-hygiene. Make sure your physicians wash their hands prior to any physical contact with you. Also, wash your own hands with the correct technique especially when coming in contact with your wounds or any body part that may allow micro-organisms to enter (such as eyes, nose, and mouth) and wear a mask if you are coughing and sneezing. Remember to also have the courtesy not to cough or sneeze at other people’s faces!

Many do not know that the very antibiotics that they now take can help to kill them in the near future if they do not follow the simple instructions from physicians or pharmacists! It is important to note that if you do not take antibiotics according to the schedule, do not complete the full course or share antibiotic medication, the antibiotic may not properly eradicate all the bacteria. This then leaves some bacteria alive and they therefore become “resistant” to future antibiotic treatments.

So, strictly adhere to the instructions given, i.e. completing the full course and do not take extra or skip doses. Taking recommended doses for the full course is very important! Otherwise, low doses may allow moderately resistant bacteria to survive and spread. One of the most common mistake committed by patients is also to stop taking the full course of antibiotics just because you are already beginning to feel better.

Antibiotics are prescribed on individual basis. Do not self-prescribe antibiotics. The medication prescribed for patient A is based on the doctor’s diagnosis for him/her alone. Therefore, the antibiotics given to patient A should never be shared with others even if they seem to experience similar symptoms.

Some antibiotics should not be consumed with certain foods or drinks, while others should not be taken when there is food in the stomach. It cannot be stressed enough that it is indeed important to follow the instructions correctly for the antibiotics to work effectively. If we don’t act now, there will be no antibiotics left for our children. Please take responsibility to prevent antibiotic resistance. Each one of us have the power to prevent future generations from dying from the infections that we now take for granted. Educate others by spreading this message and make this world a safer place for everyone!

“Bacteria are becoming more and more resistant as more and more antibiotics are being used – and they’re becoming smarter,” said Dr. Joseph Rahimian, an infectious disease specialist at Village Park Medical in New York City.

Author: Silambarasu Karuppiah 

Copyright © 2012 Sandhya Maarga Holistic Living Resources 
Holistic Living Annex (SEPTEMBER 2012)

9 Responses for “ Antibiotics, Hero or Villain?”

  1. Orsten says:

    Very good article! More people should know about this. I shared on Facebook.

  2. Rowena Dais says:

    I never liked finishing my antibiotics. Have always thought that there wasn't really a need to it and I thought that the docs were just ripping me off! This was truly enlightening. Keep up the good work.

  3. Kimi Ong says:

    We don't need supermeds to counter superbugs. We just need superbrains to keep superbugs away!! A healthy body is a result of a healthy mind. What about alternative medicine? Can alternative medicine help treat people who are infected with resistant bacteria?

  4. Laxmi says:

    We get antibiotics for almost everything here in India. How would the doctor know if it is a viral or bacteria-related disease? Can you shed us some light Mr. Karuppiah?

  5. Penny James says:

    @Kimi - I don't really know for other alternative medications. But I guess the concept of alt med is basically to restore the body back to a healthy vibrational state. If it works in a vibrational way, I don't see why not?

  6. Hailey says:

    This is scarrrrrrrrrrrrrrrryyyyyyyyyyyy! What happens to those who become antibiotic-resistant? THEY DIEEEEE?

  7. baxter says:

    hello World. let us all pRepare to bE wiped out from the surface of eARth! Probably that was what was meant with the end of the Mayan calender 12/12/12. No sinking of ships or icebergs or other shit! Our end is near because the pharmaceutical industry cannot come up with newer antibiotics in time to fight of these stupid bacteria!

  8. Dreamer says:

    Good article. Very informational. I've never known why I was supposed to finish the course of antibiotics, but I do now. Much thanks to the author.

  9. Faiz says:

    All doctors prescribe around the same medication for cold/flu! They always give antibiotics in Malaysia. I think the doctors couldn't care less about this or are they uneducated about this matter??! They should probably hire more professional pharmacists in their clinics to advise them on such an important thing!! Every little thing, antibiotics! They spent so many years studying medicine and just for money, they simply prescribe antibiotics!!! I think they must make a hell lot of money out of antibiotics, don't they?? That's why we say that doctors are the number 1 killers!


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