Taking antibiotics for granted

Taking antibiotics for granted

By Richard P. Holm, MD

We take a lot of things for granted. With the advent of antibiotics in the 1930s and 40s, we saw a true change in longevity and a reduction in premature death from infectious diseases. Now we are seeing deaths from bacteria which are resistant to every antibiotic and it’s not just the sick and decrepit who are affected. Recent studies show many more people are dying in the U.S. from antibiotic resistant bacteria than from AIDS. It’s a real crisis resulting from too much of a good thing.

Resistance is due to excessive and over-use of antibiotics, which are often incorrectly seen as the cure for whatever ails us. The most glaring example is when antibiotics are given for what is obviously the common cold, making absolutely no difference in the course of the illness. Often, I hear from the patient, “Why not start an antibiotic to keep this viral bronchitis from turning into pneumonia?” To that question I usually answer, “You are correct, when bacterial pneumonia occurs, it often follows a common cold, but studies show antibiotics don’t prevent the occurrence of that pneumonia following the cold. Rather, it becomes a pneumonia resistant to treatment.”

So why are we over-using antibiotics? Most experts say it is from patient or parent expectation. One study showed that if the doctor perceives the parents expect antibiotics for their children, 65 percent of the time the doctor will prescribe antibiotics. Conversely, when parents do not indicate an expectation for antibiotics, even when the children are similarly ill, the doctor prescribes them only 12 percent of the time. Ultimately the doctor is responsible but too often yields to pressure to provide unnecessary treatment.

Another reason for growing antibiotic resistance has resulted from use of antibiotics in animal and poultry feed which boosts animal growth and profits. In the U.S. antibiotics are now limited for use only when a veterinarian prescribes them, but similar limits are not in effect in India and other countries. Also, veterinarians are prescribing the newer broader spectrum antibiotics only for the care of sick individual animals, not the entire herd. These new moves are a start, but closer monitoring of usage needs to occur. The good news is that in countries where efforts to use fewer antibiotics are successful, within a few years, antibiotics become effective again.

Based upon current science, rather than expecting an antibiotic from the doctor, it’s in our best interest to discuss options and use antibiotics only when they are necessary. We can also benefit by taking time to read food labels carefully, choosing antibiotic-free products.

Let’s not take antibiotics for granted. By avoiding the overuse of antibiotics, we can save ourselves from a real crisis.
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