Do antibiotics treat every illness? Should you use antibiotics every time you get a sore throat? The answer is NO. Popping an antibiotic unnecessarily can do more harm than good. Here, we bring focus on some important facts about antibiotics and learn how to use them properly.
Though almost all of you would know what an antibiotic is, only a few would be aware about a broader term called antimicrobials. Antibiotics are the medicines that work against bacteria, while antimicrobials are the medicines that kill or slow the spread of various microorganisms including bacteria, viruses, protozoans, and fungi. Many a time, these terms are used interchangeably.
When a germ develops the ability to defy the impact of the medicine, rendering it ineffective, this is called antimicrobial resistance. Bacteria or fungi that have developed the ability to resist commonly prescribed medicines are called superbugs.
The threat is too serious
The spread of AMR could make many germs much more lethal in the future than they are today. It is not difficult to understand that if antibiotics fail to cure serious bacterial infections, more people will not get well even after consuming antibiotics, and the risk of complications and death increases substantially.
AMR is a leading cause of death around the world. Globally, antibiotic-resistant germs killed more than 1.2 million people in 2019, according to a new estimate published recently in the Lancet. The Review on Antimicrobial Resistance, commissioned by the UK Government, argued that AMR could kill 10 million people per year by 2050.
A latest guideline issued by the ICMR (Indian Council of Medical Research) warns against the use of antibiotics for conditions such as low-grade fever and viral bronchitis. Furthermore, it advises the treating doctors to follow a specific timeline while prescribing them and reduce duration of antibiotic use for some infections.
Resistance happens naturally,
then how does misuse of antibiotics contribute to AMR
While antibiotics attack the bacteria and kill them, not all germs get succumbed. Some bacteria and fungi have natural defense strategies to fight back and survive. Such antimicrobial-resistant germs continue to multiply. Not just this, they can spread their medicine-fighting traits to other germs, even the ones that have not been exposed to the antimicrobials.
In a nutshell, though antimicrobial resistance (AMR) is a natural process in bacteria, antibiotic misuse and overuse make it worse. The presence of antibiotics and antifungals pressure bacteria and fungi to adapt, spread and make resistant germs more common.
The more irrationally we use antibiotics, the more chances germs have to develop resistance to them. Not just misuse but also excessive inadvertent use of antibiotics as well as incomplete course of prescribed antibiotic leads to AMR.
Reality check: The discovery void
It can take 10-15 years and over $1billion to develop a new antibiotic, as per the analysis. On the other side, some studies have shown that bacteria can begin to develop antibiotic resistance as early as 11 days. Though this duration cannot be generalized as different types and strains of bacteria behave differently, it is sufficient to give a reality check on the challenges of antibiotic discovery and emergence of superbugs.
Researchers discovered the last class of highly effective antibiotics in 1987. No new major classes of antibiotics have been discovered in the last 30 years. Many scientists refer this period as the “discovery void”.
The story of tuberculosis
Tuberculosis had been one of the major threats to humankind. It was not until 1944 that an effective antibiotic therapy (streptomycin) became available. Going in line with the scientific predictions, some people with TB were found to have forms of TB bacteria that were resistant to treatment with streptomycin. Over the next two decades, additional anti-TB drugs were introduced, such as isoniazid, and rifampin. But as the newer medicines kept getting discovered, so did the appearance of TB strains that were resistant to one or more drugs.
In 1956, strains of TB that were resistant to more than one class of antimicrobials (streptomycin, para-amino salicylic acid (PAS), and isoniazid) were discovered. That led to multi-drug resistant TB and the term MDR-TB was coined. In subsequent years, when strains with resistance to an even greater number of antibiotics were found out, they were eventually called “extensively drug resistant TB” (XDR-TB)- possibly leading to Totally Drug Resistant TB (TDR-TB).
Numerous outbreaks of drug-resistant tuberculosis occurred between 1970 and 1990. The story of TB has been a grim reminder that resistance remains a challenge despite the medical advancements.
7 simple and doable ways to stop Antimicrobial Resistance (AMR)
We can all do our part in stopping antibiotic resistance by using antimicrobials wisely. Here are 7 simple ways:
1. Use antibiotics ONLY when prescribed by your doctor, and strictly adhere to the dose and duration as advised.
2. Don’t skip doses. Antibiotics work best when taken as prescribed. Never start or stop its use without consulting your doctor.
3. Never use antimicrobials prescribed to others even if your symptoms appear similar. It may not only delay the treatment but can make it worse.
4. Always speak to a doctor before taking antibiotics. Clarify if you have any doubts about antibiotics.
5. Don’t save antibiotics for the future. A medicine that works on current infection might not be suitable for future infections. Taking the wrong medicine can delay recovery and may even worsen your infection.
6. Don’t take antibiotics for sore throats, colds, and runny noses, even if the mucus is thick, yellow, or green. These are mostly viral infections. Antibiotics fight bacteria, not viruses.
7. Get your vaccine shots. Certain bacterial infections can be effectively prevented through vaccinations, so you won’t need to take antibiotics. Get yourself and your family vaccinated against diphtheria, whooping cough, and other such bacterial infections.
Primary vaccinations, as well as timely booster shots, help keep your immunity levels up, protecting you from diseases.
Find your vaccines here
The bottom line
Other than causing antibiotic resistance crises, misuse and overuse of antibiotics may even lead to unnecessary and harmful side effects. The best person to determine whether you need an antibiotic for your infection is a doctor.
Always consult a doctor before taking an antibiotic.
Talk to an expert
(The article is written by Dr. Swati Mishra, Medical Editor and reviewed by Dr. Rajeev Sharma, Vice President (Medical Affairs))
1. Online available at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext
2. Online available at https://www.wipo.int/edocs/mdocs/mdocs/en/wipo_who_wto_ip_ge_16/wipo_who_wto_ip_ge_16_www_356156.pdf
3. Guidelines for Antimicrobial use.ICMR. Online available at https://amrtg.icmr.org.in/chapter1.html