Antibiotics, more harm than good

How antimicrobial resistance will win if we don’t take action

Ever had a urinary tract, lung, ear or throat infection? I bet you have, and if you haven’t, you must have heard someone complain about having one. These infections are most commonly treated with antibiotics, and these treatments take quite some time to finish, resulting in a lot of moaning and sighing from the suffering patients. I do however hope that their general practitioner sternly told them to finish the whole course of treatment, even if the pain had subdued. I’d even vote for a health system in which antibiotic courses can only be taken in the hospital. But why am I so strict about antibiotic use?

The reason behind this can be summed up in only two words: antimicrobial resistance. At this  moment, 700.000 people die of antibiotic resistant infections each year, and this frighteningly high number is predicted to climb up to a devastating 10 million annual deaths by 2050. That’s more than 60% of the Dutch population! In 2005 there were already mentions of the world entering a post-antibiotic era, and in November 2015 scientists in China found a so called superbug: a bacteria that was able to shrug off the drug of last resort and had already spread into two other countries. So how exactly does this resistance work and what can we do to minimize the devastating effects of AMR?

Resistant bacteria use your body as their home

Most of the time, resistance comes from a part of the bacteria’s genetic code that is different from that of its little friends. This predisposition makes the bacteria more resistant to antibiotics and consequently, harder to kill. The stronger bacteria will survive the first couple of days of therapy and will make themselves comfortable in your body when treatment is stopped too soon. They will duplicate and spread without you realizing, resulting in a stronger bacterial population than before the start of treatment. This is why stopping antibiotic treatment prematurely is one of the biggest concerns in AMR.

To make matters even worse, these bacteria can transfer their lottery-winning genetic code to other bacteria, spreading their resistance to the medication. In low income countries especially, this puts a massive burden on health care. People can get the simple antibiotics without even seeing a doctor, which means that antibiotics are excessively used. However, since the access to more aggressive medicine is limited in these countries, the resistant bacteria which emerge cannot be treated properly, resulting in a wildfire-like spread.

Danger: Proceed with caution

Optimally, antibiotics should only be used when it is clear that the benefits for the patient outweigh the risk of resistance. Right now, antibiotics are used too often and carelessly, giving bacteria a free pass towards resistance. There should be a better balance between access and excess, which can be achieved by raising awareness. So, for the sake of the world, finish that antibiotics course if you ever need one.

Janeri