What is antibiotic resistance?
Antibiotic resistance — or antimicrobial resistance — occurs when standard drugs used to fight infections are no longer effective. Most of the time, we live in harmony with the many trillion bacteria in our body. In some cases, however, these organisms can enter our blood stream, invade our skin or otherwise cause an infection. When this happens, the usual treatment is to prescribe an antibiotic, but in the case of antibiotic resistance, the typical medications do not work. Because first-line drugs are not effective, infections caused by antibiotic-resistant infections are difficult to treat and they can cause serious disease.
What causes antibiotic resistance?
At the level of the individual germ, there are several ways that these organisms can develop resistance such as making enzymes to destroy the antibiotic, changing their cellular metabolism so that the antibiotics no longer work, pumping drugs out of the cell or changing the places where antibiotics attach to the cell wall. Many genes have been identified which can be transferred between bacteria to convey antibiotic resistance. These changes mean that the drugs we use to treat serious infections are no longer effective.
The big picture is that there are societal causes of antibiotic resistance. For example, antibiotics can be used when they are not needed and this causes bacteria to become resistant. This happens in the community and in healthcare settings when antibiotics are requested and prescribed needlessly. These drugs also can be used inappropriately. When they are not needed, over-use of these antibiotics can cause resistance.
How problematic are antibiotic-resistant infections?
Antibiotic resistance has been called a public health crisis of global proportions. In fact, more people die from antibiotic-resistant infections than die from car crashes, AIDS and the flu combined. What is really scary is that as antibiotic resistance spreads, we are seeing the emergence of “superbugs” for which there are no antibiotics that will work. Along with this, there are fewer new antibiotic drugs that are being developed, so there are fewer treatment options. We live in a highly mobile world, so the rapid spread of antibiotic resistant bacteria is an important public health problem. These factors contribute to what has been called the perfect storm of antibiotic resistance.
What can be done to prevent antibiotic-resistant infections?
All of us play an important role in addressing antibiotic resistance. If an antibiotic is taken when not needed, it can cause resistance in bacteria that can spread throughout the community and cause serious life-threatening diseases. Thus, we all need to take responsibility for careful use of these medications and use them only when necessary. We need to start thinking of antibiotics as a “natural resource” like air or water and be careful to use them only when necessary. Just like we try to conserve water or recycle, we should conserve the use of antibiotics.
In the hospital, there are lots of things we do every day to prevent the spread of antibiotic-resistant organisms such as cleaning, careful use of antibiotics, using sterile equipment and wearing gowns and gloves when needed. One of the biggest weapons we have against antibiotic resistance is hand washing and using hand sanitizer.
Taking personal responsibility for our health is an important means of preventing resistance.