I’ve heard so much about antibiotic-resistant bacteria, and how overuse of antibiotics has caused this problem. What can I do to help fix it or to stop it from getting worse?
This is an important question. We often hear about problems like antibiotic resistance, but rarely do our information sources tell us how we can help. The truth is that there is little we can do to reverse antibiotic resistance once it develops. However, there is a lot that ordinary people can do to help keep it from getting worse.
Antibiotic resistance has developed through evolution. When a population of bacteria is exposed to an antibiotic, the drug kills the weakest (least resistant) bacteria first. This leaves only the most antibiotic-resistant ones to survive and reproduce. With bacteria as with people, offspring tend to resemble their parents. So, drug-resistant bacteria have drug-resistant offspring. Thus, ideally, we need to kill either all of the bacteria, or none of them. Antibiotic resistance develops when we kill only some of the bacteria (the non-resistant ones) and leave the resistant ones to survive and multiply.
Thus, for any given infection, there are two possible solutions. One is to not kill any of the bacteria (i.e., not to use antibiotics). This way, the resistant bacteria won’t have any sort of advantage over the non-resistant ones. The other solution is to use antibiotics, but to make sure that ALL of the bacteria — resistant or not — are eliminated. Even relatively resistant bacteria may not survive a long course of antibiotic treatment. Which of these approaches you should use depends on what type of illness you have.
First, if your infection is viral, you don’t need antibiotics. They only kill bacteria, not viruses. So they will do you no good, but will still set to work on whatever random bacteria you happen to be carrying around, killing the weak ones and leaving more room for resistant bacteria to breed. If your infection is bacterial but is relatively mild (is not a serious health threat and is likely to go away on its own), your doctor may advise you that antibiotics are unnecessary. This approach has a number of advantages. For one, you avoid the often unpleasant side effects of antibiotic drugs. Avoiding antibiotics also allows your immune system to fight the infection and in doing so, to develop antibodies so that the same bacterium won’t be able to make you sick again. Finally, antibiotics kill not only the harmful bacteria in your body, but the useful ones as well (like those that help you extract nutrients from your food). Avoiding antibiotics will spare the lives of these ‘good guys’.
If the infection is bacterial and is more serious (say, an infected surgical wound as opposed to an infected hangnail), is unlikely to get better on its own, or if it persists for more than a week or so, then antibiotics are probably a good idea. In this case your doctor will base his or her strategy on the “make sure they’re ALL dead” theory. This means taking the FULL course of the antibiotic. You should never, ever, have any leftover antibiotic medication. Don’t stop taking the drug just because you feel better; some of those resistant bacteria are probably still alive in your system (even if you can’t feel them), and they can breed an army of resistant offspring faster than you can possibly imagine.
Your doctor is usually the one who will decide which approach is most suitable. But it’s a good idea to let him or her know that while you want to get better, you’re also concerned about antibiotic resistance and don’t want to take these drugs unless they’re necessary. Most doctors are so accustomed to patients demanding antibiotics — even for viral infections or mild bacterial ones — that they will be impressed by your attitude and will be pleased to discuss the best options with you.
By using antibiotics wisely and only when they’re necessary, we can all help ensure that they will still work when we really need them to fight a serious, life-threatening infection. Thanks for writing,
E-mail your questions to Heather at firstname.lastname@example.org. Some submissions may be edited for length or to protect confidentiality: your real name and location will never be printed. This column is for entertainment only. Heather is an AU student offering objective advice to her peers; she is not a professional counsellor and this column is not intended to take the place of professional advice.