Issue of December 9, 2018

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Antibiotic resistance

Infections caused by bacteria range from mild to severe. Severe infections can cause sepsis syndrome in which major organs of the body can fail and the outcome may be serious or fatal. Antibiotics are used to treat bacterial infections but bacterial resistance to antibiotics is increasingly becoming a worldwide problem in the practice of medicine. Many bacterial infections are no longer responsive to the antibiotics that were used to treat them. Newer generations of drugs have been developed but bacteria rapidly adapt and become resistant.

Antimicrobials are prescribed by physicians based on several factors like the type of the infection, the causative organism, patient’s age and risk factors, and severity of the illness. The duration of treatment, dose, and drug combinations are determined based on guidelines issued by several medical organizations that govern the use of the drugs. Ultimately, the goal is to prevent resistance of bacteria to the effects of antibiotics.

Antibiotic resistance develops when bacteria that have been exposed to an antibiotic undergo mutations or changes so that the antibiotic can no longer weaken or kill them. This will make it hard for doctors to treat the infection.

Antibiotics do not have a role in the treatment of infections caused by viruses like the common cold, influenza, or sore throat. Fluids, bed rest, and medication for fever will suffice. Sinusitis and acute bronchitis may also start as viral infections not requiring any antibiotic. A doctor will not prescribe an antibiotic if the sinusitis lasts less than 10 days.

What can we do to prevent antibiotic resistance?

1. Take an antibiotic only when prescribed by your doctor. He or she will decide on what antibiotic to prescribe for your infection since not just any antibiotic can be prescribed for any infection. Your doctor has a list of the common bacteria that cause common infections and constant updates on antibiotic responsiveness or resistance. He will then do empiric therapy based on guidelines. If you do not improve, your doctor will reassess you and will consider working you up. This work up would include culture of your blood, urine, or the specific specimens he deems necessary to send for examination. Culture and sensitivity result will guide him on the use of a specific antibiotic.

2. When prescribed with antibiotics, you have to follow the correct dosage (eg: once a day, twice a day) and complete the duration of intake (eg: five days, seven days) even if you already feel better. Skipping doses and not completing the prescribed duration would allow the bacteria a chance to undergo mutations.

3. Do not use antibiotics prescribed to another person and do not let another person use an antibiotic prescribed to you.

Surveillance of antibiotic usage in medical institutions is being done worldwide. We can contribute to the cause through simple means since even “last-resort” antibiotics like Vancomycin do not work anymore in infections where it used to be very effective.

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