You may have wondered why your general practitioner recommended (and declined) against antibiotic prescription for your cold, or any other illness that you may have thought could be helped by taking antibiotics. Among other reasons which will be detailed later, it is mainly due to antibiotic resistance, and unlikely significant bacterial involvement.
Bacteria and antibiotics
Hold on. Aren’t all infections treated with antibiotics?
This may be a question you have asked yourself.
Let’s talk about bacteria and antibiotics.
Bacteria are single-celled microorganisms that exist everywhere, from soil to the human gut, and can be beneficial or harmful to health.
Unlike bacteria, viruses are not cells but small particles that require living hosts to multiply, often causing diseases.
Fungi, which include molds and yeasts, are complex organisms that can live as single cells or as multicellular organisms, and they play various roles in decomposition, fermentation, and sometimes infections.
Protozoa are single-celled organisms with more complex structures than bacteria, often found in water and soil, and can cause diseases in humans.
While bacteria, viruses, fungi, and protozoa can all be pathogens, their structures, life cycles, and ways of causing disease differ significantly, necessitating different types of treatments for infections they cause.
Antibiotics are used to treat bacterial infections.
Antivirals, such as Paxlovid used in treating CoViD-19, treat viruses.
Anti-fungals treat fungi.
Which mean, not all infections require antibiotics to treat them.
What is antibiotic (antimicrobial) resistance?
Antibiotic resistance happens when the germs that make us sick, like bacteria, become immune to the medicines we use to kill them.
Imagine if you had a magic eraser that could wipe out all the bad bugs that make you sick. But over time, some of these bugs figure out how to dodge your eraser. Now, your magic eraser doesn’t work on them anymore.
That’s what happens with antibiotic resistance. The more we use antibiotics, especially when we don’t really need them, the more chances these bugs have to learn how to beat them. So, when we really need the antibiotics to work, they might not. This can make simple infections harder to treat and can make medical procedures more dangerous.
This resistance makes it harder to treat bacterial infections and increases the risk of disease spread, severe illness, and death.
New Zealand, like other countries, faces challenges with bacteria such as MRSA (methicillin-resistant Staphylococcus aureus) and increasing resistance in common bacteria that cause urinary tract infections, pneumonia, and bloodstream infections.
Causes and Challenges
- Antibiotic Use in Healthcare: There is an ongoing effort to ensure antibiotics are prescribed only when necessary and that the correct antibiotics are used to minimise the development of resistance.
- Agricultural Use: New Zealand has a significant agricultural sector, and the use of antibiotics in livestock is a concern for the development of resistance. There are regulations and guidelines to minimise overuse and misuse of antibiotics in animals.
Other important points
Some infections including bacterial infections go away on their own. Which means they do not need antibiotics although sometimes us doctors can get the severity wrong and the infections worsen.
Antibiotics also come with side effects. It can cause life-threatening allergies, and an infection in the gut which can cause bloody diarrhoea and inflammation in the large intestine.
Doctors are bound by The Hippocratic Oath: do no harm. It is our duty to ensure the responsible use of antibiotics to protect patient health, reduce the spread of resistance, and preserve the effectiveness of antimicrobial drugs. By adhering to stewardship practices, we commit to prescribing antibiotics only when necessary, thereby minimising unnecessary exposure to these drugs and the potential for harmful side effects or the development of resistance. This approach embodies the oath’s commitment to patient care and safety, ensuring that antibiotics remain a viable treatment option for future generations.
Leave a Reply