Antibiotic Resistance : A Public Health Issue

Introduction:

There are moments in a hospital when patients request antibiotics for some conditions that do not qualify for antibacterial treatment. The most common request comes around flu season for a shot of a common injectable antibiotic.

The flu is a viral illness that does not get better with antibiotics. It becomes harder with time to educate patients at every visit, and more often than not, it is a lot easier when patients inform each other and become advocates for themselves. Treating severe conditions like meningitis and pneumonia is becoming complicated due to antibiotic resistance.

Antibiotic resistance is a problem that surpasses a single patient, as it involves the broader population, and one being affected can cause problems for an infinite number of individuals. We call this a public health issue. The problem is so rife that a report claims that there will be a death brought on by antibiotic resistance every three seconds in less than 35 years if no action is taken. The Centers for Disease Control and Prevention (CDC) considers this a public health threat worldwide and is taking all necessary steps to eradicate the misuse of antibiotics.

What Exactly Is an Antibiotic?

An antibiotic is a drug that helps fight infections caused by bacteria, commonly prescribed by healthcare professionals for urinary tract infections, pneumonia, and skin infections. Antibiotic resistance occurs when these bugs (bacteria) gain superpowers and are no longer affected by antibiotics that could initially kill them. This is a problem because a superbug that cannot be destroyed is created, and this bug can spread like wildfire in schools, homes, and the workplace causing severe and long-lasting illness in large numbers of the population. These superbugs are challenging to treat and expensive to manage, and introduce new factors into the global burden of disease.

How Is Antibiotic Resistance Created?

The important fact is that a person does not develop resistance to antibiotics, and it is the microbe that develops resistance. A type of bacteria generally controlled by antibiotics, under certain conditions, fails to be eliminated and instead undergoes some changes that make it more powerful than the drug. This occurs by the process of mutation, and this change is passed on to the next generation, thus producing naturally resistant bacteria. This is how antibiotic-resistant bacteria are created.

Who Is at the Highest Risk for Antibiotic Resistant Infections?

Antibiotic-resistant infections can impact individuals from all walks of life. However, certain groups face a higher risk due to their health conditions or living circumstances. Those most vulnerable to these serious infections include:

• Infants, particularly premature babies.

• Elderly individuals aged 65 and above.

• Individuals facing homelessness or residing in overcrowded settings.

• People with weakened immune systems.

• Individuals on prolonged antibiotic treatment.

What Causes These Changes in the Bacteria?

• When antibiotics are prescribed for a condition that does not warrant antibiotic treatment, this is common when the doctor is awaiting a laboratory report. Meanwhile, the patient is put on antibiotics.

• One of the primary reasons for antibiotic resistance is self-medication. In today's world, everyone has become a doctor with the help of information available on the internet. However, taking medications (antibiotics) without a medical professional's prescription can lead to antibiotic resistance. Paving the way for this is that antibiotics are available to buy over the counter. Economic crisis and lack of doctors and hospitals are other reasons.

• When drugs are prescribed in a higher or lower dosage than required.

• When the patient does not complete the antibiotic course prescribed to them, in that case, the residual bacteria will increase in number, and there are chances it will become more resistant. Relapse of infection with more antibiotic-resistant bacteria is more common.

• Even pandemics play a role in developing antibiotic resistance. Especially during COVID-19, there was a skyrocketing increase in the usage of antibiotics.

• Disposal of waste products from hospitals, clinics, and expired medicines in the environment tends to expose the bacteria in the environment to antibiotics. Thus, creating antibiotic resistance.

• Overuse in livestock. Though the connection between feeding livestock with antibiotics and antibiotic resistance in people eating the livestock is limited, the available resources suggest adverse effects. Antibiotics are fed to livestock to prevent infections. This, in turn, develops resistant bacteria, which then enter the human body, causing resistant bacteria infections, which can be serious most of the time.

• Lack of hygiene.

What Does Superbugs Mean?

Superbugs are bacteria, viruses, or other germs that have become resistant to the medications usually used to kill them. They become resistant to the drugs, meaning they do not go away when treated and keep causing infections. There is a risk that no antibiotic will be effective.

Some bacterial infections that have become superbugs include:

1. Clostridioides difficile (C. diff).

2. Drug-resistant gonorrhea

3. Methicillin-resistant Staphylococcus aureus (MRSA).

4. Multidrug-resistant Mycobacterium tuberculosis (MDR-TB)

5. Vancomycin-resistant Enterococci.

How to Reduce the Rate of Superbug Spread?

• Use only antibiotics prescribed. That means staying away from grandma's medicine cupboard when ill and consulting an actual healthcare professional.

• Always make sure that the prescribed antibiotics are necessary to cure the infection. There is no harm in cross-checking with the doctor.

• Complete the course of antibiotics as directed by a medical professional and try not to skip any doses, even when starting to feel better and there are ten big pills left to swallow. If left halfway, the remaining bacteria become resistant to antibiotics.

• Do not demand antibiotics from the doctor. Healthcare professionals understand which conditions require antibiotics and which do not. Allow them to guide you accordingly.

• Try to prevent infection from spreading within the home, school, or work. Always maintain hygiene, attend to illness promptly, and stay away from work or school when ill.

• Avoid using antibiotics for viral or parasitic infections. A healthcare professional can help identify bacterial infections and determine if antibiotics are necessary.

• Inform the healthcare professional about being aware of the consequences of misuse and overuse of antibiotics and not wishing to contribute to the spread.

• To prevent antibiotic resistance spread, even the industries producing antibiotics should treat the wastewater well to minimize exposure of environmental bacteria to the antibiotics.

• Educate friends and family about the antibiotic resistance spread and ways to prevent it.

What Measures Should Be Taken to Prevent Antibiotic Resistance?

Following are a few tips to prevent antibiotic resistance.

1. Maintain good hygiene practices. Practicing hygiene helps in avoiding bacterial infections that require antibiotics. The more antibiotics are used in society, the greater the problem of antibiotic resistance can become. Handwashing is a crucial step to take in this regard.

2. Only use antibiotics when necessary. Antibiotics do not treat viral infections. However, sometimes bacterial and viral infections may present similar symptoms, leading one to believe antibiotics are needed when they are not. If someone is unwell, discuss with the doctor the specific medication required and the reasons behind it.

3. Receive the vaccines recommended by the healthcare provider. Currently, most bacteria causing antibiotic-resistant infections do not have vaccines available.

   1. One exception is the pneumococcal vaccine, which protects against S. pneumoniae-related pneumococcal disease. This vaccine is particularly important for certain groups, including children under age 2 and adults over 65. Other vaccines, such as the flu shot, are also crucial.

   2. Avoiding viral infections can prevent symptoms that may trigger unnecessary antibiotic use.

Conclusion:

Though antibiotic resistance might sound like a petty issue, it is a huge problem that will show its adverse effects in the coming years. So taking proper preventive measures and being aware of the situation will greatly impact the medical world. Public health issues are best conquered by everyone doing their bit of the work. Unfortunately, healthcare professionals can only advocate for patients to a certain extent. So let us own our health and improve the lives of our families, friends, and colleagues by sharing the correct information. The cure begins with prevention.