Experts warn against abuse and overuse of antibiotics

Severe acne. Bronchitis. Pink eye. If you’ve come down with anything more than the common cold, you’ve probably been prescribed an antibiotic. And it likely cured you.

But almost nothing is foolproof when it comes to modern medicine. In February, the World Health Organization identified 12 types of bacteria that are “priorities” in urgent need of new antibiotics. It’s been a concern for quite some time as these bacteria are simply evolving and becoming immune to the drugs. People also continue to use them when they don’t really need to.

“The less we expose people to antibiotics, the less there is going to be that risk for developing resistance in the first place,” says Dr. Thomas File, chair of the Infectious Disease Division at Summa Health System in Akron, Ohio.

Don’t add fuel to the fire

It’s important to understand when to take an antibiotic, which is for a bacterial infection, not for viruses such as the flu, common cold or a sore throat.

“Antibiotics, like all drugs, have a number of side effects that can be bothersome or harmful,” says Dr. Kristen Nichols, a clinical pharmacist at Riley Children’s Health in Indianapolis who focuses on antibiotic resistance education. “In addition to killing the harmful bacteria, they also kill off the ‘friendly’ bacteria in your body. Without a bacterial infection, antibiotics are not good for us.”

Dr. Saul Hymes, a pediatric infectious disease specialist at Stony Brook Children’s Hospital in New York, says it’s a “common misconception” that our bodies build up a tolerance and resistance to certain antibiotics. But that’s not the case.

“The bacteria themselves are becoming resistant to antibiotics by simple evolution and natural selection,” Hymes says. “As bacteria grow, there will naturally be some that mutate to be resistant to antibiotics.”

With each exposure, bacteria learn how to avoid the effects of the antibiotics to survive. “While some bacteria are killed off, the ones that mutate to be resistant to the antibiotic survive and replicate,” says Nichols, who also is on the Antibiotic Resistance Advisory Committee with the Indiana State Department of Health.

Nichols and Hymes both emphasize avoiding antibiotics unless you absolutely need to take them. “Do not take antibiotics for a cold or for a cough unless you are sure it is due to a bacteria,” Hymes says. “Even many bacterial infections like ear infections in children may get better without antibiotics.”

Back to the basics

The top three priorities on the WHO’s list classified as “critical” are linked to hospital-acquired infections. In the U.S., one in 25 hospital patients is estimated to have at least one hospital-acquired infection, according to the Centers for Disease Control and Prevention. Drug-resistant bacteria are estimated to cause 700,000 deaths each year, according to WHO. If no action is taken, bacteria are expected to kill 10 million people annually by 2050.

Hospitals and their staff can help lower the likelihood of patients acquiring these bacteria.

“First and foremost, health care professionals in these settings should adhere to good infection control principles — the most basic of which is frequent and thorough hand-washing,” File says. “It may sound simple, but it’s of crucial importance as many infections are transmitted from skin-to-skin contact.”

In terms of staying on top of your own health, be cognizant of your role in infection control. “Respiratory etiquette, coughing into your sleeve or handkerchief, not your hand, and avoiding public places if you are sick,” File says.

Nichols is hopeful that in the near future antibiotics will only be used when they’re clearly necessary. “But this will require effort from patients and prescribers,” she says.