Antibiotics: The Overused Miracle Medicine

Antibiotics: The Overused Miracle Medicine

Dr. Phillip Treadwell received his Doctor of Pharmacy degree from the University of Florida and has been a faculty member of the Tallahassee Memorial Family Medicine Residency Program since 2000. He is credentialed in HIV medicine by the American Academy of HIV Medicine.

By: Phillip Treadwell, Pharm.D.

Antibiotics are truly miracles of modern medicine. As an example, prior to the discovery of penicillin and sulfonamides in the early 1900s, almost everyone who got meningitis (an infection around the brain) died. As soon as antibiotics became readily available in the 1940s, the rate of death from these same infections dropped dramatically. Many other infections were also cured with these “miracle” drugs.

This remarkable effectiveness led to use of these agents for all sorts of medical problems including suspected, but unproven, bacterial infections and even infections strongly suspected to be caused by viruses. Even though it is well known that antibiotics do not treat viral infections, physician perception that “it can only help” to give an antibiotic led to patients expecting to get an antibiotic when they had an infection of any kind. However, over time, we have learned that the overuse of antibiotics can be detrimental to individual patients and society.

Common antibiotics can produce severe or fatal allergic reactions in some people. In addition, antibiotics can often cause nausea or diarrhea, and some classes of antibiotics can cause tendon injury, nerve damage, liver injury or confusion. Another set of adverse reactions to antibiotics includes problems related to death of the “friendly” bacteria that help the body maintain health. This can lead to problems such as yeast infections or a particularly troublesome type of infectious diarrhea called Clostridium dificile colitis.

Societal issues with the overuse of antibiotics are also a very real problem. Bacteria can learn to tolerate antibiotics once effective at killing them. This can happen to a patient while on a given antibiotic, but the bigger problem is that when antibiotics are used widely, new populations of bacteria that are more difficult to kill with antibiotics become common. Methicillin-resistant Staph aureus (MRSA) is a very good example of what can happen with the widespread use of antibiotics.

When penicillin was originally developed, it was very effective against one of the worst bacteria that we faced, Staph aureus. Within one year of penicillin’s introduction, some Staph had become resistant to penicillin. Within ten years, 50% of Staph was resistant to penicillin. Because of this, methicillin was developed. This was effective for all Staph aureus, but, again, within about one year, resistance had developed. Today, most Staph aureus has become methicillin resistant (MRSA). Infections with MRSA now commonly occur in people who have not taken any antibiotics in the recent past and even happen in children who have never taken antibiotics.

Antibiotics save many lives every day, but overuse is a major problem for individuals and society. We can do our part by not requesting antibiotics and questioning our healthcare provider when antibiotics are prescribed for viral infections such as colds or flu. We need to change our approach from one of “What can it hurt?” to that of “Is this really what is best for me?” With careful use, we can maintain the effectiveness of these miraculous medicines for generations to come.

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