The discovery and use of antibiotics to treat infections was a giant step in medical science. And though these medicines continue to do wonders for countless numbers of people every day, concern has been growing regarding the development of bacterial resistance to their effects.
Antibiotics are chemicals that kill or stop the growth of bacteria and other germs. They have been around for thousands of years if you consider that many ancient civilizations used herbal remedies that contained natural antibiotics to cure infections. The antibiotics we use today were discovered and began to be commercially used around the turn of the century.
We use antibiotics primarily against bacterial infections. These chemicals are synthetic derivatives of naturally occurring substances, such as penicillin, which comes from the Penicillium mold. All antibiotics exert their effect by interfering with various life-sustaining structures or functions of the bacteria. For example, penicillin works by inactivating a specific enzyme needed to form an intact bacterial cell wall. In the presence of penicillin, susceptible bacteria will essentially explode.
The phenomenon of antibiotic resistance has come about due to both our use and misuse of these drugs. Through mutations in the bacteria’s DNA, some bacteria have developed the ability to resist the effect of specific antibiotics. Some bacteria make substances that inactivate the antibiotic. Others change their surface receptors, making it impossible for the antibiotic to attach properly. Still others have developed mechanisms to pump the antibiotic back out of their environment.
These resistant bacteria will survive a normal course of antibiotic treatment. They can then transfer this ability to resist destruction to other bacteria. The next time the antibiotic is used it is less effective or has no effect at all. This is how some bacteria, such as MRSA, have adapted to become “superbugs” – resistant to many of our most commonly used antibiotics.
We can combat this resistance by prudent use of antibiotics. Antibiotics should only be used in cases where there is evidence of a bacterial infection. Taking antibiotics for a cold (which is a virus) can lead to increasing bacterial resistance. Also, if antibiotics are prescribed for you by your physician, you should take the medicine for the prescribed amount of time. Stopping it prematurely can allow stronger and resistant bacteria to survive and adapt.
Today, there are many different classes of antibiotic medications. Some have been modified and upgraded through the years to make them more effective against specific wily bacteria. However, many of our older and most popular antibiotics can’t touch today’s superbugs.
Finally, recent years have seen a decline in the number of new antibiotics being developed. Pharmaceutical manufacturers can make more money selling medicines that are used every day (such as cholesterol, blood pressure and diabetes medications) than they can on drugs used for a relatively short period of time. Because of this, many more superbugs may arise and we won’t have the weapons to fight them. We need to outsmart the bugs by being smart with our drugs.
The content in this column is for informational purposes only. Consult your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.