Misuse of Antibiotics and a Deadly New Generation of Superbugs

New strains of antibiotic-resistant bacteria are developing, and our modern methods of fighting infection are at risk. What is causing this? And what can you do to stop it?

Misuse of Antibiotics and a Deadly New Generation of Superbugs

Without antibiotics, our ability to fight disease reverts to that of the past, when a simple infection could mean sudden death. According to the World Economic Forum “arguably the greatest risk...to human health comes in the form of antibiotic-resistant bacteria.”

News coverage of these bacteria is growing. Recently, the CDC warned America’s hospitals of a strain of Carbapenem-Resistant Enterobacteriaceae (CRE), a group of gut bacteria that resists even the strongest antibiotics. Dr. Thomas Frieden, director of the CDC, refers to CRE as a “nightmare bacteria,” which can kill up to half of patients who get bloodstream infections. Once only restricted to a few states, the dangerous bacteria has spread to 42 states and doesn’t show signs of stopping.


However, the onslaught of resistant bacteria isn’t new. Reports of MRSA (Methicillin-Resistant Staphylococcus aureus) broke out in 2000. This strain of the mostly respiratory and skin bacteria became resistant to a commonly used class of antibiotics called beta-lactams. The result is a hard-to-treat infection that requires special, more powerful antibiotics, like vancomycin. Dangerous antibiotic-resistant strains of tuberculosis, gonorrhea and Pseudomonas aeruginosa are also popping up in health clinics and hospitals around the country.

Many physicians believe this rapid development of antibiotic resistance comes from the overprescription and misuse of antibiotics.

How Did This Begin?

According to Dr. Brad Spellberg, an infectious disease expert, resistance to antibiotics has been in development for eons. “Prokaryotes [bacteria] 'invented' antibiotics billions of years ago, and resistance is primarily the result of bacterial adaptation to eons of antibiotic exposure.” The development of new antibiotic-resistant CRE and other stains isn’t a novel feat for bacteria.

The development of resistance depends on Darwin’s “survival of the fittest” concept. “[Antibiotic] use naturally selects for preexisting resistant populations of bacteria in nature,” says Spellberg. As those populations survive and grow, they have the potential to spread to the general population.

In the 1930s, when the first antibiotic drugs were introduced, death rates plummeted. We kept ahead of any bacterial resistance by developing new antibiotics in the '40s, '50s, '60s and '70s. Then, however, the pharmaceutical industry stopped investing in antibiotics research. So, now, we have a growing number of bacteria that is resistant to most of the antibiotics we throw at them.

What Can I Do to Stop Antibiotic Resistance?

 

Dr. Brad Spellberg and The Dr. Oz Show have developed several methods for you to slow the development of new antibiotic-resistant bacteria.

Don’t push your physician to prescribe antibiotics when it isn’t warranted. Many demand antibiotics when it isn’t warranted, for viral infections like colds, the flu, stomach flu, some sinus infections, and most sore throats. In these cases, antibiotics will be more harmful than helpful. Not only does it promote antibiotic resistance, it comes with side effects. They include diarrhea, abdominal pain, rashes and possible allergic reactions.

Do question your physician if you really do need an antibiotic. Your body is able to fight off infections on its own, in which case, an antibiotic is unnecessary. If you do need one, ask about broad-spectrum antibiotics versus narrow-spectrum antibiotics. Broad-spectrum antibiotics have a greater chance of killing most of the good bacteria in your gut along with the bad. You can request the most highly targeted antibiotic if you require one.

When taking antibiotics, take probiotics with them. They help replenish the good bacteria in your gut and help protect your body from resistant bacteria.

Avoid antibiotic soaps. Household soaps and other products with antibacterial chemicals such as triclosan or triclocarban don’t prevent infection any better than products without them. However, they pose the risk of encouraging antibiotic-resistant strains of bacteria. Instead, wash your hands with regular soap or use an alcohol-based hand sanitizer. Be sure to choose a product containing 60-95% alcohol.

On Taking Shorter Courses of Antibiotics

This is a hotly debated topic in the medical community: Should I stop taking a course of antibiotics early if I feel better? Many organizations, including the Mayo Clinic and the Tennessee Department of Health, say no because stopping your course of antibiotics too soon “often wipes out only the most vulnerable bacteria while allowing relatively resistant bacteria to survive.”

However, multiple studies have shown that taking shorter courses of antibiotics for infections like strep throat, pneumonia or UTIs are just as effective as longer courses. Initially, physicians treated pneumonia with a 14-day course of antibiotics. However, that duration became 10 days, then 7 days, then 5 days. Now, there are studies that show that a 3-day antibiotic course is just as effective. 

So if you feel 100% better and still have 3 to 4 days left of your antibiotic prescription, call your physician and ask if you can stop. The doctor may say, “Yes, you can stop if you feel 100% better.” However, you should always consult your doctor before stopping your course of antibiotics.

Your Parent Has Dementia: What to Talk to Their Doctor About

Make sure all their doctors are aware of all the medications she is taking.

Q: My mom is 94 and has dementia. She is taking a whole medicine cabinet-full of medications and I think they actually make her fuzzier. How should I talk to her various doctors about what she is taking and if she can get off some of the meds? — Gary R., Denver, Colorado

A: Many dementia patients are taking what docs call a "polypharmacy" — three or more medications that affect their central nervous system. And we really don't know how that mixture truly affects each individual person.

A new study in JAMA Network that looked at more than 1 million Medicare patients found almost 14% of them were taking a potentially harmful mix of antidepressants, antipsychotics, antiepileptics, benzodiazepines such as Valium and Ativan, nonbenzodiazepine benzodiazepine receptor agonist hypnotics such as Ambien or Sonata, and opioids. And almost a third of those folks were taking five or more such medications. The most common medication combination included an antidepressant, an antiepileptic, and an antipsychotic. Gabapentin was the most common medication — often for off-label uses, such as to ease chronic pain or treat psychiatric disorders, according to the researchers from the University of Michigan.

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