Antibiotics: Less is More

There are many origins of infections a person encountered today such as pneumonia (bacterial), athlete’s foot (fungal), the common cold (viral), and giardiasis (parasitic), etc. The body’s immune system prevents and fights these infections. When infections are strong enough then the immune system alone cannot fight against them.

Physicians prescribe medications and antimicrobials against these infections.

Bacteria are microorganisms, which means life forms. The word antibiotic splits into anti means against and biotic means life. Antibiotics work against bacterial infection. About 70 years ago, before the development of antibiotics, there was a higher mortality rate from bacterial infections. For example, tuberculosis, pneumonia, and STDs. The first antibiotic developed from fungi e.g. penicillin which specifically fights bacteria.^[1]

In this article we will explain the significance of bacteria in the human body, how do antibiotics work, the usual length of antibiotic therapy, and the complications of antibiotic use. We’ll also look at the danger associated with the misuse and overuse of antibiotics, things to prevent yourself from antibiotic resistance, and antibiotic stewardship.

Bacteria are single-celled microorganisms. The human hosts trillions of microbes, with an estimate of 10,000 bacterial species living in and on the surface of human bodies. The dominant genera include Bacteroides, Clostridium, Peptostreptococcus, and Bifidobacterium, etc. Escherichia and Lactobacillus, are present in the gut to some extent.

In the digestive system, some bacteria help and break down the food into smaller particles to facilitate digestion in the human body. These bacteria release some waste products which are nutrients for our human body. Probiotics refer to live microorganisms having beneficial effects, and popular knowledge of this surged the use of probiotics for eg: Yakult.

Pathogenic bacteria cause infection when the human body gets injured and common external bacteria enter through the bloodstream, or in the cases of food poisoning.^[1][2]

Antibiotics work against bacteria by several mechanisms such as:

• Inhibiting the bacteria’s ability to build the cell wall
• Blocking the reproduction, or
• Interfering with the ability to store and use its energy

Antibiotics do not usually affect human cells but some people may have side-effects from antibiotics too. These are divided into broad-spectrum antibiotics e.g. penicillin and aminoglycosides affecting a wide range of bacterias and narrow-spectrum antibiotics e.g. macrolides and vancomycin affecting certain species of bacterias. Some antibiotics work against bacteria that require oxygen (aerobic) e.g penicillin and others work against bacteria that survive in the absence of oxygen (anaerobic) e.g. metronidazole and clindamycin and some work against both aerobic as well as anaerobic bacterias.

Antibiotics are generally grouped based on their mechanism of action. Each type of antibiotic works against certain types of bacteria. The main types of antibiotics used for particular infection include Amoxicillin (pneumonia, ear, and chest infection), Cefaclor (Pneumonia and other lower respiratory tract infection), Tetracycline (Pneumonia), Erythromycin (Diphtheria and bronchitis), Metronidazole (skin and mouth infections) Ciprofloxacin (UTI and pneumonia), and Nitrofurantoin (Urinary infection).

When you are administered with an antibiotic pill or liquid, it enters the digestive tract undergoes a metabolism process, and then is absorbed into the bloodstream to exert its action at the target area. Antibiotics are administered intravenously to bypass metabolism and are directly absorbed in the bloodstream when an infection gets severe.

Antibiotics in the form of topical cream or ointment are quickly applied directly in skin infection to get the desired result. This allows the exposure of drugs to a small area when there is no need for them to be absorbed in the bloodstream.^[1][3]

The length of treatment varies a lot as it depends on what kind of infection or illness you have, how severe it is and how quickly you can get better after the treatment. Treatment can be:

• For just a few days in case of a water infection (urinary tract infection).
• For one or two weeks in case of pneumonia
• For a few months in case of bone infections
• For many months in case of acne

You may develop allergic reactions due to antibiotics which are relatively minor skin reactions. However life-threatening allergic reactions may occur sometimes which can be swelling of the throat and difficulty in breathing. If you develop an allergic reaction, stop taking the medication and consult your clinician immediately.

Antibiotics do not distinguish between good and disease-causing bacteria which results in the disturbance of the natural balance of organisms leading to severe diarrhea(a loose bowel movement) or yeast vaginitis in women. In this case, the physician recommends probiotics following antibiotics treatment. Other complications such as severe gastrointestinal upset and photosensitivity reactions may arise from the side effects of certain antibiotics.

Bacteria can develop resistance to an antibiotic when it is overused. When more antibiotics are used, more resistance is evident then. Few bacteria are resistant to all widely known antibiotics.^[4]

Antibiotic resistance is one of the biggest health challenges nowadays. At least 2.8 million people get an antibiotic-resistant infection every year in the United States, and more than 35,000 people die due to not being treated by the developed antibiotic resistance.

Overuse and misuse of antibiotics create microbes that can no longer be treated by antibiotics called superbugs. Antibiotics overuse has led to few bacteria changing their form or structure and becoming resistant to few antibiotics, due to which they do not work when needed. For example, Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that has become resistant to several antibiotics and is difficult to treat now. Other bacteria that produce chemicals called enzymes such as Extended-spectrum beta-lactamase (ESBLs) make them resistant to certain antibiotics.

According to the Centers for Disease Control and Prevention, up to one-third to one-half of antibiotic use in humans is unnecessary or inappropriate.

For example, strep throat is caused by the bacterium Streptococcus pyogenes whereas sore throats are caused due to viruses that antibiotics cannot treat. But people with a sore throat also get prescriptions for antibiotics that they do not need.

A growing list of bacterial infections such as pneumonia, tuberculosis, cellulitis, gonorrhea, blood poisoning, and foodborne diseases are becoming harder, and impossible to treat as antibiotics become less effective against these.

Certain antibiotics accelerate the patient’s kidney failure or lead to liver inflammation and drug rashes. Another consequence of antibiotic misuse is Clostridium difficile infection.

Other consequences of antibiotic-resistant infections include:

• More serious illness
• Longer recovery
• More-frequent and longer hospitalization
• More doctor visits
• More expensive treatments

According to The Centers for Disease Control and Prevention, antibiotic resistance is one of the world’s most pressing public health challenges. It’s mainly concerned in low-income and developing countries because of:

• Health care providers often lack quick, helpful diagnostic tools and techniques that identify illnesses caused by bacteria, viruses, and fungi separately.
• Widespread access to antibiotics in most of the areas.
• Lack of potable water, poor sanitation, and limited vaccine programs contribute to the bacterial infections and illnesses for which antibiotics are prescribed.^{[5][6][7][8][9]}

You must know the difference between bacteria, parasites, and viruses. Antibiotics can treat only bacterial infections. If you are suffering from viral disease and are taking antibiotics, these antibiotics will attack good bacteria present in the human body thus becoming antibiotic-resistant. The antibiotic resistance nature of good bacteria will be shared with the bad bacteria too. So don’t automatically ask for antibiotics to treat viral infections and illness.

Following the instructions prescribed by pharmacists is of utmost importance in case of antibiotic therapy. Antibiotic resistance also comes from failing to take antibiotics as prescribed. Antibiotics are strong and, when used as prescribed, make you feel better in a day or two. You might start thinking to stop taking the medicines but consult with your doctor first before discontinuing the therapy.

Be educated about the medicines you’re being prescribed and using them correctly can also help to reduce resistance. Supplementary therapy includes steam therapy, consuming lots of fluids, lozenges, and over-the-counter medicines, like decongestants, naproxen, ibuprofen, antihistamines, or cough medicines. Talk to your doctor or pharmacist if you miss out on any dose,

With the threat of antibiotic-resistant bacteria growth, it’s crucial to strengthen your immune system. Make sure to have a balanced diet, enough sleep, and exercise regularly. You can also eat foods rich in vitamin C like red and green peppers, kiwi, grapefruit, and oranges.

Don’t forget to wash your hands regularly, especially after interaction with someone who is sick and before you eat to avoid getting infected.^[10]

The appropriate use of antibiotics often called antibiotic stewardship which can help to:

• Preserve the effectiveness of current antibiotics
• Extend the lifespan of current antibiotics
• Protect people from antibiotic-resistant infections
• Avoid side effects from using antibiotics inappropriately^[8]

Bacteria cannot be seen by naked eyes and are present everywhere. Pathogenic and non-pathogenic bacterias are found. Antibacterial or antibiotics work by different mechanisms to treat bacterial infections which can be life-threatening sometimes. It is significant to understand that antibiotics don’t work against viruses and viruses cause diseases like cold, flu and sore throat, etc. The usual length of antibiotics depends on the type and severity of the infection. Side effects and complications of antibiotic therapy include allergic reactions, skin rashes, diarrhea, and antibiotic resistance. When antibiotics are misused or overused bacterias transform their form and structure and become resistant to the antibiotics. Patients on antibiotic therapy must complete the entire course of therapy as failing to do so become the cause of antibiotic resistance too. We need to understand that taking fewer antibiotics is of utmost importance as overuse of antibiotics can make the infection worse and untreated due to developed antibiotic resistance. Other consequences include longer recovery, hospitalization, and expensive treatments too. Antibiotics resistance led to the death of thousands of people, so if you miss out on the dose for a day or two, consult your pharmacist immediately.

References:

Also Read:

• Pros and Cons of Antibiotics
• Antibiotics: Groups or Classes, Side Effects, Do Antibiotics Treat Viral Infections & Fungal Infections Also?
• What Happens When You Mix Alcohol With Antibiotics?
• How Antibiotics Have Been Effective & Why its Resistance is a Growing Concern?
• 8 Natural Antibiotics