Antibiotics and the Looming Disaster

April 7th, 2019

The New York Times reported in an article titled, “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy” on the front page today that a new fungus called Candida auris is causing several deaths worldwide.  This could be what the medical profession has been dreading for the past 50 years, an antibiotic resistant microorganism for which we have no arsenal of weapons to fight.  How did we know this was inevitable?  Right now, antibiotics are overprescribed with approximately one in three prescriptions considered unnecessary.  In addition, much of our food supply has been tainted with antibiotics.  Animals raised for food are often susceptible to infections, so they will often be given antibiotics even if they aren’t sick.  How does this translate into antibiotic resistance?  It’s all a matter of numbers.  When you kill 99% of the bacteria with antibiotics a small number will develop resistance to that medicine and multiply.  Magnify this by the number of people taking antibiotics and how much we can easily travel from continent to continent and we have a recipe for disaster.

Even worse, there have been no new antibiotics developed in the past 10 years and there doesn’t seem to be any new development to fight the resistant microorganisms.  What can we do about this looming crisis?  Here are some things you can do.

• Don’t take unnecessary antibiotics.  Cold and flus are caused by viruses and antibiotics do NOT work on them.  Some people think that because they took a friend’s Z-pack last time they had a cold and “miraculously got better really fast” that the antibiotics had anything to do with it.  If they had been given placebo (or candy), they may have recovered just as quickly.  The perception that if a pill is a prescription, it is automatically “stronger” is a fallacy.  Do not pressure your healthcare provider into prescribing antibiotics.  If you health care provider prescribes an antibiotic, ask him/her if it is really necessary.  In some healthcare settings such as urgent care settings, some providers have gotten so used to prescribing unnecessary antibiotics for colds because they have become tired of arguing with patients and would rather just prescribe it.  This is a sad situation that many hope will be changing.  I have seen in my own practice, patients who become very irate when they don’t get their “Z-pack”.  Instead, ask the provider what other things you can take to feel better.  Maybe ask the provider if you could check back in 3 days and be reevaluated if things aren’t better.  As a rule, most sinus infections, coughs, and sore throats do not require antibiotics.
• Eat certified organic, antibiotic-free foods.  It’s shocking how much antibiotics are being given to livestock and farmed fish.  These antibiotics ABSOLUTELY get introduced into our bodies when we eat them.
• If you are prescribed antibiotics, take the entire course as directed by your healthcare provider.  Do not stop because you feel suddenly better.  Resistance is more likely to occur when you don’t eradicate enough of the bacteria.  Also, do not save the antibiotic pills for a future infection. I have had many patients who said they did this.  Antibiotics can not be taken without proper medical supervision.
• Discard antibiotics appropriately.  Unused pills should never be thrown in the garbage or flushed down the toilet.  Many studies have found antibiotic resistant bacteria in fish living in waters contaminated by sewage likely because of the introduction of these chemicals.  Instead, bring the leftover meds to your local pharmacy or healthcare provider office.  Both of these places will have proper medication disposal systems that won’t pollute the environment.
• Increase the “good” bacteria in your body.  Here is blog on probiotic foods.
• Stay out of the hospital.  Many resistant bacteria start off in hospitals.  They can spread easily via surfaces such as doorknobs.  No matter how clean a hospital is, there is always a potential for coming in contact with resistant bacteria each time you enter a hospital.  Try to limit unnecessary visits to hospitals (social visits).  Does someone really need 20+ family members visiting their loved one?  It can also be stressful for person who is sick as they feel obligated to thank each of their guests.  Save the visits for after the person goes home.  If you are on an immunosuppressant medication for an autoimmune disorder (IBD, psoriasis, rheumatoid arthritis, MS, lupus, etc.) you absolutely should not go to hospitals if you do not need to.  As an alternative, set up a “virtual visit” with your loved one via video chat, or maybe create a video card they can see on their phone.
• If you do go to visit someone in the hospital, check in with the staff on duty first.  If there has been a resistant bacteria detected on your loved ones body, you may need to wear gown, gloves, and possibly a mask.  I would also recommend washing the clothes you wear immediately after you get home.   Use hot water and high heat dryer setting.
• Avoid bringing home items from the hospital.  Some people bring home the flowers and balloons they get from visitors.  Please avoid doing so, as they may have been contaminated.  I recommend leaving those items at the hospital with the nurses who have provided you with care.  If you brought clothing to the hospital, make sure you wash them thoroughly after you get home.