The development of antibiotics was one of the most important advances of medicine but because of the overuse and misuse of these antibiotics the bacteria have developed antibiotics resistance which is a serious issue, says Dr Sonal Dubey while talking to Nagpur Today.
Antibiotics, the miracle drugs that saved millions of lives since they were first developed in 1940, are now losing their power day out and day in because of overuse and misuse. Bacterial infections that were once easily cured with antibiotics are becoming harder to treat. The killer bacteria have developed antibiotic resistance. The World Health Organization (WHO) has recently labeled antibiotic resistance as one of the greatest threats to public health today. Nagpur Today had a talk with Dr. Sonal Dubey on this serious public health related issue. Dr. Sonal Dubey is MVSc & AH and also a gold medalist in Veterinary Pharmacology and Toxicology.
Nagpur Today asked Dr Sonal Dubey a range of vital questions on the issue of antibiotic resistance, bacterial infections, overuse and misuse of antibiotics, ignorance and carelessness on the part of patients about antibiotics treatment and other related aspects. Dr Dubey answered the questions and thus cleared the picture in an expert way.
What is Antibiotic Resistance?
Replying to this question, Dr Sonal Dubey said, “Antibiotic Resistance happens when bacteria change to protect themselves from an antibiotic. They are then no longer sensitive to that antibiotic. When this happens, antibiotic that previously would have killed the bacteria or stopped them from multiplying, no longer works. Antimicrobial drugs or antibiotics are medicines used to treat infections or diseases caused by bacteria (e.g. respiratory tract infections such as pneumonia and whooping cough, urinary tract infections, skin infections and infected wounds). Antibiotics work by blocking vital processes in bacteria, killing the bacteria or stopping them from multiplying. This helps the body’s natural immune system to fight the bacterial infection,” stated Dr Dubey.
How do bacteria develop antibiotic resistance?
Throwing light on the fact, Dr Dubey said that the bacteria can become resistant to antibiotics by mutating (changing) their genes after coming in contact with an antibiotic. These changes allow the bacteria to survive or ‘resist’ the antibiotic. Unfortunately, bacteria can also develop antibiotic resistance through contact with other bacteria. Resistant bacteria can pass their genes to other bacteria, forming a new antibiotic resistant ‘strain’ of the bacteria. Resistant strains of bacteria can spread to other people.
What causes antibiotic resistance?
Major causes of antibiotic resistance include:
• Using antibiotics when they are not needed.
Many people think that antibiotics can cure cold or flu and can help to shorten their illness. This is not true, because most respiratory tract infections are caused by viruses and antibiotics do not work against viruses, so antibiotics are of no use. A course of antibiotics won’t help to get over cold or flu (influenza) faster, won’t stop infection from getting worse, and won’t prevent infection being passed onto other people. If you are usually healthy and well, your immune system will take care of most respiratory tract infections — both viral and some bacterial infections — by itself. In the meantime, you can make yourself more comfortable by resting, treating your symptoms and drinking lots of water and non-alcoholic fluids.
“If you do have symptoms of a respiratory tract infection caused by bacteria (e.g. whooping cough), or if you are at risk of the complications of a cold or flu (often a second bacterial infection like pneumonia), your doctor may prescribe antibiotics,” said Dr Sonal Dubey.
• Not taking antibiotics at the doses and times that a doctor prescribes — this allows time for the bacteria to become resistant.
“A large number of people do not finish a course of antibiotics primarily because they feel better before the infection is eradicated so doctors must provide instructions to patients when it is safe to stop taking a prescription. Patients taking less than the required dosage or failing to take their doses within the prescribed timing results in decreased concentration of antibiotics in the bloodstream and tissues, and in turn, exposure of bacteria to suboptimal antibiotic concentrations increases the frequency of antibiotic resistant organisms in the body. Some infections require treatments long after symptoms are gone, and in all cases, an insufficient course of antibiotics may lead to relapse (with an infection that is now more antibiotic resistant)”.
• Antibiotics are also often overused in animals (in veterinary medicine and in agriculture).
The emergence of antibiotic-resistant microorganisms in human medicine is primarily the result of the use of antibiotics in humans, although the use of antibiotics in animals is also partly responsible. Antibiotics are used widely in animals as growth promoters and to prevent and treat infection that are intended for human consumption, such as cattle, pigs, chickens, fish, etc. The resistant bacteria which antibiotic exposure selects in animals can be transmitted to humans via three pathways, those being through the consumption of animal products (milk, meat, eggs, etc.), from close or direct contact with animals or other humans, or through the environment. The World Health Organization concluded that inappropriate use of antibiotics in animal husbandry is an underlying contributor to the emergence and spread of antibiotic-resistant germs and that the use of antibiotics as growth promoters in animal feeds should be prohibited, in the absence of risk assessments. As in human medicine, antibiotics can often be bought without prescription and veterinary supervision for use on pets and livestock. Bacteria remaining in these animals are likely to be resistant to the antibiotics used and may be passed into the environment by the excretion and secretion of materials such as milk, feces, urine, saliva, semen etc. The actual impact of these resistant germs depends on their specific type and on the animal or organism they henceforth infect.
Antibiotics are also sprayed onto fruit trees to prevent and also treat infection. Traces of antibiotics that remain after the initial spraying may encourage emergence of resistant strains of bacteria. During spraying, the wind can spread low concentrations of the antibiotic further afield, possibly increasing the risk of resistant bacteria. In both cases, it is possible for antibiotic resistant bacteria to enter the food chain, ultimately reaching humans. Fecal waste from food animals treated with antimicrobials, which is often composted and spread as fertilizer, is implicated in environmental contamination with resistant bacteria. As bacteria replicate quickly, the resistant bacteria that enter the environment replicate their resistance genes as they continue to divide. In addition, bacteria carrying resistance genes have the ability to spread those genes to other species, elaborated the expert.
How to prevent Antibiotic Resistance?
One can prevent antibiotic resistance by:
• Understanding that most people don’t need antibiotics for colds and flu because they are caused by viruses. So tell doctor to prescribe an antibiotic if it is really necessary.
• Taking the right dose of an antibiotic at the right time, as prescribed by the doctor and completing the full prescription, even if feels better.
• Never share antibiotics with others or use leftover prescriptions.
• Taking simple steps to avoid infections and prevent them from spreading.
• Avoid indiscriminate use of antibiotic in animals and in agriculture.
As told to Puja Singh