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Antibiotic Resistance

In 1953, Dr. Arthur Tye, professor of pharmacology at The Ohio State University, since deceased, told his class that if we (the medical profession and the public) were not careful with how we used this newly emerging class of drugs called antibiotics, it wouldn’t be too long before we created “super bugs” that the antibiotics could no longer stop.  How prophetic!  Today we are having to cope with these “super bugs.”   The Alliance for the Prudent Use of Antibiotics (APUA) has stated, “…the misuse of these miracle drugs is destroying the miracle.”  This is not just a phenomenon in this country.  The shrinking world has made this an international problem.  Resistant bugs from another part of the world can climb on an airplane, along with the passengers, and end up at our front doors.

Resistant bugs develop when we:

  1. forget to take or just quit taking the balance of an antibiotic prescription;

  2. play doctor, passing unused pills on to family members or friends who seem to have the same affliction; or;

  3. save unused medicine for a next time.

In developing countries it is not unusual for a poor person to buy just a few antibiotic pills from a street vendor or under-the-counter drug merchant…what they can afford…expecting that a little miracle is better than none.  They unwittingly add to the nasty bug population.

Drug resistance is a natural phenomenon.  It’s not unlike the genetic evolution of 7-foot basketball players or 300 pound football linemen.  When taking an antibiotic some bacteria develop ways to bypass the effect of the drug.  As these genetic mutations replicate themselves, and when a sufficient number are involved in an infection, they are less likely to be affected by the first-choice antibiotic.  A recent study by the Centers for Disease Control (CDC) indicated that over 33% of the antibiotic prescriptions written for patients outside of hospitals are unnecessary, and that the cost of treating antibiotic-resistant infections now exceeds $4 billion a year.

What can we do to help reduce the economic impact, human distress, and even mortality, associated with the overuse and abuse of antibiotics?

A cooperative effort between the medical community and patients to reduce the overuse and abuse of antibiotics to try to stem the advance of resistant bacteria makes economic dollars and sense.  Not only will fewer unnecessary antibiotic prescriptions be written and filled, but also there will be a reduced urgency for the development of newer, more powerful and more expensive alternatives.  Most importantly, it might save somebody’s life…maybe yours.  

December 2000

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