Antibiotics, a blessing that could lead to a curse? In 1941, an antibiotic, penicillin, was used for the first time. This discovery was a blessing and saved millions of lives. However, like anything, with excessive use, antibiotics have grown to become a curse; that curse being the evolved antibiotic resistant bacteria. For many years, antibiotics were successful in treating bacterial infections. In today’s world, we are starting to see a plethora of bacteria that are resistant to the antibiotics commonly used as treatment for a number of bacterial diseases, some even deadly.
For starters, we need to make sure that there is a correct understanding of what antibiotic resistance is. This natural phenomenon occurs when the antibiotic is no longer able to control or kill the bacterial growth in a patient. In this case, the bacteria continue to multiply and infect the subject because they are ‘resistant’ to the antibiotic.
When bacteria are exposed to an antibiotic, the susceptible bacteria have a small chance of survival, in comparison to the ones that resist the antibiotic, because they are either inhibited or killed off. For the resistant strains, this creates a selective pressure for survival. Bacteria can evolve resistance to antibiotics either by obtaining it from other bacteria or by genetic mutation(s). Mutations can occur randomly in the bacteria’s genetic material. However, through a process known as conjugation, bacteria are able to share or transfer genetic material with each other; this material can include the genes that are resistant to antibiotics, also known as transposons, and resistance plasmid from resistant strains. So, for example, living in the same household as someone can cause the antibiotic resistant bacteria to be passed around.
There are many different causes of antibiotic resistance. One of which is the extensive use of antibiotics in agriculture. The use of antimicrobials as cleaning products, the careless use of antibiotics and the behavior of health-care providers are also prominent causes of this issue. One last example of this cause is the failure of following through on the treatment regimens – a mistake that many people continue to make. Who do we blame? The doctors? The patients? The system that lacks in public education and knowledge about public health issues?
Due to bacteria rapidly acquiring antibiotic resistance, a multitude of pressing health issues have arisen. One of which is the lack of a treatment for these bacterial infections and diseases. The result of this phenomenon is a multitude of diseases that are not only more difficult to treat but also more expensive. The resistance to the antibiotics has caused a barrier to treatment and that is a scary problem to have. The book titled Patient as a victim and vector: ethics and infectious disease, written by M. Pabst Battin, states one statistic that really summarizes this pressing issue: 70% of the agents that cause bacterial infections in hospitalized patients are resistant to at least one of the antibiotics generally used to treat them (230). Such an increase in resistance could potentially have a direct relationship with overall population death rates (meaning the death rates would incline).
With such rapid progression, it is quite difficult to think of one solution that would solve this issue. There are many factors that play into this public health scare. One factor that is crucial to consider is thinking about the patient as both a victim and a vector—not only a vector when trying to preserve the antibiotics and dodge the resistance, but also not only a victim when trying to treat the patient in the best possible way. Antibiotic use must be managed so as to best protect the health of current patients and patients with bacterial infections in the future.
I believe that one possible solution to this issue of balancing the patient’s needs now and the needs of future patients would be to monitor how these antibiotics are being prescribed. If there is a possibility for the patient to heal on their own, without the use of antibiotics, then I see no reason in prescribing the patient that form of medication. I realize that social issues come in to play here. Parents, for example, want a quick solution for their child’s illness – a quick solution means less time out of school for the child and less time out of work for the parent. In order to be considerate of the patients in the future, it is reasonable to overlook such social factors. I also believe that finding a way to raise funds for new antibiotic research is a crucial first step when looking to alleviate such a situation. If we could add a small surcharge to the antibiotics covered by health insurances, then nationally we would be able to generate funds to support such research; the surcharge would not have to be unaffordable (maybe a $1 or $2 surcharge depending on the antimicrobial type).
In conclusion, the idea of not having back-up treatments for bacterial infections and diseases is scary. Some hospitals have started taking the initiative to monitor antibiotic use, especially when it comes to cases of MRSA (Methicillin-resistant Staphylococcus aureus). One can only hope that with the technology and knowledge we have today, we will be able to figure out a different mechanism to target in such diseases. \
Until then, all we can do is create awareness for this public health issue and stay hopeful.
Feel free to message with me any questions, comments or concerns. Sending much love your way, everyone.