Prescriptions, particularly antibiotics, are alarmingly easy to get a hold of these days. Antibiotics are usually used to treat bacterial infections and not viruses, though recently doctors have begun prescribing them more liberally. The New England Healthcare Institute (NEHI) says that physicians often resort to prescribing antibiotics because “determining if an infection is viral or bacterial is expensive and time-consuming,” so the seemingly “safe” solution is to provide the drugs. Additionally, doctors want to avoid issues of malpractice, which could arise if an actual bacterial infection goes untreated.

Patient influence also has some weight in a physician’s decision on whether to prescribe antibiotics or not. NEHI states “patients may pressure providers to prescribe antibiotics for conditions for which they are inappropriate…or inappropriately save antibiotics for later use.” These ostensibly commonplace habits may seem harmless, but they have unfortunately led to a rise in antibiotic resistance.

The CDC claims that instead of resorting to antibiotics as a quick fix for clearing up viruses, “symptom relief might be the best treatment option.” Overuse of antibiotics for viruses, such as colds or other respiratory issues, could lead to the drug losing its effectiveness against bacterial infections. Bacterial infections like MRSA and C-difficile are drug-resistant and have been a major cause of concern in the past decade due to their high mortality rates.

According to the Tufts University Alliance for the Prudent Use of Antibiotics (APUA), antibiotics resistance happens when “an antibiotic has lost its ability to effectively control or kill bacterial growth.” Antibiotic resistance also occurs naturally. During the use of an antibiotic, some bacteria can resist being killed, which can increase future survival of even more of that “resistant strain” of bacteria. The overuse of antibiotics can exacerbate this process. Genetic mutation of bacteria and “acquired resistance” from other bacteria can also breed more resistant bacterium.

Preventing disease in the first place by practicing good hygiene is the first suggestion that Tufts gives to combat antibiotic resistance. Additionally, they suggest that overall, antibiotics must be used less frequently. Patients who are prescribed antibiotics should complete the course of their antibiotics, even if they are feeling better partway through, and not save antibiotics for future unsupervised use.

This issue not only exists in the first world, where antibiotics are clearly incredibly accessible, but this problem also plagues developing countries. According to Nature: International Weekly Journal of Science, “around the globe, overuse of these drugs has created resistant strains of deadly bacteria.”

In developing nations like India and Pakistan, as high as 95 percent of adults “carry bacteria that are resistant to β-lactam antibiotics,” whereas only 10 percent of adults in Queens, N.Y. are carriers, says Timothy Walsh of Cardiff University in an interview with Nature. This could be attributed to poor sanitation in developing countries. Due to a lack of restrictions on hygiene, bacteria are spread more easily. Additionally, training of pharmacists must be improved so that the incorrect use of antibiotics decreases.

Potential solutions to this crisis have been broached. Developing new antibiotics can be incredibly expensive, “requiring approximately 10 years and $300 million” according to Tufts. However, scientists have considered strengthening existing antibiotics or using “decoy molecules” to trick bacteria into attacking the decoy instead of the antibiotic. Additionally, it has been suggested that antibiotics be altered to combat “the mechanisms that promote resistance,” rather than solely focus on destroying the bacteria itself.

While these solutions are certainly credible, decreased use of antibiotics and more strict regulations are the primary step toward eliminating the antibiotic resistance epidemic.

  — Bridget Tobin

Sources: New England Healthcare Institute, Center for Disease Control, Tufts (1), Tufts (2), Nature
Photo: Nature