Is prevalent especially during the season of acute respiratory infections and may have dangerous consequences.

Ever since their inception in the early part of the last century, antibiotics have been overused and abused all over the world.  However, antibiotic abuse has become more prevalent with time and is increasingly causing serious personal and ecological health-related problems.

Antibiotics are agents that kill or inactivate bacteria but lack activity against viruses and fungi.  When used appropriately, these anti-bacterial agents can be life saving but when used indiscriminately they can endanger life and the ecology.

The commonest disorders that invite antibiotic abuse and overuse are the acute respiratory infections that present as head and chest colds.  These combination syndromes, which encompass head congestion, runny nose, cough, sore throat, discolored sputum, discolored nasal discharge, and mild fever are caused by viruses and do not respond to antibiotics.  With very few exceptions, bacteria, which primarily cause localizing infections such as sinusitis or pneumonia, are incapable of the rapid, widespread invasion of the entire respiratory tree that viruses seem to accomplish so effortlessly.

Nevertheless, secondary bacterial infections, which are bacterial infections that develop on top of the primary viral illness, can occur in vulnerable individuals such as smokers, asthmatics, or those who have seasonal allergies, chronic lung diseases, or otherwise weak lungs or sinuses.  Such antibiotic-responsive infections should be suspected in these individuals but appropriate medical evaluations should be undertaken before antibiotics are prescribed.  Situations that might be caused by secondary bacterial infections include the following:

a) High fever and shortness of breath—suggest bacterial pneumonia.

b) Yellow nasal discharge or yellow sputum beyond the second or third week of the viral respiratory illness—suggest bacterial bronchitis or sinusitis.       

c) Severe sore throat that occurs in isolation with no associated nasal or bronchial symptoms—suggests streptococcal infection.       

d) Cough that persists beyond the third week of a respiratory viral illness—suggests smoldering bacterial sinusitis or bronchitis.       

e) Ear ache, especially if unilateral and severe—suggests bacterial ear or eardrum infection.

Some of the serious consequences of antibiotic overuse and abuse include the following:

a) Bacterial resistance, which means that the bacteria, because of repeated antibiotic exposures, have evolved defenses that protect them form the deadly actions of antibiotics.  Such evolved, antibiotic-resistant bacteria often cause life-threatening treatment failures.  A patient with pneumonia who should promptly respond to penicillin deteriorates while on treatment, ends up on the respirator, and may die because no antibiotic can be found that can cure the infection.  Another patient who has a staphylococcal skin infection may become septic while on treatment because the skin bacteria manage to invade the blood and cannot be stopped.  Etc… 

b) Bacterial epidemics, which mean that bacteria that used to attack one person at a time have become so immune to the antibiotics that they now attack many persons at the same time.  Such epidemics in hospitals and intensive care units have caused many deaths and are hard to stop unless the contaminated hospital ward or intensive care unit are closed and antibiotic use is temporarily suspended.

c) Antibiotic colitis is a condition where the protective, normal bacterial flora of the colon is displaced by aggressive bacteria that invade the colon, contaminate the environment, and spread to others who are not taking antibiotics.  If untreated, antibiotic colitis may destroy the colon and cause death.  

Under mounting antibiotic pressure, displacement of our environmentally friendly bacteria by unfriendly, destructive bacteria has been occurring globally over the past one hundred years.  These unfriendly bacteria have spread through sewage to underground waters and have contaminated our entire ecosystem.  The consequences of this ongoing, antibiotic coup d’état are yet to be fully understood.

Bacteria, because of their ability to multiply rapidly, are capable of evolving resistance to our antibiotics at a much faster rate than we can develop new antibiotics.  This race between bacteria and man is nearing its end and, from all signs, bacteria will be the sure winners unless we learn to use antibiotics more responsibly.

  The Monthly - Mars 2010 - Issue 92

 

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