It's time we come clean about antibiotics. They are not the harmless
miracle drugs the public and physicians think they are, they don't
work for everything, and if we keep using them indiscriminately, they
might not work when we really need them.
Drug-resistant bacteria are on the rise because of the overuse and misuse
of antibiotics. The most notorious are methicillin-resistant Staphylococcus
aureus (MRSA), which are resistant to many antibiotics and are associated
with 11,000 deaths per year.
We are entering the post-antibiotic era, a time when a simple bacteria
infection can be deadly since antibiotics have stopped being effective.
This is happening across the world and in our community.
What most people might not realize, however, is that even when used correctly,
antibiotics are not benign. Side effects range from a bad rash (amoxicillin)
to a ruptured Achilles tendon (Cipro) to a stopped heart (azithromycin,
or Z-Pak). Just ask pop star Miley Cyrus, who was hospitalized in 2014
following a severe allergic reaction to the antibiotic Cephalexin, which
she reportedly took to treat a sinus infection.
Antibiotics can interfere with other medications, including birth control
pills. So add to the list of side effects, unintended pregnancies. In
many cases they cause nausea, yeast infections and hives.
And yet, we live in a society that has become more fearful of gluten than
of these powerful pharmaceuticals. This boggles the mind. Glutens are
naturally occurring proteins that allow bread to keep its shape; antibiotics
are manmade chemicals designed to kill.
And kill, they do.
In their quest to eviscerate the "bad" bacteria that ails us,
antibiotics also indiscriminately destroy the "good" bacteria
our bodies need to help us digest food. Each year improper prescribing,
misuse and overuse of antibiotics contribute to rising rates of such conditions
as Clostridium difficile, or C. diff, which causes severe diarrhea and
is associated with more than 29,000 deaths per year.
At Hoag we have seen an alarming rise in cases of C. diff in our community,
despite stringent measures to counter this infection. As we examine the
issue, it appears that 80% of our cases originate outside the hospital,
meaning that we need to educate private doctors, nursing homes and patients
about the dangers of unnecessary or incorrect antibiotic use.
In addition to C. diff, our community now faces drug-resistant forms of
tuberculosis, gonorrhea and staph infections, not to mention gram-negative
bacterial infections, which are not only drug-resistant but can pass along
genetic code that allows other bacteria to become drug-resistant as well.
Antibiotics have advanced medicine immensely. They have made organ transplants
possible, allowed us to conquer bacterial meningitis and saved countless
lives from formerly fatal wound infections. But their use comes with a
cost, and it is time we hold ourselves accountable to the proper use of
these powerful medicines.
Every time a sleep-deprived parent begs a pediatrician to prescribe an
unnecessary antibiotic, we as a society take another step toward drug-resistant
superbugs and preventable deaths and illnesses.
We have the power to stop this. If doctors only prescribe antibiotics to
treat bacterial infections and patients use those antibiotics as directed
(i.e. taking the whole course of medications, regardless of whether you're
starting to feel better), we can change our thinking about these medications,
stop the rise of drug-resistant super bugs and protect ourselves from
severe side effects and illness.
With so many public health issues at stake, isn't it time we become
at least as discerning about ingesting these powerful chemicals as we
are about eating bread?
PHILIP ROBINSON, M.D., is medical director, Infection Prevention and Hospital Epidemiology,
at Hoag Memorial Hospital Presbyterian in Newport Beach.