Who Would Have Known Antibiotics Are Bad

Abstract

This paper discusses the fundamental approaches needed to combat antimicrobial resistance. Secondary infections, also known as superinfection, is a condition whereby an individual is infected by a secondary bacterial infection while the person gets treated for a primary infection, usually a virus. Everyone is susceptible to catching bacterial infections by superinfection since someone else is receiving treatment for their infection. Doctors are given training to know when it is acceptable for antibiotics to be given and not given. There are times where illnesses are rarely seen and can be given the wrong antibiotics to fight off the infection. When someone first takes any antibiotic, their body begins creating bacteria resistant mutation towards that antibiotic. Antibiotics do not last for very long, which leads to increased dependence even though they do not fully work. Vaccinations have longer-lasting effects than antibiotics and have been proven to be effective in reducing antimicrobial resistance (AMR). Yet, the World Health Organization has strategies to improve prescription and distribution of antibiotics hoping to lower the chances of disease and the rising of AMR. Considering that the hospital is the number one place where bacteria is created and exists, providers have to begin enforcing the improvement of a sanctioned environment in order to get this problem under control. As this problem grows, both doctors and patients need to be aware of the risk of taking antibiotics.

Who Would Have Known Antibiotics Are Bad

Bacteria is present everywhere we go since they exist on every surface and objects we lay our hands on, which represents a threat to our health. Bacteria is easily transferable between humans and can cause many different types of infections. There is a growing universal health threat of antibiotic resistance, even though there have been attempts to put an end to the issue. Antibiotic-resistant infections have led to the evolution of “superbugs”. Superbugs is a term that us used to represent the strains of bacteria resistant to a majority of commonly used antibiotics. These bacterial bugs have been reported to affect more than 2 million Americans, which results in 23,000 or more deaths annually (Wong and Santiago, 2017; Alpert, 2017). Things that may cause the spread of antibiotic-resistant bacteria to accelerate is the use and/or misuse of antibiotics, poor infection prevention standards, a mishandle of food, etc. With this growing lack of resistance, the United States healthcare system lost $20 billion of annual investment and contributing economic companies lost $35 billion in productivity. Antibiotics are no longer the antidotes we need protecting us from the expansions of infections. The situation at hand needs to be dealt with in order to improve the healthcare system and their attitude towards bacterial resistance, such as tackling antibiotic distribution, adapting to new drugs and forms of technology and antibiotic category alignments that aid in long term effects, as well as having patient awareness and frequent sanitation in hospitals.

There is a global health concern with the increasing rate of antimicrobial resistance (AMR). With the growing multiplication of the bacteria, our antibiotics are no longer useful in taming infections. The more antibiotics that are used trying to cure an infection, the worse the situation gets. Penicillin, which was discovered by Alexander Fleming in 1928 at St. Mary’s Hospital in London, had been used to treat soldiers in World World 2 with infections (Alpert, 2016). It was referred to as the “miracle drug” and began being used as an antibiotic that many believed would bring an end to infectious diseases. However, before this discovery there have been peaks of already growing resistance to Staphylococcus, which is a bacterium in a genus that includes many pathogenic kinds that cause pus formation, especially in the skin and mucous membranes. Fleming had put the word out on the possibility of antibiotic resistance and it was already coming into effect before the availability of penicillin. In result to this, antibiotics began being used more and more, causing the possible negative health defect outcomes. Since antibiotics are already out and available in the world, your first consumption can already trigger the effect of AMR.

Doctors often mistakenly give out antibiotics to treat colds and other viral illnesses. As the Center for Disease Control and Prevention states, “Antibiotics do not work on viruses, such as colds and flu, or runny noses, even if the mucus is thick, yellow or green” (CDC, 2017). Because of this, taking antibiotics to treat a cold would only make the infection worse. Antibiotics are very likely to be wrongly prescribed by doctors and patients take them, unaware of the harm they may be inflicting on their body. “Approximately 50% of antibiotic prescriptions are not optimally prescribed…or prescribed incorrectly for a given illness episode,” (Aplet, 2016). Bacteria mutates and spreads its genes along so that whenever the antibiotic is taken again, it will no longer have an effect on the infection. By that time the patient will not have any other options for treating the primary illness. Yet, “antimicrobial drugs also play a key role in preventing infections such as pertussis, and are often administered before surgery to prevent infection following the operation; for this reason, immunizations and antimicrobials have been fundamental in improving health across the socioeconomic spectrum” (Lomazzi, 2019). However, those under therapy who have to take antibiotics are more prone to its bacteria-resistant factors. The antibiotics are killing the bacteria that are used as a protection for the body fighting the infection and are having little effect on the pathogens that caused the illness to begin with. As a consequence to this antibiotic resistance, antibiotics are now silent deadly weapons, even when they are most needed. 

Antibiotics are being distributed based on a favoritism between healthcare providers and patients.. In low economic communities, doctors do not have all available resources to evaluate someone’s illness and fully come up with the best support which results in them doing empirical therapy. Empirical therapy is therapy begun on the basis of a clinically educated guess in the absence of complete or perfect information. Patients with low income also are not able to afford the “best” type of medication needed to treat their illnesses. “Physicians are likely to prescribe antibiotics to socioeconomically deprived patients due to concerns about complications, which may actually arise from poor hygiene, sanitation, and nutrition,” (Basu, 2018). This practice is unethical regarding future generations of these patients because it can lead to even more antibiotic resistance. In addition, there are unethical procedures doctors are using to prescribe narrow-spectrum and broad-spectrum antibiotics based on the influence of social class. Those who share a close relationship with the doctor, either their family, friends, or “heart-to-heart” patients, are more likely to be given the “better” medication, which is considered broad-spectrum antibiotics since it has reported little resistance against bacteria (Basu, 2018). Patients who receive narrow-spectrum antibiotics usually undergo empirical therapy which does not provide much benefit to those who are in high antimicrobial-resistant communities. This can result in patients taking more than the labeled amount of the drug in the hope of lessening the infection, yet they are only giving it more growth. Given this, doctors are supposed to abide by a code that does not give off favoritism towards any patients. The first rule of antibiotic prescription is: Antibiotics save lives. When a patient needs antibiotics, the benefits outweigh the risks of side effects or antibiotic resistance (CDC). This indicates that the illness that is being treated by the antibiotic is more severe than the consequences that may follow without taking them. The existing clinic social challenge between doctors and patients is an ethical violation to prescription distribution. Inappropriate prescribing can have outcomes from unfortunate effects, to financial weights, or most likely death with the statistical odds.

As an alternative, vaccinations have been proven to be much more effective than antibiotics in combating AMR. Vaccinations are treatments to produce immunity against a certain disease and have been around and distributed to humans for decades. “Increasing coverage of existing vaccines and developing new vaccines that target antibiotic-resistant organisms can play important roles” (Black, 2018). What is useful with vaccinations is that they have a longer active period in controlling diseases that may form inside our bodies due to bacteria. Vaccines target pathogens when they are relatively small lowering the chance of resistant mutations forming; which is why healthcare providers require you to get a certain amount of shots when you are a newborn until the age of 21. No new antibiotics have been mentioned or used in the last few decades, but the ones that do fail inspection of effectiveness at targeting the resistant bacteria. We are no longer in the golden era of antibiotics, but of vaccinations. “Not only have numerous vaccines been licensed during the last 40 years, but vaccines are also well poised for further development against many AMR bacteria” (Black, 2018). There has been studies taken with people using vaccinations and antibiotics to treat infections. It was shown that vaccines indirectly counteract the usage of antibiotics, meaning that the vaccine dismantles the antibiotics taking so they do not have any effect on the body. “Health professionals overwhelmingly support universal immunization, recognizing the impact of vaccines in reducing the burden of disease infections such as smallpox, measles, and polio” (Balasegaram, 2019). Vaccination development technologies have been introduced since the 1990s and its improvements show promising results working towards a solution to antimicrobial resistant bacteria.

Interestingly enough, the World Health Organization (WHO) has come up with solutions to organize the distribution of antibiotics that require a three category plan. The three categories from the WHO consist of: watch, access, and reserve, which will hopefully contain antibiotic resistance, optimize antibiotic treatment and preserve our “last-resort” antibiotics (Cha, 2017). In this plan, antibiotics are put into subcategories that indicates what it is for and how to properly take it. For example, the medicine known as amoxicillin, which is used for infection from the ear to pneumonia, will be in the “access” group which is available at all times. The next group, “watch” medications, which include first or second-line treatments like ciprofloxacin, commonly taken for strep throat or sinusitis, should be dramatically reduced. Finally, the “reserve” group of antibiotics will be used as a last line of defense. These include colistin and few cephalosporins that should only come up when every other alternative has failed (Cha, 2017). Following this plan seems like the best way to categorize and distribute medication amongst patients. People usually listen to the advice their doctor gives them, so categorizing drugs into groups would make the doctor job easy to prescribe a less resistant antibiotic. The upside to this is that companies that advertise these types of antibiotics will begin to lose money to accommodate the WHO’s proposal. The money generated from the publication of antibiotics. Drugs need to sale in order to develop new ones, but only the best, recommended ones should be the main focus in selling and advertising by these companies. 

The greatest source that carries antibiotic resistant infections is the hospital setting. All the sick patients inside these facilities are passing along their illnesses, without intention, to their nurses and doctors. Hospital rooms are disinfected and cleaned after a patient has used it, however, there are still antimicrobial resistant superbugs lying around waiting to target their next individual. Not every superbug has been released and about “10 percent of patients entering a hospital have a multidrug-resistant species on their hands” (McCarthy, 2019). The superbug known as MRSA (Methicillin-resistant Staphylococcus aureus) which is a staph bacteria resistant to antibiotics used to treat ordinary staph, can be deadly and has colonized roughly 5% of healthcare workers. The best way for hospitals to stray from these growing resistant microbes is having intensive environmental cleaning and disinfection of patient care rooms and areas. “They have antibiotic stewardship programs to ensure that drugs are used correctly and have sophisticated strategies to identify and isolate anyone who develops a superbug infection.” (McCarthy, 2019). This problem can be contained within hospitals if both the facility and persons are kept cleaned. Thorough cleanings from rooms to bathrooms and hallways. Humans need to wash their hands more often and keep their environment clean to prevent any chance of catching bacterial infections. Being in a sanitary environment allows better opportunity to not catch any bacterial resistant microbes.

The time has come to put an end to the growing antibiotic resistant bacteria. There has been test done with new technologies, organizations coming up with distribution procedures and hospitals coming out with their understanding and efforts to tam the extension of superbugs inside the facility. Combating an already growing issue takes more than one person to figure out. The use of antibiotics have been around for almost a century and has been having a lot of negative impacts on its consumers. Because antibiotics are no longer the best at their jobs there are other solutions that have to be considered in attaining this problem. Best alternative option to antibiotics is vaccines. The reign of antibiotics has been coming to an end with the era of vaccinations proving to be more effective for longer periods of time and having less probe resistant effects. (Include more side view) Companies do not favor the idea of losing money. In order to ensure correct usage of antibiotics, they need to be categorized, advertised, and used only when it proves most beneficial to patients’ needs. Hospitals also need to make sure that they are running properly and cleaning any trace of microbes so that a decrease of superbugs can be found.

References

Center for Disease Control and Prevention (CDC)  (2017, September 25). About Antibiotic Prescribing and Use Retrieved from https://www.cdc.gov/antibiotic-use/community/about/index.html.

Alpert, P. T. (2016, July 11). Superbugs: Antibiotic Resistance Is Becoming a Major Public Health Concern . Retrieved from https://journals-sagepub-com.ccny-proxy1.libr.ccny.cuny.edu/doi/full/10.1177/1084822316659285.

Basu, S., & Garg, S. (2018, May 12). Antibiotic prescribing behavior among physicians: ethical challenges in resource-poor settings. Retrieved from https://web-b-ebscohost-com.ccny-proxy1.libr.ccny.cuny.edu/ehost/pdfviewer/pdfviewer?vid=9&sid=901009d8-c2b2-4816-9550-e43a536d09a5@pdc-v-sessmgr01.

Bloom, D. E., Black, S., Salisbury, D., & Rappuoli, R. (2018, December 18). Antimicrobial resistance and the role of vaccines. Retrieved from https://www.pnas.org/content/115/51/12868.full.

Cha, A. E. (2019, March 30). WHO creates controversial ‘reserve’ list of antibiotics for superbug threats. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2017/06/06/who-creates-controversial-reserve-list-of-antibiotic

Lomazzi, M., Moore, M., Johnson, A., Balasegaram, M., & Borisch, B. (2019, July 2). Open Access Antimicrobial resistance – moving forward? Retrieved from https://web-b-ebscohost-com.ccny-proxy1.libr.ccny.cuny.edu/ehost/detail/detail?vid=5&sid=ef0d3814-eefb-46f2-9277-414e04d1300d%40sessionmgr102&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=137289585&db=a9hMccarthy, M. (2019, May 20). What Superbug Hunters Know That We Don’t. Retrieved from https://www.nytimes.com/2019/05/20/opinion/hospitals-antibiotic-resistant-bacteria-superbugs.html?searchResultPosition=4.