Fighting the Resistance
By Hilina Woldemichael
You’re sick. It seems to be nothing more than a cold, albeit a severe enough one to warrant a doctor’s visit. After going to the doctor, antibiotics are prescribed and you are told to finish all of them over a certain course of time. You may not know exactly how the medicine works, but after all, the doctor knows best. What could possibly go wrong? As it turns out, a lot.
Antibiotics are drugs that are specifically designed to target bacterial and fungal infections.1 As with most medications, antibiotics fall under different categories. Generally, an antibiotic can be classified as broad or narrow-spectrum. Broad-spectrum antibiotics such as penicillin—the first ever antibiotic—are effective against a broad set of bacteria, as the name suggests.1 Narrow spectrum antibiotics, on the other hand, are designed to target specific species of bacteria, often attacking biochemical pathways or structural characteristics unique to that microbe.1 Designing narrow-spectrum antibiotics requires a deep knowledge of the microbe of interest, which is not always possible in cases where multiple bacteria are at play, or if the cause of the infection is unknown.
Due to their relatively non-specific targeting strategies, broad-range antibiotics appear superior to narrow-spectrum antibiotics at first glance. But if this is the case, why are broad-spectrum antibiotics not used to treat every infection? Firstly, because broad-spectrum bacteria have such general targeting strategies, often they kill neutral and even helpful bacteria that live alongside the pathogen.1 These side-effects are especially dangerous because they can disrupt the body’s microbial ecosystem, which can result in additional downstream health problems.
While both varieties of antibiotics have their positives and negatives, one of the most pressing issues in modern antibiotic medicine lies in their over-prescription. According to the Centers for Disease Control and Prevention (CDC), of the approximately 154 million prescriptions written every year, nearly one-third of them are for illnesses that do not call for antibiotic treatment.2 In such cases, it is recommended to allow the body to fight off the illness using its natural immune system.
But why can’t antibiotics help along in the healing process? It has been found that over-prescription of antibiotics inflicts direct harm on the population by promoting antibiotic resistance in bacteria. A 2013 report by the CDC found that an estimated 2 million people in the United States are infected by antibiotic resistant-bacteria each year, and approximately 23,000 people die from these infections.3
The over-prescription problem is most concerning in children. Antibiotics are among the most common medicines prescribed to sick children.4 However, one study of antibiotics use in U.S. children demonstrates that a sizeable population used antibiotics for diseases such as bronchitis and the common cold—ailments in which antibiotics are rarely the canonical treatment.5 Another study of 41 hospitals worldwide found that, among children who did receive antibiotics, 32.9 percent were for preventative measures. Even more, approximately half of these prescriptions were for broad-spectrum antibiotics.6 While a pre-emptive strike on possible pathogens in the body may sound like a safe insurance measure, the overuse of broad-spectrum antibiotics is linked with increased levels of microbial resistance.6
Fortunately, professional recommendations have sought to lessen the rate of unnecessary antibiotic prescriptions in recent years. Medical professionals have been calling for limited use of broad-spectrum antibiotics, as well as the use of antibiotic cocktails for prevention rather than treatment. In addition, narrow-spectrum antibiotics are increasingly recommended to be used over shorter periods of time.7
With enough medically-conscious decision making, there is hope that the current antibiotic resistance crisis can be managed in the near future.
Works Cited
[1] Saggau, Danene. (2018). “Broad-spectrum versus narrow-spectrum antibiotics: what you should know.” Lake Meridian Chiropractic, lakemeridianchiropractic.com/broad-spectrum-versus-narrow-spectrum-antibiotics-what-you-should-know/
[2] “Antibiotic / antimicrobial resistance.” (2018). Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/drugresistance/threat-report-2013/.
[3] “CDC Newsroom.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2013, www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html.
[4] Ekins-Daukes, S., McLay, J. S., Taylor, M. W., Simpson, C. R., & Helms, P. J. (2003). Antibiotic prescribing for children. Too much and too little? Retrospective observational study in primary care. British Journal of Clinical Pharmacology, 56(1), 92–95. http://doi.org.ezp-prod1.hul.harvard.edu/10.1046/j.1365-2125.2003.01835.x
[5] Sarpong, E. M., & Miller, G. E. (2015). Narrow- and broad-spectrum antibiotic use among U.S. children. Health Services Research, 50(3), 830–846. http://doi.org.ezp-prod1.hul.harvard.edu/10.1111/1475-6773.12260
[6] Hufnagel, M., Versporten, A. Bielicki, J. Drapier, N. Sharland M. Goossens H. “High rates of prescribing antimicrobials for prophylaxis in children and neonates: results from the antibiotic resistance and prescribing in european children point prevalence survey.” Journal of the Pediatric Infectious Diseases Society, 22 March 2018.
[7] Pediatric Infectious Diseases Society. "Antibiotics often inappropriately prescribed for hospitalized kids, global study suggests." ScienceDaily. ScienceDaily, 22 March 2018. <www.sciencedaily.com/releases/2018/03/180322103245.htm>.
You’re sick. It seems to be nothing more than a cold, albeit a severe enough one to warrant a doctor’s visit. After going to the doctor, antibiotics are prescribed and you are told to finish all of them over a certain course of time. You may not know exactly how the medicine works, but after all, the doctor knows best. What could possibly go wrong? As it turns out, a lot.
Antibiotics are drugs that are specifically designed to target bacterial and fungal infections.1 As with most medications, antibiotics fall under different categories. Generally, an antibiotic can be classified as broad or narrow-spectrum. Broad-spectrum antibiotics such as penicillin—the first ever antibiotic—are effective against a broad set of bacteria, as the name suggests.1 Narrow spectrum antibiotics, on the other hand, are designed to target specific species of bacteria, often attacking biochemical pathways or structural characteristics unique to that microbe.1 Designing narrow-spectrum antibiotics requires a deep knowledge of the microbe of interest, which is not always possible in cases where multiple bacteria are at play, or if the cause of the infection is unknown.
Due to their relatively non-specific targeting strategies, broad-range antibiotics appear superior to narrow-spectrum antibiotics at first glance. But if this is the case, why are broad-spectrum antibiotics not used to treat every infection? Firstly, because broad-spectrum bacteria have such general targeting strategies, often they kill neutral and even helpful bacteria that live alongside the pathogen.1 These side-effects are especially dangerous because they can disrupt the body’s microbial ecosystem, which can result in additional downstream health problems.
While both varieties of antibiotics have their positives and negatives, one of the most pressing issues in modern antibiotic medicine lies in their over-prescription. According to the Centers for Disease Control and Prevention (CDC), of the approximately 154 million prescriptions written every year, nearly one-third of them are for illnesses that do not call for antibiotic treatment.2 In such cases, it is recommended to allow the body to fight off the illness using its natural immune system.
But why can’t antibiotics help along in the healing process? It has been found that over-prescription of antibiotics inflicts direct harm on the population by promoting antibiotic resistance in bacteria. A 2013 report by the CDC found that an estimated 2 million people in the United States are infected by antibiotic resistant-bacteria each year, and approximately 23,000 people die from these infections.3
The over-prescription problem is most concerning in children. Antibiotics are among the most common medicines prescribed to sick children.4 However, one study of antibiotics use in U.S. children demonstrates that a sizeable population used antibiotics for diseases such as bronchitis and the common cold—ailments in which antibiotics are rarely the canonical treatment.5 Another study of 41 hospitals worldwide found that, among children who did receive antibiotics, 32.9 percent were for preventative measures. Even more, approximately half of these prescriptions were for broad-spectrum antibiotics.6 While a pre-emptive strike on possible pathogens in the body may sound like a safe insurance measure, the overuse of broad-spectrum antibiotics is linked with increased levels of microbial resistance.6
Fortunately, professional recommendations have sought to lessen the rate of unnecessary antibiotic prescriptions in recent years. Medical professionals have been calling for limited use of broad-spectrum antibiotics, as well as the use of antibiotic cocktails for prevention rather than treatment. In addition, narrow-spectrum antibiotics are increasingly recommended to be used over shorter periods of time.7
With enough medically-conscious decision making, there is hope that the current antibiotic resistance crisis can be managed in the near future.
Works Cited
[1] Saggau, Danene. (2018). “Broad-spectrum versus narrow-spectrum antibiotics: what you should know.” Lake Meridian Chiropractic, lakemeridianchiropractic.com/broad-spectrum-versus-narrow-spectrum-antibiotics-what-you-should-know/
[2] “Antibiotic / antimicrobial resistance.” (2018). Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/drugresistance/threat-report-2013/.
[3] “CDC Newsroom.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2013, www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html.
[4] Ekins-Daukes, S., McLay, J. S., Taylor, M. W., Simpson, C. R., & Helms, P. J. (2003). Antibiotic prescribing for children. Too much and too little? Retrospective observational study in primary care. British Journal of Clinical Pharmacology, 56(1), 92–95. http://doi.org.ezp-prod1.hul.harvard.edu/10.1046/j.1365-2125.2003.01835.x
[5] Sarpong, E. M., & Miller, G. E. (2015). Narrow- and broad-spectrum antibiotic use among U.S. children. Health Services Research, 50(3), 830–846. http://doi.org.ezp-prod1.hul.harvard.edu/10.1111/1475-6773.12260
[6] Hufnagel, M., Versporten, A. Bielicki, J. Drapier, N. Sharland M. Goossens H. “High rates of prescribing antimicrobials for prophylaxis in children and neonates: results from the antibiotic resistance and prescribing in european children point prevalence survey.” Journal of the Pediatric Infectious Diseases Society, 22 March 2018.
[7] Pediatric Infectious Diseases Society. "Antibiotics often inappropriately prescribed for hospitalized kids, global study suggests." ScienceDaily. ScienceDaily, 22 March 2018. <www.sciencedaily.com/releases/2018/03/180322103245.htm>.
