10-4 Magazine - For Today's Trucker

RESISTING THE URGE
BY FAMILY NURSE PRACTITIONER NORMA STEPHENS HANNIGAN

ACHOO! Before you run to the medicine cabinet to grab some of that leftover penicillin from the last time you had a cold, stop and think about the potential risks of antibiotic abuse. Since they were invented, scientists have known that antibiotic resistance could be a problem, but no one worried too much about it until the past 20 years or so. Now it’s time to put a stop to their indiscriminate use – before it’s too late.

WHAT ARE ANTIBIOTICS AND HOW DOES ANTIBIOTIC RESISTANCE HAPPEN? Antibiotics, a miraculous invention of the 20th Century, are medicines that kill disease-causing bacteria. Until they became widely available in the 1940’s, people often died of infectious diseases like dysentery, tetanus, infected wounds, and tuberculosis. Antibiotics saved many lives. However, a trend began where almost EVERYTHING that could be considered infectious was treated with them. Physicians (at that time they were the only professionals diagnosing and treating patients) thought nothing of ordering a little penicillin for whatever ailed anyone with a fever, even though the cause was not clearly bacteria. The thinking was, and still is, “It couldn’t hurt, right?” Well, as it turns out, it can hurt. As the years roll by, several infectious diseases are becoming resistant to antibiotics because of overuse. Bacteria that had been sensitive, that is, easily killed, by them are now resistant. In 1992, according to the Centers for Disease Control, 13,300 hospital patients died of bacterial infections that were resistant to antibiotic treatment. Some antibiotics aren’t working at all any more due to overuse and resistance.

THE BACTERIA BAD GUYS. Bacteria are like super-villains in comic books, making a power grab to take over your body; antibiotics are like defending soldiers. The antibiotic strikes out against the villains and wipes out the weakest of them initially. But, like the comic book super-villains, bacteria can continue perpetrating their treacherous acts by morphing, or changing form. Once the transformation has taken place, the antibiotic medicine can no longer attack them. The bacteria villains win and are able to keep on reproducing, making their victims sicker. It’s a matter of “survival of the fittest”. When you are prescribed an antibiotic for a bacterial infection and only take it for a couple of days until you feel better, the weakest of the bacteria have died but the fittest ones go forth and multiply. You may get sick again soon because of the hearty bacteria still hanging around, but this time it may be harder to find an antibiotic that will kill them. Commercially prepared beef and chicken contain antibiotics that also contribute to the problem of resistance.

HOW DO PEOPLE SURVIVE WITHOUT ANTIBIOTICS? Most people with normal immune systems are equipped to fight off common infections, bacterial and viral, using the body’s own defenses. Colds, coughs, ear infections, vomiting and diarrhea are more often than not caused by viruses. Antibiotics DO NOT kill viruses! Viruses run their course without complication most of the time. Fever is your body’s way of fighting infection and is produced with the mobilization of disease fighting cells. Most viruses take 7-14 days to run their course completely. The good news is that exposure to microorganisms helps our bodies build more defenses. In fact, a recent study showed that children in daycare are less likely to develop leukemia, a cancer of the blood/immune system, probably because of exposure to other kids’ germs.

WHY ARE RESISTANT BUGS A PROBLEM? If I have a resistant bacteria and I sneeze on you, you breathe in my resistant bug. You get sick and blow your nose, don’t wash your hands afterward, and then shake the hand of the guy next to you at a family gathering. Now he’s got the resistant bacteria. He goes to visit his pregnant daughter, kisses her hello and good-bye and now she’s got it. See where this is going? If these are dangerous disease causing microorganisms, they are now being spread from person to person. And since they’re antibiotic resistant, if the person gets very sick, there may be few or no antibiotics that can treat them. For a while we thought we had tuberculosis, a serious lung disease, beat. As it turns out, the TB germ became resistant to a few of the medicines used to treat it. Now we have MDRTB – multi-drug resistant TB, a new form of tuberculosis – as well as other dangerous resistant germs that need new antibiotics to outwit the bacteria that have outwitted the old antibiotics.

WHAT CAN WE DO ABOUT IT? Sometimes antibiotics are the best thing for treating an illness; sometimes they are not. The most difficult part for health care providers is telling the difference between viruses and bacteria. Many times we have to treat empirically, relying on experience or observation alone. In other words, it is an educated guess without any way to be absolutely sure of what we are treating. We have come to realize now that many of the common complaints that bring people to the clinic are caused by viruses, not bacteria. Patients feel that we must do something, but sometimes doing nothing, just watching and waiting, is the best approach. If you have a viral illness, all the antibiotics in the world won’t cure you and, in fact, they may harm you. It’s important to understand that many illnesses can resolve without treatment with antibiotics.

FINAL THOUGHTS. Someone who feels very sick should be checked out by a health care professional. When you do visit your health care provider, don’t ask automatically for antibiotics. Ask if he/she feels your illness may be one you will get over without antibiotic treatment. There is usually the option of waiting a few days, trying a few home remedies or taking over the counter medicines to relieve symptoms. You can always go back and be reassessed if your condition is worsening. Resist the urge to borrow your friend’s penicillin – in the long run, it will serve us all.