Did you know that every time you use an antibiotic, you increase your risk of developing antibiotic resistance? Harmful, antibiotic-resistant bacteria strains can threaten your ability to combat infectious diseases. A growing list of common conditions, such as strep throat, pneumonia, food poisoning, and gonorrhea, are becoming harder and, in some cases, impossible to treat because of antibiotic resistance. (13)
Antibiotic resistance is rising to dangerously high levels globally. According to the World Health Organization’s 2019 report, at least 700,000 people die worldwide every year because of drug-resistant diseases. If nothing changes, antibiotic-resistant infections could account for up to ten million annual deaths by 2050. (46)
Keep reading to learn more about the relationship between antibiotics and human health. (5)
What are antibiotics?
Antibiotics, also known as antibacterials, are specific types of antimicrobial drugs used to kill and restrict the growth of harmful bacteria. (3)
Alexander Fleming discovered the first antibiotic—penicillin—in 1928. It all started with a mold that accidentally grew on a Staphylococcus culture plate. The discovery of penicillin and other antibiotic “wonder drugs” completely changed the course of medicine. (3)
By World War II, other antibiotics had been discovered and were in widespread use. Life expectancy went up by almost two decades, surgeries became safer, and people began surviving what used to be deadly infections. (18)(39)
Broad-spectrum vs. narrow-spectrum antibiotics
Some antibiotics work on numerous types of bacteria. These are often called broad-spectrum antibiotics. Other antibiotics target bacteria more specifically and are known as narrow-spectrum antibiotics. To use narrow-spectrum antibiotics, healthcare providers have to diagnose offending bacteria accurately and quickly before an infection spreads. (14)(22)
Broad-spectrum antibiotics are easier to use on a large scale, as they can work for various bacterial infections. They can also be administered when immediate treatment is needed or if there is a lack of resources. Still, they also affect the beneficial microbes found in the gut and can harm the microbiome. (22)
How antibiotics disrupt the microbiome
There are trillions of microscopic microbes in your gut, up your nose, and on your skin. The ecosystem that lives in and around the body is known as the microbiome. The microbiome supports the immune system and other vital functions essential to human survival. (29)
In the microbiome, it’s not uncommon to carry harmful bacteria that are known to cause serious illness. In healthy individuals, the bacteria simply coexist in equilibrium with their hosts. (32)(41)
Disrupting normal gut health
Antibiotics target bacteria microbes, which are one of the four types of microbes found in the human microbiome. Unfortunately, most antibiotics, particularly broad-spectrum antibiotics, target more than the harmful bacteria. Studies have shown that taking antibiotics can disrupt your normal gut microbiome and destroy your good gut bacteria along with the bad. (47)
A clinical example of antibiotics hurting the microbiome
How does antibiotic resistance develop? It can be helpful to look at patients using clindamycin, a type of antibiotic, as an example.
Although clindamycin is a broad-spectrum antibiotic used to treat strep infections, chlamydia, and other common infections, it has been shown to negatively impact gut health. (33) In one clinical study, antibiotic treatment of clindamycin diminished patients’ beneficial gut health, which led to the overgrowth of the pathogenic bacteria Clostridium difficile (C. difficile). This triggered symptoms such as diarrhea and colitis. Long-term side effects from the antibiotics, including reduced microbiome diversity, increased active antibiotic-resistant genes in the gut’s microbiome, and recurrent C. difficile infections, persisted up to two years. (19)(40)
Did you know? There are four types of microbes found in the human microbiome: bacteria, fungi, viruses, and protozoans. (24)
What is antibiotic resistance?
Why do once-reliable antibiotics stop working, and how do bacteria become resistant to antibiotics? It all comes down to mutations. (7)
Antibiotic resistance occurs when a bacterial strain mutates and develops the ability to survive exposure to antibiotics that have been designed to destroy bacteria or stunt the growth of bacteria. Once a bacteria is resistant to one or more antibiotics, it can grow, reproduce, and cause harmful infections in its human or animal host and then spread to others. (7)
Similar to all living things on earth, bacteria are constantly evolving to survive, and they are naturally prone to DNA mutations. Antibiotics have successfully killed bacteria for decades, but over time, bacteria have learned to become resistant. (7)
Did you know? When a bacteria is resistant to multiple antibiotics, it is known as a “superbug.” (2)
How does bacteria become antibiotic resistant?
The defense strategies bacteria use to combat antibiotics are known as antibiotic resistance mechanisms. (18)(30) For example, a bacteria can use the following mechanisms to fight off antibiotics:
- Resistant bacteria change or destroy antibiotics with enzymes.
- Resistant bacteria develop new cellular processes that avoid using the antibiotic’s target.
- Resistant bacteria restrict access by changing their cell’s entryways or limiting the number of entrances.
- Resistant bacteria switch an antibiotic’s target so it can no longer address the bacteria.
- Resistant bacteria use pumps to push antibiotics out of their cell. (31)
What causes antibiotic resistant bacteria?
Evolution naturally causes antibiotic resistance, but some controllable drivers also accelerate the rate at which the bacteria evolve, mutate, and spread worldwide.
The overprescribing of antibiotics in humans
Did you know that the U.S. Centers for Disease Control and Prevention (CDC) estimates that 47 million unnecessary antibiotic prescriptions are written in the United States alone every year? In the United States and other developed countries, the overprescribing of antibiotics is a driving factor in antibiotic resistance. Attribution factors for overprescribing antibiotics include inadequate diagnostic tools and a lack of regulations around antibiotics. (9)(34)
The inappropriate use of antibiotics by patients
Antibiotics cannot treat viral infections, such as the common cold, cough, or seasonal flu. It’s important to only use antibiotics when medically necessary and when instructed by your practitioner. Furthermore, if you’re prescribed antibiotics, it’s essential to take them exactly as directed. (34)
The misuse of antibiotics on farms
Farmers administer antibiotics to livestock to prevent illness and promote animal growth, but according to new research, the medications are losing their effectiveness. The routine use of antibiotics can make it challenging for farmers to raise animals and treat them if they get sick. Further contributing to the issue, harmful and hard-to-contain bacteria strains could develop and spread to humans. (20)(26)
Poor hygienic standards in hospitals
It is essential to implement basic hygienic standards such as handwashing and cleaning shared surfaces in public settings to stop the spread of germs. Hospitals cater to seriously ill patients who are even more susceptible to infections than most and often need one or more antimicrobials. The combination of hospital hygiene protocols and the overuse of antibiotics for patients with weak immune systems has driven the spread of antibiotic resistance. (43)
The growing popularity and ease of global travel
Antibiotic resistance is intrinsically linked to global travel health. Travelers who overuse antibiotic medications for conditions such as traveler’s diarrhea and who also fail to practice basic cleanliness with handwashing have contributed to the spread of antibiotic resistance. (6)(37)
Could I be at higher risk for antibiotic resistance?
Antibiotic resistance can impact any person, at any stage of their life, though some people are more susceptible, including:
- Frequent out-of-country travelers
- Individuals over 70 years old
- Individuals who have inappropriately used antibiotics Individuals with chronic diseases or serious injuries
- People who consume large quantities of meat that is not organic or antibiotic-free
- People who live near farms using antibiotics
- Very young children (4)(12)(15)(19)(21)(23)(25)(28)
9 ways to prevent antibiotic resistance and protect yourself
Wondering how to prevent antibiotic resistance? Experts say there are precautions and straightforward steps you can take as an individual that can make a significant difference in the spread of antibiotic resistance globally, while also keeping yourself and your community safe.
So what can you do? Here are nine things you can do to prevent the spread of antibiotic resistance.
1. Eat meat from animals raised without antibiotics
Avoiding meat from animals raised with antibiotics may help stop the spread of antibiotic resistance. In the United States and Canada, farmers use antibiotics to prevent diseases among their livestock and boost the animals’ growth. Furthermore, livestock are often raised in tight living conditions where they’re exposed to the urine and feces of several other animals. When you introduce antibiotics to this environment, it’s the ultimate breeding ground for drug-resistant bacteria. (42)
2. Frequently wash your hands
Washing your hands after going to the bathroom, before you prepare or eat food, and every time you cough or sneeze can help to minimize your risk of illness, antibiotic use, and subsequent antibiotic resistance. (10)(27)
3. Prepare food safely
When you bring home any groceries, always make sure to follow the World Health Organization’s (WHO) Five Keys to Safer Food. The five keys include:
- Keep clean: Wash your hands frequently, especially after handling raw food
- Separate raw and cooked foods.
- Cook food thoroughly.
- Keep food at safe temperature ranges.
- Use safe water for washing or boiling foods. (45)
4. When you travel, carry hand sanitizer and don’t take antibiotics preventatively
Avoid taking over-the-counter antibiotics abroad without talking to a licensed healthcare provider first. It’s also very important to practice proper hygiene. Using hand sanitizer when traveling has been shown to reduce the risk of diarrhea and vomiting. (17)
5. If you’re prescribed antibiotics, ask your practitioner questions
If you are prescribed antibiotics by a practitioner, don’t be afraid to ask questions to ensure that antibiotics are the right course of treatment for you. Is your practitioner certain that bacteria are causing your symptoms? How are they sure that the antibiotics will work? What are the possible side effects? (35) Consider also inquiring about other possible effective treatments and alternative therapies that may be appropriate for you. (35)
6. Never pressure a healthcare provider to give you an antibiotic
Every time you take an antibiotic, you raise the risk of developing resistant bacteria on your skin or in your body. These bacteria can then spread from your household to your community. By using antibiotics more selectively, we can help revitalize the antibiotics to which we’ve become resistant. (35)
7. Take antibiotics for bacterial infections and as directed by your practitioner
As long as your antibiotics are not causing any dangerous adverse reactions, you should always complete your prescribed course of treatment. If you stop your treatment too soon, some bacteria may survive, evolve, and re-infect you. You should also never take antibiotics that are prescribed to someone else or that are old or leftover. (35)
8. Do not take antibiotics for viral, parasitic, or fungal infections
Antibiotics should only be used to treat bacterial infections. They should not be taken to address the common cold or flu, yet they are all too frequently prescribed for this purpose. (35)
9. Ask your practitioner about probiotics
Studies demonstrate that certain probiotic strains may be useful for restoring the gut microbe after antibiotic treatment. However, probiotics may not be appropriate for everyone. Before taking probiotics, speak to your practitioner to ensure they’re right for your wellness plan. (38)
Did you know? As of 2019, more than 2.8 million antibiotic-resistant infections occur in the United States each year, and more than 35,000 people die annually as a result. (9)
The bottom line
Our human microbiomes are responsible for countless essential functions, but after 80 years of using antibiotics, we are now beginning to realize how these groundbreaking drugs have reshaped and changed our microbiome. (8)
Do you think you may have a bacterial infection and are concerned about antibiotic resistance? Seek out assistance from a trusted healthcare provider. And remember, there are things you can do day-to-day to protect against the spread of antibiotic resistance on an individual level.
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