Preventing a Post-Antibiotic Era

Episode: 
92

Does your doctor tell you to be sure and finish all of your antibiotic? You might think, well, I’m feeling better so I’m not going to put more of that stuff in my body.

Or, do you ask the pediatrician for an antibiotic every time your child has an ear infection? You might say, nothing else works, and the antibiotic takes care of it every time.

Both of these scenarios relate to public health, an important concern of bioethics we may not think about. Public health focuses, naturally, on large groups of people. Its goals include prevention of disease using tools such as research and education. Decisions you make with your doctor are an aspect of clinical ethics. Public health officials are interested in the cumulative impact of those individual decisions, as well as better ways to help prevent widespread diseases.

Public health officials have become concerned about the growing problem of antibiotic resistance.  Increasing numbers of infectious bacterial strains have become unresponsive to commonly prescribed antibiotics.  This means that people who develop an infection after scraping their knee may not be able to fight off these new superbugs.  Doctors and hospitals are virtually helpless against these new bacterial strains since there are no drugs they can give to kill the infection.  Because of this, the World Health Organization fears that we may be creating a “post-antibiotic era.”  They estimate that current strains of these superbugs kill 25,000 people a year in Europe alone.

How did we arrive at this problem?  Well, bacteria are living organisms that can easily adapt to their environments to promote their survival.  That means frequent exposure to antibiotics increases the chance that they will develop resistance. 

Let me give you an example.  India develops one-third of the world’s antibiotics. Pharmaceutical runoff and the liberal use of a few drugs have killed off a number of common bacterial strains, allowing other bacteria resistant to these antibiotics to thrive and multiply.  These are the superbugs that develop resistance to all known antibiotics.. First identified in a Swedish man in New Delhi, the NDM-1 superbugs are spreading across the globe.[1]

The good news? The public health response is making a difference.. A few drug companies are working on new lines of drugs to fight the NDM-1 superbugs, even though there is little money to be made.[2]  Due to public health initiatives discouraging the overprescription of antibiotics, the number of antibiotics given to children, especially for viral infections, has dropped by 14%.[3]

Keep this important public health issue in mind the next time you ask your doctor for an antibiotic for a cold or ear infection.  Don’t be surprised if he or she asks you to wait a day or two before writing a prescription. And, take all of the drugs prescribed. Our choices make a difference. The cumulative impact of these small steps can help prevent a “post-antibiotic era.” 



[1] Jason Gale and Adi Narayan, “Drug-Defying Germs From India Speed Post-Antibiotic Era,” Bloomberg, May 7, 2012, http://www.bloomberg.com/news/2012-05-07/drug-defying-germs-from-india-speed-post-antibiotic-era.html (accessed August 10, 2012).

[2] Rachel Cooper, “The Battle to Discover New Antibiotics,” Telegraph, January 12, 2012, http://www.telegraph.co.uk/finance/newsbysector/pharmaceuticalsandchemicals/9010738/The-battle-to-discover-new-antibiotics.html (accessed August 10, 2012).

[3] Alexandra Sifferlin, “Prescriptions for Kids: ADHD Meds and Birth Control Pills are Up, Antibiotics are Down,” TIME, June 18, 2012, http://healthland.time.com/2012/06/18/prescriptions-for-kids-adhd-meds-and-birth-control-pills-are-up-antibiotics-are-down/ (accessed August 10, 2012).

 

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