Antibiotic Resistance Explained

Antibiotics have changed the face of infection treatment, making many diseases that were once death sentences — the bubonic plague, for example — frequently treatable. But now, antibiotic resistance threatens to turn the tables once again, with superbugs rising to wreak havoc on unsuspecting populations.

Antibiotics are important in the treatment of numerous infections, but overuse has led to strains of drug-resistant bacteria. Inappropriate prescribing, excessive course lengths and use in agriculture are a few of the biggest offenders. Antibiotic resistance can occur through persister cells, which take on temporary changes to survive an attack, or through permanent mutations that can be shared with other bacteria. Let's look at antibiotic resistance, and to learn how to reduce our chances of developing a drug-resistant disease.

Antibiotic Overuse

Every time you expose bacteria to antibiotics, you’re taking a chance of creating a drug-resistant strain. This wouldn’t be such a big deal if we all used antibiotics responsibly, but far too many of us continue to take the life-saving drugs for minor or viral ailments.

Nearly one-third of outpatient antibiotic prescriptions are written for conditions they cannot treat, such as colds, the flu and other viral infections. This exposes people, and the bacteria residing in them, to unnecessary antibiotic courses, increasing overall chances of resistance.

Antibiotic overuse is also a problem in agriculture. About 80% of all antibiotics in the U.S. end up going to livestock. Agricultural use increases the risks of antibiotic resistance in the animals being treated and the people who consume them. Antibiotics are excreted through animal waste, so they can contaminate fertilizer and local groundwater runoff as well.

Defense Techniques

Bacteria respond to attacks just like most other living organisms, and they have numerous approaches they can take to preserve their colony. One approach involves the formation of persister cells. These stubborn bacteria can survive an onslaught of antibiotics due to temporary changes that alter the drug’s effects on them, usually by going dormant. Almost all bacteria can form persister cells, although some strains do this more often than others.

A more sinister trick bacteria have up their proverbial sleeves is the ability to mutate in response to chemical attacks. This is usually where antibiotic-resistant strains begin. The threat is especially high if the wrong antibiotic or dosage is prescribed, making what should be a targeted attack into a looser, less specific one. Mutations create permanent changes that can counteract specific antibiotic effects. What’s more, bacteria can share these changes with other bacteria. That means new strains of drug-resistant disease can potentially form in a person carrying anything with the right resistance mutation.

Course Length Debate

This isn’t to say complete avoidance of antibiotics is always the answer. Some infections won’t go away on their own, and in some cases, antibiotics may be needed to treat potentially deadly infections. The possibility of creating resistance exists in these cases too, unfortunately, but if this is the only time we use these drugs, we are, overall, reducing the likelihood of mutations.

There is growing debate over the long-standing belief that a person must finish an antibiotic course even after they feel better. Researchers are finding that this practice could actually be doing more harm than good, since infections often can be treated with shorter courses, and longer ones may be increasing resistance risks by exposing other bacteria in the body to medications that target other bacteria. Still, the World Health Organization recommends following your doctor’s prescribing advice for the time being.

Antibiotics are incredible tools against infection, but like all great things, there’s an ugly side to their abuse. We all must do our part to ensure these life-saving medications remain useful for generations to come. Reduce your exposure by using them only when your doctor thinks they’re 100% necessary and seeking out antibiotic-free meats and dairy products. With responsible use, the right treatments will be there — and work more effectively — when we really need them.

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