Reliance on antibiotics: savior or hindrance?
by KC Jones, feature editor

    According to an article in the February edition of Parent and Child magazine, the number one illness-related cause of absence for school children is ear infections.

   Every time I take my daughter to the doctor, it seems she has an ear infection or sinusitis. He always prescribes antibiotics, and it concerns me because I have heard health experts say not to overuse antibiotics. But what are antibiotics, and should I be concerned about giving them to my daughter?

   According to Mosby’s Nursing Reference, a broad-spectrum antiinfective/antibiotic such as amoxicillin works by causing the cell wall of susceptible organisms to swell and burst from osmotic pressure.

   Amoxicillin is frequently prescribed to treat a variety of bacterial infections including many strains of strep, salmonella and E. coli. While the disease can be debilitating, so can the drug. Side effects and adverse reactions include anemia, bone marrow depression, vomiting, diarrhea, headache and rash.

   D   iarrhea is a potential side effect with almost any antibiotic because the medications not only kill the bad bacteria but also the good bacteria that live in the intestines and aid in digestion.

   Once the delicate balance of bacteria is disturbed, the bad guys like clostridium difficile can multiply unrestricted. C. difficile are now free to multiply to the point they produce enough toxins to injure the lining of the colon and rectum producing a condition called PMC, pseudomembranous colitis.

   PMC is not the mild diarrhea that clears up once you finish your medication. It is a serious situation that warrants immediate medical attention. Symptoms include watery, profuse diarrhea that can be bloody, severe abdominal pain and cramping, dehydration, fever and nausea. Ironically, your doctor may prescribe metronidazole or vancomycin, both antibiotics, to treat PMC. PMC is highly contagious, so extra hygiene precautions are required until the condition clears up.

   Yogurt can help. It is important to replace the good bacteria in the body. There are supplements and yogurts that contain live, active bacteria such as lactobacillus that can help get the balance back in the bowels.

   Dr. Stuart Levy, professor of molecular biology, microbiology and medicine at Tufts University School of Medicine, is also president of the Alliance for the Prudent Use of Antibiotics. He is an expert on this issue and explains what the concern is about.

   Levy says that there has been increasing bacterial resistance to many antibiotics that once cured bacterial diseases readily.

   “Not only in the treated individual but also in the environment and society at large,” he said.

   Extended use is one of the main factors he cites.

   “The compounds should thus be used only when they are truly needed, and they should not be administered for viral infections, over which they have no power,” he said.

   The other factor is the increasingly resistant genes of pathogen/harmful bacteria. This resistance occurs as the bacteria develop a resistance to the antibiotics that are attacking them. The genetic resistance is passed easily within the strain of bacteria, one to another; then the bacteria are passed from one person to another and super-infections begin to occur.

   Therefore, high traffic places like hospitals, farms and daycare centers are increasing the levels of resistant bacteria in people and animals that are not even being treated.

   By not taking enough of the medication to kill the bacteria, it becomes stronger from the inoculation.

   According to Levy, antibiotic use is out of control.

   “Human treatment accounts for roughly half the antibiotics consumed every year in the United States. Perhaps only half that use is appropriate, meant to cure bacterial infections and administered correctly,” he said.

   Centers for Disease Control and Prevention have estimated that some 50 million of the 150 million outpatient prescriptions for antibiotics every year are unneeded.

   Forty percent of the antibiotic use is for farm animals, mostly given in growth formulas in feed. But the doses are too low to kill disease, and the microbes can be passed on to the caretakers or people who prepare the meat or consume it undercooked.

   Antibiotics are also applied as aerosols over acres of agriculture with resistant results in the environment as well.

   “If the antibiotic drugs are going to retain their power over pathogens, they have to be used more responsibly,” Levy said.

   A number of actions could help reverse the trend, if individuals, businesses and governments around the world can find the will to implement them.

   Improved hygiene would go a long way to enhance livestock development.

   Consumers should wash produce to remove resistant bacteria and antibiotic residue.

   Patients should complete the full course of any antibiotic drugs and not save medicine for future use.

   Patients should not demand their use for minor conditions such as acne or viral infections that they will not be effective against.