As exciting as the journey of discovery of antibiotics has been, there are some problems to consider...
The Antibiotic Dilemma
By Peter N. Landless and Allan R. Handysides
I was recently diagnosed with pneumonia, and my doctor prescribed antibiotics. I was feeling very unwell, but because I don’t like taking any medications, I took the antibiotics only until I felt better and then stopped. Is it safe to use the balance later?
This question highlights some very important concepts.
Antibiotics are helpful medications intended to fight infections and diseases caused by bacteria. They work by either killing the bacteria or preventing them from reproducing. Antibiotics are helpful in bringing infections under control, and assisting the body’s immune system in the process of eliminating offending bacteria from the system.
Sir Alexander Fleming discovered the earliest known antibiotic in 1928. Only in the 1940s was penicillin used in the treatment of wounded soldiers in World War II. This successful experience ushered in an exciting era of progress in fighting bacteria with antimicrobials (antibiotics). Since that time many different kinds of antibiotics have been manufactured, even to the extent of the so-called designer type of antibiotic, which aims at very specific mechanisms to control the multiplication and kill the bacteria.
As exciting as the journey of discovery and refinement of antibiotics has been, it has also been fraught with numerous problems. Some individuals are unable to tolerate certain antibiotics; this intolerance ranges from severe allergy (anaphylaxis)—which may even cause death—to skin rashes; mild to moderate diarrhea; and superadded infection with fungi, such as Candida.
In addition, numerous bacteria have developed the ability to create resistance to the antibiotics being used; Fleming himself noted this characteristic in the earliest days of penicillin. This has resulted in the need for the use of combinations of antibiotics, and also for the development of what have become known as third- and fourth-generation classes of specific antibiotics.
The mechanism by which bacteria develop resistance has been recognized for many years; these microorganisms undergo genetic changes, which are mediated by phages and plasmids. These small molecules, or “packages,” of DNA (genetic material) can be transferred from one bacterium to another. Recently Chinese scientists have noted a very significant and extremely worrying development: the ability of certain bacteria to transfer this resistance horizontally between different bacterial strains. This was noted in routine surveillance of food animals, such as pigs, and signaled the first time that such resistance to the polymyxin antibiotic colistin was observed. This has caused great consternation in the scientific world, with fears that if such resistance continues to develop, the practical and helpful use of antibiotics may be coming to an end! Although the resistance described above is currently limited to China, it is anticipated that it will spread throughout the world.
Back to your question: Always complete the course of antibiotics, even if you feel better before the treatment is completed. This will decrease the amount of antibiotic resistance. There should never be leftover antibiotics in your medicine cabinet. Encourage those over whom you have influence to do the same.