Matthew Nisbet, PhD
Jul 24 · 4 min read

False patient beliefs contribute to lethal superbugs and unhealthy guts

As millions of Americans visit their health care providers this winter complaining of a cold, surveys suggest that one in four will be expecting their provider to prescribe them an antibiotic, falsely believing that the antibiotic will help them recover more quickly from the virus.

The demand for antibiotics by patients is not surprising, considering other survey findings. Only about half of Americans know correctly that antibiotics kill bacteria but not viruses, a proportion that has remained relatively stable for more than a decade.

Similarly false beliefs across countries have contributed to a dangerous rise in antibiotic use. Between 2000 and 2010, worldwide sales of antibiotics by pharmacies and hospitals increased 36 percent.

Americans are by far the highest per capita consumers of antibiotics in the world. The Centers for Disease Control estimates that 50 percent of all antibiotics prescribed in the United States are not warranted.

The demand for antibiotics by Americans is a main driver of what many public health experts consider to be an escalating crisis of superbug infections resistant to treatment, and to the lesser but no less serious risk of longterm damage to the health of many Americans’ digestive systems.

Making headway on the problem will not only require smart policymaking, but also a major shift in public awareness that will require Americans to not only recognize the risks of antibiotic over-use but also to take responsibility for the problem.

Recognizing the risks

The overuse of antibiotics in the United States and other countries combined with the rapid growth in the use of antibiotics to grow livestock has led to the evolution of lethal “superbugs,” bacteria that are resistant to most antibiotics.

When people overuse antibiotics, they are more likely to kill off “good” bacteria in their bodies that protect them from infection.

Drug-resistant bacteria are then more likely to take over, festering in places such as the gut. These superbugs can spread to other people at home and at work or in a hospital.

The rise of superbugs and the loss of antibiotic effectiveness not only makes it more difficult to combat common threats, such as urinary tract infections or pneumonia, but those patients undergoing joint replacements, dental surgery, cancer therapy, and other procedures — who often depend on antibiotics to recover — are also put at high risk.

Each year at least 2 million Americans battle serious bacterial infections that are resistant to one or more antibiotics, according to CDC estimates, and at least 23,000 die annually as a direct result of those infections.

In a 2016 report, the World Bank warned that by 2050 the growth in drug-resistant infections, if not contained, would cause a level of global economic damage equivalent to, if not worse than, the 2008 financial crisis.

The over-use of antibiotics also disrupts the healthy mix of bacterial microbes that live in our intestines, killing off the bacteria we need to efficiently digest food, and may be one of the causes of obesity.

Studies also suggest that gut flora are linked to mental health, likely aiding in the regulation of mood and depression.

Taking responsibility

Health care providers are under immense pressure from patients to provide unwarranted antibiotic prescriptions for treatment of colds and other viral illnesses.

A 2012 survey found that half of U.S. health care providers say that their patients expect an antibiotic when visiting for a viral infection. According to studies, a health care provider’s perceptions of patient expectations are important since they tend to be a reliable predictor of over-prescribing.

Patients also report other means by which they obtain antibiotics, using prescriptions left over from past visits or using those obtained by a family member or friend .

In the U.S. and Europe, members of the public still do not see antibiotic resistance as a personally relevant problem that poses risks to their health or that is a function of their own choices as a health consumer. Instead, they tend to blame doctors, hospitals, and the government.

Tips from integrative medicine

Rather than go to your doctor for an antibiotic, there are a number of easy-to-adopt behaviors that can help prevent colds and upper respiratory infections, boost immune function, and keep gut flora healthy, writes Dr. Andrew Weil in 2017’s Mind Over Meds.

A first step is to pay attention to your body, and to recognize when you are sick, slowing down the pace of your life, so you can rest and recover. You should also try to isolate yourself if you can, so that you do not pass your viral infection on to others.

To prevent infection and its spread, make sure to frequently wash your hands, and avoid touching your face or lips with your hands. (People on average touch their face about 16 times an hour, according to one study).

To promote gut health, take a daily probiotic supplement, and eat probiotic rich foods such as sauerkraut, kimchi, yogurt, and kefir. If consuming animal products, be sure to purchase meat and dairy products that are antibiotic free.

Wealth of Ideas

Knowledge-driven stories for the optimistic, curious, and introspective.

Matthew Nisbet, PhD

Written by

Northeastern University professor writing about science, politics, and a more focused life at Medium’s www.wealthofideas.org/ Columnist at www.issues.org.

Wealth of Ideas

Knowledge-driven stories for the optimistic, curious, and introspective.

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