Squashing Superbugs
When I was that last of all my friends to go down with the freshman plague, going to the doctor was not the course of action I first considered. Taking the antibiotics one of my friends had brought from home seemed much easier than making an appointment, trudging up to Yale Health, and going to the pharmacy. When I eventually chose the latter, I learned that I had a viral infection and was sent home prescription-free. Only three days later, I was fully recovered, glad to have chosen a 30-minute wait at the acute care clinic over what would have been an unnecessary antibiotic course. As I have seen around my own campus, unnecessary or inappropriate antibiotic prescriptions, which may make up as much as 50% of hospital antibiotic prescriptions, is surprisingly common and not without serious consequences.
Although it cannot be denied that antibiotics are one of the most transformative medicines to exist, their overuse is devastating because it leads to the proliferation of resistant strains of disease-causing bacteria that have evolved to evade antibiotics. Now recognized as a public health crisis and a threat to national security, antibiotic resistance is responsible for over 2 million infections and 23,000 deaths annually in the United States alone, as well as a huge economic burden.
Aside from spawning multi-drug-resistant superbugs projected to cause 10 million deaths worldwide by 2050, overuse of antibiotics can damage one’s health. As we unnecessarily use antibiotics, we subject ourselves to side effects ranging from nausea and diarrhea to infection by the dangerous Clostridioides difficile (C. diff) bacteria. We deplete the “good bacteria” that reside in our gut and are essential to appropriate immune responses, drug metabolism, and vitamin synthesis, thus increasing our susceptibility to other diseases. This is an especially important consideration when prescribing antibiotics to pregnant women, as it may hinder development of the fetal immune system. Recent research investigating the effectiveness of probiotics to recolonize the gut shows that restoring our microbiota after a course of antibiotics is not as simple as I once thought.
Thankfully, growing awareness of these drawbacks is motivating biomedical research efforts to find alternatives to antibiotics. For example, Women’s Health Research at Yale funded a study led by Dr. Toby Chai investigating a method of increasing estrogen activity in the bladder lining to treat chronic urinary tract infections in women. Although antibiotics are typically used to treat such infections, which women are 30 times more likely to develop than men, they do not always prevent recurrent infections and can become ineffective with the rise of resistant bacteria. Research such as Dr. Chai’s can lead to the development of effective therapies that reduce reliance on antibiotics.
Experts recommend multiple approaches to win the war against antibacterial resistance. These include training health care providers to avoid overprescribing antibiotics and creating incentives for the pharmaceutical industry to renew the development of new antibiotics. But we can also take actions in our own lives.
The simplest way for me to minimize my antibiotic use is to actually visit the doctor when I am sick and only take antibiotics as prescribed. While this course of action may seem obvious, self-medication with antibiotics obtained from nonmedical sources such as relatives and health food stores is surprisingly common in the United States. Because antibiotics should only be used to treat certain bacterial infections or for those especially vulnerable to infections, receiving a doctor’s diagnosis will reduce the risk of unnecessary antibiotic use. Sticking to prescribed treatments, rather than ending courses early upon feeling better, is important to avoid treatment again later. And of course, proper hygiene will minimize the risk of contracting a bacterial infection in the first place.
Ultimately, using antibiotics responsibly not only benefits our own health but also ensures that these powerful medicines, which have saved countless lives, will continue to do so.
