What is Antibiotic Resistance?

Antibiotics—medicines used to treat bacterial infections—are among the most incredible medical inventions. Their utility is not to be underestimated, as multiple millions of lives have been saved since the dawn of antibiotic treatment. Antibiotics are not without their caveats, however, particularly when it comes to antibiotic resistance, a growing problem that is leading to higher mortality and prolonged hospital stays.

Knowing what causes antibiotic resistance can help you potentially prevent it.

How Antibiotics Work 

Everyone has likely taken an antibiotic (especially given how overprescribed these types of drugs are today), yet not everyone understands how they work. Also referred to as “antimicrobials,” antibiotics fight infections caused by bacteria known to be harmful in humans and animals; and if left unattended, these bacteria can cause illnesses that lead to death. These types of drugs typically work in one of two ways, either by inhibiting the growth and multiplying of bacteria or killing them outright.

One of the biggest misconceptions about antibiotics is that they can be used to treat infections that are caused by viruses. Contrary to this belief, antibiotics work only to treat infections caused by bacteria—a difficult factor to discern at times but a very important distinction to try to make. Illnesses such as the common cold and flu are never caused by bacterial infection, which means antibiotic treatment will do nothing to restore health. Things get trickier when it comes to infections such as sinusitis or certain manifestations of sore throat, both of which can be either viral or bacterial in nature – hence the importance of knowing the difference to administer proper, effective treatment.

While the vast majority of physicians know not to prescribe antibiotics to treat a bout of the flu, the decision isn’t quite so clear when someone suffers from what could either be a viral or bacterial infection, especially in situations where testing to confirm either is impossible. This uncertainty can lead many doctors to prescribe an antibiotic as a prophylactic measure, or “just in case.” This is one of the primary reasons why antibiotic resistance is a problem in the world today for the individual and for communities: when people remain sick from bacterial infections, they communicate that infection easily, creating an outbreak.

Antibiotic Resistance

In a perfect scenario, a person who has come down with a bacterial infection takes an antibiotic (killing the bad bacteria) and everything goes back to normal. Unfortunately, this is seldom the case, which is one reason why so many people suffer ongoing side effects after taking even just a single course of antibiotics. Antibiotics are “smart” -- in that they’re able to target specific pathogenic bacteria to arrest development of the illness it causes, but they’re not able to identify the bacteria that is beneficial to health. Therefore, the drugs kill as much bacteria as they can without discriminating between “good” and “bad” microbes.

Once a course of antibiotics has both restored health by vanquishing the pathogens and done its damage, it leaves the gut microbiome in a compromised state. Beneficial microflora that help to keep food-borne illness and other health problems at bay tend to be present in much smaller numbers than is ideal. While this can lead to chronic issues such as irritable bowel syndrome (IBS), it also has the potential to create antibiotic resistance — a threat that should not go overlooked.

In general, antibiotic resistance is the ability for bacteria to fight against antibiotic treatment. It occurs when bacteria change in ways that render the drugs less effective, allowing some pathogenic bacteria to proliferate at alarming levels. The way in which it works is quite simple. It begins with a target population of microbes, which an antibiotic is used to either kill or degrade in some way. A small, but significant portion of these harmful bacteria are actually drug resistant by nature, which means they stick around undisturbed throughout the course of antibiotic treatment.

As the drug works, it kills the bacteria causing whatever illness is being treated and the beneficial bacteria your body needs to maintain balance in the microbiome. All of a sudden, those few harmful bacteria that were resistant to antibiotic therapy are now in charge, taking control over the microbiome while also lending their drug-resistant characteristics to other bacteria. If this scenario is allowed to progress, finding a drug that can effectively treat the growing infection becomes more difficult as it also becomes more urgent.

Spreading Antibiotic Resistance

While it may seem obvious that an individual’s own health may be at risk resulting from antibiotic resistance, it often spreads, compromising communities globally. A cycle exists in the spreading of antibiotic resistance, starting with treatment for both humans and animals to kill (or in the latter example, prevent) infections that inevitably lead to some bacteria becoming resistant. In people, these same bacteria can be spread in healthcare and office environments, or throughout the community due to poor hand-washing and other hygiene habits.

Animals play a key role in the spread of antibiotic resistance, too, primarily because drug-resistant bacteria are capable of transferring from animals to human via food. Even the water or fertilizer used to grow food crops can be contaminated with these bacteria, eventually making their way to the human gut and restarting the cycle. Since using antibiotics in any way can result in resistance, even those who have never taken antibiotics before are at risk due to environmental factors.

How to Prevent Antibiotic Resistance

There are several actions you can take to protect yourself and those around you from developing antibiotic resistance, but those around them, too. Here’s a quick overview of how we can collectively work to solve the global issue of antibiotic resistance:

1. Prevent Infection

Although there’s no straightforward way to prevent getting sick 100% of the time. That said, the first step in curbing antibiotic resistance is to reduce the prevalence of antibiotic use -- this starts with preventing infection. This is one of the biggest areas for individuals to focus on, as immunizations, proper hand-washing hygiene and safe food preparation practices, all of which are instrumental in fighting infection.

2. Don’t Beg for Antibiotics

For many people, a visit to the doctor isn’t complete without bringing home a medication that will make them feel better. Bear in mind, however, that viral infections such as the common cold and flu cannot be treated with antibiotics and taking a course of these drugs when it isn’t absolutely necessary can cause antibiotic resistance. If your doctor chooses to send you home with a prescription of rest and plenty of fluids, he or she likely believes it to be viral, so trust their professional advice rather than assuming you need antibiotic therapy.

3. Take Probiotics

One of the primary reasons why harmful bacteria can gain such a strong foothold after taking a course of antibiotics is because they have such a small population of good bacteria to fight back against them. The solution to this common problem may be found in taking a probiotics supplement both during and after a necessary course of antibiotics. Probiotics add a significant increase in beneficial microflora in the gut microbiome, where they are needed in the presence of resistant bacteria. Be sure to choose a reputable brand, and look for single-strain supplements, which are far more effective at populating the gut with the good microbes than those containing multiple potentially competing strains of bacteria.

4. Eat Less Meat

While it’s essential to get enough protein in your diet daily, the fact that most meat comes from animals that are given feed containing antibiotics is an attractive reason for avoiding animal protein altogether. There are plenty of other protein sources that are less likely to contribute to antibiotic resistance in the body—soy protein, for example. At the very least, avoid eating meats that have been “factory farmed,” where antibiotic use is common. Instead, select beef, chicken or pork that are grass-fed, cage-free and organic.

Antibiotic resistance holds scary consequences for the world on both macro and micro levels. While these drugs are necessary in some circumstances, their overuse has caused problems that could never have been expected at the time of their discovery. By following the above steps, you can dramatically reduce the risk of developing antibiotic resistance.
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