The reality of antibiotic resistance
Posted on 14 November 2016
The overuse of antibiotics in both healthcare and agriculture has led to a growing rate of bacterial resistance. An infectious disease specialist at Mediclinic explains why antibiotic resistance is such a big concern to future health and what we can all do to help.
What is antibiotic resistance?
Antibiotics are a type of antimicrobial drug used to combat or kill harmful bacteria that cause infection in the body. Dr Philip Botha, infectious disease specialist at Mediclinic Cape Gate, says the overuse of antibiotics in health care, as well as agriculture, has contributed to more and more cases of what’s known as antibiotic resistant bacteria.
‘Antibiotic (or antimicrobial) resistance means the bacteria has developed the ability to resist the effects of antibiotics. But this resistance is a natural occurrence. It’s actually a revolutionary mechanism that’s inherent in the genetic material of the bacteria. When exposed to antibiotics, this genetic mechanism is activated,’ he says.
The misuse and overuse of antibiotics, however, is accelerating this process and creating drug-resistant strains of bacteria, also referred to as ‘superbugs’.
Antibiotics, together with vaccinations, led to the near elimination of diseases like tuberculosis (TB) in the developed world during the 20th century. The World Health Organisation (WHO) reports that there are now 480 000 people globally who develop multi-drug resistant TB every year.
Causes of antibiotic resistance
‘The concern is that in the future we are going to enter a post-antibiotic era where certain infections will become untreatable. Already in some patients, there are infections that are resistant to all known antibiotics,’ says Dr Botha.
Common examples of antibiotic misuse:
- Incorrect dosage and administration.
- Failure to complete an entire prescribed course of the antibiotics.
- Failure to rest for sufficient recovery.
- Using antibiotics to treat viruses, like the common cold or flu that do not respond to antibiotics.
- Using broad spectrum or general antibiotics, rather than antibiotics specific to the cause of infection.
Dr Botha adds another component at work: the indiscriminate use of antibiotics in the agricultural industry. ‘Seventy percent of the antibiotics used [in South Africa] is not in the health setting, but in agriculture – to stimulate growth. Antibiotic resistance can be transferred through digesting certain types of food.’
In the EU the use of antibiotics as growth-promotional agents has been banned since 2003. Locally, its use in livestock is unregulated.
Antibiotic stewardship – how we can all play a role
The South African Antibiotic Stewardship Program (SAASP) promotes appropriate antibiotic prescribing through educating and engaging various industry stakeholders.
‘Antibiotic stewardship is basically a set of guidelines, for all healthcare providers, that promotes good antibiotic prescribing practices to ensure good patient outcomes and proper treatment of infections,’ says Dr Botha.
He advises that where people can play an important role is just to be educated about antibiotics and their appropriate use. He says patients should work with their GPs and not insist on antibiotics when it’s clearly not necessary. ‘Your average healthy person with uncomplicated flu should only have treatment to ease the symptoms.’
‘We need to cut back on our use of antibiotics. Patients with bacterial infections will require antibiotics, but it needs to be the appropriate antibiotic, dose, and duration,’ he concludes.