By Eduardo Gonzales, MD
What are superbugs? Are we really responsible for their rise? — Arlene S., Makati City
Superbug refers to disease-causing bacteria or germs that cannot be killed using multiple antibiotics. Needless to say, infections caused by superbugs are harder to treat, although they are not necessarily more serious.
The emergence and spread of superbugs pose a serious and growing threat around the world, according to the World Health Organization and, unless something is done about this, we will lose one of our greatest tools in treating bacterial diseases and enter a post-antibiotic era, in which common infections and minor injuries can kill because doctors have run out of antibiotics that can treat them.
How widespread are superbugs? At present, about two million people get sick from a superbug every year, according to the US Centers for Disease Control and Prevention, and about 23,000 die.
The making of a superbug
Antibiotics, such as penicillin, amoxicillin, erythromycin, tetracycline, etc., are medicines derived from microorganisms or fungi that can arrest the growth or kill other microorganisms. We rely on them when we acquire serious infections such as pneumonia, urinary tract or blood infections, infectious diarrhea, or sexually transmitted diseases.
Germs, on the other hand, are smart. All have the capacity to mutate their genes and become resistant to an antibiotic. When we get an infection and take an antibiotic improperly, we give the bacteria that infected us the chance to mutate. A mutated gene can be passed between bacteria, allowing for the creation of bacteria that carry resistance genes to many different antibiotics, a superbug. Antibiotics are very powerful and, oftentimes, life-saving medicines, but they should be used correctly because our misuse of antibiotics is the “single leading factor” contributing to the emergence of superbugs.
How to use antibiotics correctly and prevent the rise of superbugs
1. Do not self-medicate with antibiotics. Antibiotics work only against pathogenic bacteria, although a few possess anti-protozoal activity. They are useless against, and may even prolong or complicate, viral and other non-bacterial infections such as the common cold and flu. In so far as bacteria are concerned, there are numerous types of pathogenic bacteria and many types of antibiotics. No single antibiotic is effective against all types of bacteria. Most, even the broad-spectrum ones, are effective only against a limited number. To be able to tell which antibiotic is appropriate against a particular infection, you need to identify the offending microorganism, something that is beyond the capability of a layman. It is the physician’s expertise, so let the physician identify your bug, if and when you get bothered by one.
Also, not all bacterial infections need treatment with antibiotics. Our body’s natural defenses are often able to fend off mild ones. Antibiotics are only indicated when it becomes apparent that our body’s natural defenses are inadequate to cope with an infection.
Although antibiotics are prescription drugs, people are able to get hold of them and self-medicate because some drugstores still sell them over-the-counter. Likewise, some people keep their leftover antibiotics from a previous prescription instead of discarding them, and use them to self-medicate.
2. When you are prescribed an antibiotic, take it in the prescribed dose, interval or frequency, and duration. Proper dose and frequency of intake depends on the type of antibiotic and the severity of the infection. Under-dosage makes an antibiotic ineffective, even if it is the correct one, while over-dosage increases the possibility of adverse reactions and toxicity. By the way, all antibiotics can cause adverse reactions and toxicity, some of which can be fatal or 1ife-threatening.
With regard to duration of treatment, a course of treatment that is too short can lead to a relapse while prolonged treatment can cause super-infection, a condition where a second type of microorganism (that is resistant to the antibiotic) infects the patient.
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