Antibiotics are over used. Period. End of sentence.
My pharmacy is getting ready to install a robotic dispensing system. It takes your pharmacy’s top 200 or so drugs and automatically counts them for you, saving the pharmacist time. To determine those 200 drugs we ran reports based off of 12 months of previous medications dispensed. The number 1 drug dispensed was Zithromax, a what was once a powerful antibiotic is now used to treat the common cold and mild respiratory infections. Among those 200 drugs are an additional 27 antibiotics. This is just at my pharmacy. I’m sure this is the trend throughout the United States and into Europe. This is scary. Before penicillin existed people died from infections. Penicillin was discovered and helped save hundreds if not thousands of lives in World War II. More antibiotics were developed in response to bacterial resistance to penicillin. Medicine advanced because of antibiotics. Preventing infection allowed the discovery and ability of joint replacement, organ transplantation, open heart surgery and proper burn treatment, just to name a few things. But if the overuse of antibiotics continues, and resistance becomes imminent, what would a post antibiotic world look like? A coworker of mine e-mailed me this article this afternoon, and it is hands down the best thing I have ever read about antibiotic resistance. It puts things into simple terms and in a very real perspective. Part of it is below, but I highly suggest that you read it in it’s entirety. I hope it will make you think twice before you prescribe or take that antibiotic. If you’re healthy, the likelihood of you even needed that strong antibiotic to treat your “common cold” is slim. You’re just hastening the inevitable.
A few years ago, I started looking online to fill in chapters of my family history that no one had ever spoken of. I registered on Ancestry.com, plugged in the little I knew, and soon was found by a cousin whom I had not known existed, the granddaughter of my grandfather’s older sister. We started exchanging documents: a copy of a birth certificate, a photo from an old wedding album. After a few months, she sent me something disturbing.
It was a black-and-white scan of an article clipped from the long-goneArgus of Rockaway Beach, New York. In the scan, the type was faded and there were ragged gaps where the soft newsprint had worn through. The clipping must have been folded and carried around a long time before it was pasted back together and put away.
The article was about my great-uncle Joe, the youngest brother of my cousin’s grandmother and my grandfather. In a family that never talked much about the past, he had been discussed even less than the rest. I knew he had been a fireman in New York City and died young, and that his death scarred his family with a grief they never recovered from. I knew that my father, a small child when his uncle died, was thought to resemble him. I also knew that when my father made his Catholic confirmation a few years afterward, he chose as his spiritual guardian the saint that his uncle had been named for: St. Joseph, the patron of a good death.
I had always heard Joe had been injured at work: not burned, but bruised and cut when a heavy brass hose nozzle fell on him. The article revealed what happened next. Through one of the scrapes, an infection set in. After a few days, he developed an ache in one shoulder; two days later, a fever. His wife and the neighborhood doctor struggled for two weeks to take care of him, then flagged down a taxi and drove him fifteen miles to the hospital in my grandparents’ town. He was there one more week, shaking with chills and muttering through hallucinations, and then sinking into a coma as his organs failed. Desperate to save his life, the men from his firehouse lined up to give blood. Nothing worked. He was thirty when he died, in March 1938.
The date is important. Five years after my great-uncle’s death, penicillin changed medicine forever. Infections that had been death sentences—from battlefield wounds, industrial accidents, childbirth—suddenly could be cured in a few days. So when I first read the story of his death, it lit up for me what life must have been like before antibiotics started saving us.
Lately, though, I read it differently. In Joe’s story, I see what life might become if we did not have antibiotics any more.
Predictions that we might sacrifice the antibiotic miracle have been around almost as long as the drugs themselves. Penicillin was first discovered in 1928 and battlefield casualties got the first non-experimental doses in 1943, quickly saving soldiers who had been close to death. But just two years later, the drug’s discoverer Sir Alexander Fleming warned that its benefit might not last. Accepting the 1945 Nobel Prize in Medicine, he said:
“It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them… There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”
As a biologist, Fleming knew that evolution was inevitable: sooner or later, bacteria would develop defenses against the compounds the nascent pharmaceutical industry was aiming at them. But what worried him was the possibility that misuse would speed the process up. Every inappropriate prescription and insufficient dose given in medicine would kill weak bacteria but let the strong survive. (As would the micro-dose “growth promoters” given in agriculture, which were invented a few years after Fleming spoke.) Bacteria can produce another generation in as little as twenty minutes; with tens of thousands of generations a year working out survival strategies, the organisms would soon overwhelm the potent new drugs.