Ask Your Pharmacist

November 21, 2018
Q:

What are these “superbugs” I am hearing about that antibiotics won’t work against? 

A:

Last week was worldwide Antibiotic Awareness Week, and the “superbugs” you heard about are bacteria that have become resistant to antibiotic treatment (and that makes them super).

Antibiotic resistance is a complex topic but an important one worldwide as we rely heavily on antibiotics in the 21st century. We treat common illnesses with antibiotics but also prevent infections with antibiotics as well. Surgery as we know it would not be possible if we did not have antibiotics to prevent infection during and after the procedure. It’s hard to imagine being sick, requiring antibiotics but finding out that antibiotics no longer work and there is nothing doctors can do. This may sound like an exaggeration but this is happening now in Canada! Health Canada’s website offers a sobering story about a woman named Mary who waged a nine-month battle against infection that started with a small skin infection and escalated to heart-failure as specialists tried to treat a resistant c.difficile infection. I can’t help but think about what happened before penicillin (the first antibiotic) was available in the 1940’s. Infections were treated with leeches and blood transfusions. People who had leprosy were banished into isolation. The reality is antibiotic resistance rates are rising, and new antibiotics are not being developed in high numbers. That means stories like Mary’s will become more common. The goal of Antibiotic Awareness week is to educate people about antibiotic resistance and reduce the unnecessary use of antibiotics. Reducing the amount of antibiotics used requires the combined efforts of healthcare professionals and the support of patients. Let’s dive deeper.

Antibiotics are medications used to treat bacterial infections by killing the invading bacteria. Bacteria are microscopic living organisms that have existed on earth for over three billion years. They have survived so long by mutating quickly, allowing them to survive virtually anywhere on the planet. They are so good at adapting that the first resistance to penicillin was observed between the time when it was first discovered and before it was commercially available. Resistance is bound to occur; bacteria are just too adaptable. Every time antibiotics are given to a patient, the chance of increasing resistance occurs. Consider that you have billions of bacteria covering your entire body and your entire digestive tract. You take an antibiotic, and many of these bacteria are killed off and will be replaced. If some of those bacteria are resistant, then those bacteria survive when the others are killed off, allowing them to grow freely without competition. These resistant bacteria can then pass the gene for resistance to other potentially harmful bacteria which lead to infectious bacteria resistant to this particular antibiotic.

Infection in the body can be caused by bacteria, viruses (cold and flu), or fungus (yeast infection). Antibiotics are effective only against bacteria, so using them for colds, or other viral infections is the most common inappropriate use of antibiotics. I often hear frustration from patients when they visit their physician with a “chest infection” and are not prescribed antibiotics or a parent whose child has an ear infection but the doctor has recommended waiting a few days before prescribing an antibiotic. Remember antibiotic have side effects and usage contributes to resistance. Your doctor has determined that your infection is viral, and antibiotics will do more harm than good in this situation. When you do require antibiotics, remember to take your antibiotics as they are directed and do not share or take old antibiotics. Your prescriber and pharmacist work together to make sure you have the right antibiotic, for the right kind of infection, at the right dose. If you have questions about when to seek antibiotics, ask your local pharmacist for advice.

Jared Mactavish (BSc., Pharm) is a pharmacist in Saint John. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.