ID Care: Antibiotics – The Good, the Bad and the Ugly

September 13, 2016

Sir Alexander Fleming, a Scottish biologist, changed medicine forever when he accidentally discovered Penicillin in his laboratory in 1928.

“When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first antibiotic, or bacteria killer,” Fleming would later say, “But I suppose that was exactly what I did.”

Fleming had inadvertently contaminated a colony of Staphylococcus with a mold called Penicillium. When the Staphylococcus colony stopped growing and even died, he realized that he had found a way to kill a bacteria that was a common killer in society. By the 1940s, Penicillin was being produced and saving lives. Before its introduction, there was no effective treatment for infections such as pneumonia, meningitis or rheumatic fever.

Hospitals were full of people with blood poisoning contracted from a cut or a scratch, and doctors could do little for them but wait and hope. Antibiotics may be the most valuable discovery in modern medicine, for they have saved countless lives and have contributed to the increasing lifespan of humans in society.

In the 21st century, however, not all is wonderful in the world of antibiotics. Antibiotics may be considered the keystone of modern medicine but their overuse continues to generate unwanted side effects. Unfortunately, there are dire consequences when antibiotics are misused, and unnecessarily prescribed to patients.

When someone takes antibiotics, they will not only work against the infection they are treating but also kill helpful bacteria that live in our gut supporting immunity and helping with digestion of gut. When this balance is disrupted, a person’s gastrointestinal system can be thrown out of whack leading to severe digestive problems. Additionally, bacteria called Clostridium Difficile can flourish in this environment leading to harmful and even sometimes deadly disease called C. Dif colitis.

When modern antibiotics are overused, bacteria are enabled to meet them and study them over and over again. These bacteria are very smart and can produce defense mechanisms to resist the killing of the antibiotics by altering their genetic make-up. The more antibiotic classes the bacteria are allowed to see, the more they figure out ways to resist the killing of the antibiotic. This leads to fewer antibiotic choices for doctors to prescribe against what are termed “superbugs.”

The further antibiotic resistance spreads, the more often common antibiotics — including many available as generics — must be retired. This means that ridding patients of infection requires longer, more expensive forms of therapy, which in turn, drives up health care costs. We must continue to be conscious about not excessively prescribing antibiotics for nonbacterial infections.

Both physicians and patients must be responsible to “do the right thing” and make sure Alexander Fleming’s discovery remains intact for years to come.

ID Care is the largest enterprise in NJ dedicated to the identification, treatment and prevention of infectious diseases. ID Care is the right specialist to get the right care.

Antibiotic Stewardship, Infectious Disease Blog