Special to the Journal By Douglas MacQueen, MD
In the era of modern medicine, people are often surprised to learn that we have a limited number of antibiotics to treat bacterial infections. The more often bacteria are exposed to antibiotics, the more likely they are to become resistant to them, which renders them ineffective. There are ways of using antibiotics that decrease the risk of bacteria becoming resistant to them. It is important to consider these principles, both in coping with illness and in purchasing food for your table.
I mention the food industry because this is an area in which antibiotic misuse is significant. Animals raised for human consumption are typically fed low-doses of antibiotics to stimulate growth. As a result, they begin to develop antibiotic-resistant bacteria in their digestive tracts. These resistant strains of bacteria eventually make their way into the environment and into our food supply. They can subsequently become part of the normal bacteria in us and, in the right setting, cause infections that are difficult to treat.
What steps can I take to keep my family and myself safe?
In terms of the food you buy, read labels and purchase meat products from animals that were not raised on antibiotic feed. Meat products bearing the USDA Organic label come from animals that were not given antibiotics. In terms of treating your own illnesses, it is very important to use antibiotics only when necessary.
When is a course of antibiotics the right treatment?
Antibiotics are only effective in treating bacterial infections. These drugs will not cure viral infections. This time of year, upper respiratory infections are common. Most of them are viral and will get better on their own. This includes coughs, colds, the flu, bronchitis, and sinusitis. The best course of action is to treat the symptoms of the illness, knowing that you will feel better in time. Cold medicine, anti-inflammatory medication for fever and aches, fluids, and rest will help your body overcome the virus, which sometimes takes weeks.
What if I develop a productive cough?
When people with respiratory infections begin to produce colored mucous, the cause is still most likely viral. However, it may be a good idea to see a doctor at this point in the illness if it includes high fever or difficulty breathing. This may still be due to a viral infection that can be treated without antibiotics.
What if I do need antibiotics?
Bacterial infections do require treatment with antibiotics. To optimize their effectiveness and decrease the chance of creating a resistant strain of bacteria, the medication should be as specific as possible to the type of bacteria causing the infection, be of the correct dose, and be prescribed for the shortest time that is still effective. It is important to take the antibiotics exactly as prescribed. To help prevent collateral damage to your body’s “good” bacteria, stock up on yogurt while you are taking antibiotics.
At Cayuga Medical Center, we have a program designed to optimize antibiotic effectiveness for patients in the hospital. In antibiotic stewardship programs such as ours, infectious diseases doctors work with hospital pharmacists to monitor and optimize antibiotic use in hospitals. The goal is to decrease the development of infections in hospitals due to resistant bacteria. As part of this program, we have invested in special technology in our microbiology lab to rapidly detect bacteria, reducing the time it takes to identify pathogens from days to hours. This gives our patients and their doctors access to technology normally only available in larger academic medical centers. As a result, we can prescribe an antibiotic for the specific bacteria causing the infection and prevent antibiotic resistance at both hospitals in the Cayuga Health System.
Through antibiotic overuse, there are types of bacteria that have become resistant to most or all antibiotics. When they cause infections, they can be fatal. Our goal in limiting antibiotic use is to prevent more of these strains from developing. When an individual takes an antibiotic that is not needed, it can increase the chance that there are fewer antibiotic options to treat someone else’s life-threatening infection.
Dr. MacQueen is board certified in internal medicine and infectious diseases. He is a member of the medical staff at Cayuga Medical Center and can be reached at the Cayuga Center for Infectious Diseases at (607) 241-1118.