Family Health Magazine - FAMILY MEDICINE
The war against antibiotic-resistant bacteria
If you watch the news or read the paper, chances are you’ve heard of ‘superbugs.’ The headlines read like an alphabet soup of these complicated bacterial names.
- Methicilline resistant Staphylococcus aureus (MRSA) – bacteria that can overcome most penicillin based antibiotics.
- Vancomycin resistant Enterococcus (VRE) – which withstands the antibiotic Vancomycin (previously the most common antibiotic used for this bacteria).
- Streptococcus pyogenes – which causes necrotizing fasciitis, or flesh eating disease.
- Clostridium difficile (C. difficile) – which affects the intestinal tract, often causing severe diarrhea and other problems.
These bugs are responsible for much pain and suffering, and some deaths. Should we worry about these bugs? Is there anything we can do about them?
Handwashing is the best way to stop the spread of respiratory tract infections. Eighty per cent of common infections are spread by hands.
Wash your hands:
- Before meals
- Before breastfeeding
- After using the toilet or helping your child use the toilet
- After changing diapers
- After blowing your nose or wiping your child’s nose
- After playing with toys shared with other children.
Hand wash the right way:
- Use soap and water. Washing with water alone does not get rid of germs.
- Wet your hands.
- Apply soap. Do not use
- Rub your hands together for at least 20 seconds (or the time it takes to sing Twinkle, Twinkle Little Star).
- Rinse your hands for 10 seconds. Some experts suggest twice as long.
- Dry your hands with a towel.
- Expect doctors, dentists, nurses and therapists to wash their hands before they examine you or your child.
- Make sure soap is available in the washroom of your child’s school and your workplace.
- Make sure that childcare sites have places for adults and children to wash their hands.
- Use regular soap. Antibacterial soap is not needed because it promotes bacterial resistance.
- Teach by example.
How did superbugs develop?
Like us, all bacteria in the world are in a constantly changing environment. They adapt, creating new versions of themselves that can thrive in their current environment. Bacteria that evolve to become resistant to antibiotics are often called ‘superbugs’.
Frequent use of antibiotics is the main reason these bacteria have adapted into new forms. These bugs all developed within hospitals and institutions where the use of antibiotics is high. Over the past 50 years, superbugs have expanded out of the hospital and become more common in the community.
Although superbugs can fight off the effects of antibiotics, they are not super in their ability to compete with other bacteria. For example, although C. difficile has been responsible for a number of deaths in hospitals, it only appears after something has changed the bacteria normally found in the gut.
Usually, the person has been taking antibiotics. Once other organisms sensitive to antibiotics are killed, this antibiotic-resistant bacterium multiplies. Unfortunately, C. difficile also releases toxic substances. These create illness and diarrhea, and in some situations cause death.
How do our bodies fight bugs?
Each of us has a strong immune (defence) system. Normal bacteria live on our skin and mucous membranes. For instance, about 25 per cent of people carry harmless Staphylococcus aureus bacteria inside their noses. We also have good bacteria inside our gut. These populations of friendly microbes living inside of our body can easily out-compete invaders. All of these qualities provide us with high resistance to infections.
In the course of each day, we come in contact with many bacteria and viruses. Only a few create disease in us. Most of us are not likely to be in contact with a superbug. Even if we are exposed to one, the chance that we will get sick is usually quite small. If we are healthy our risk from superbugs is low, as our immune systems can fight dangerous invasions.
Can we fight superbugs?
We can take steps to reduce both individual and group risks from superbugs.
First, understand the difference between diseases caused by bacteria and those caused by viruses. Antibiotics do not affect viral diseases. They only work against bacteria. Taking antibiotics for a viral illness will not make you feel better, help you get better more quickly, or prevent the spread of your illness.
When it comes to fighting bacteria, antibiotics are very helpful. However, they must be taken exactly as prescribed. Using antibiotics unnecessarily or inappropriately helps superbugs become stronger. Keep the following points in mind.
- Talk to your health care provider about antibiotic resistance.
- Do not demand an antibiotic for a cold or other viral illness if your doctor does not prescribe one. Ask about other ways to help relieve symptoms (see sidebar).
- If your doctor does prescribe an antibiotic, be sure to take it exactly as directed.
- Take ALL of your antibiotic, even if you start feeling better.
- Do not save some of your antibiotic for the next time you get sick.
- Do not take antibiotics prescribed for someone else.
You can help to stop the spread of bacteria and viruses that cause illness through the community.
- Hand washing is the best way to stop the spread of infections. Wash your hands often with soap and water or alcohol-based preparations (see sidebar on page 39). Do not use antibacterial soap, as these products contribute to antibiotic resistance.
- Stay home until your illness is over. Going to work or school while still sick increases the spread of illness.
- If we all do our part to manage the spread of infections and to reduce the widespread inappropriate use of antibiotics, we will stay healthier and more able to resist superbugs as they develop. We will also reduce exposure to bugs and protect community members who are less able to withstand infection.
- Learn more about antibiotic resistance and what you can do. The following Internet sites have excellent information for adults, children and health care professionals.
When it comes to fighting illness, the unnecessary or inappropriate use of antibiotics unnecessarily can actually do harm. Remember, bacteria exposed to antibiotics can change into superbugs and become resistant. Over time, fewer antibiotics are able to work effectively against them. Help control the spread of superbugs by treating your illness appropriately and using antibiotics only when needed.
No Antibiotics At This Time
To help reduce antibiotic overuse, doctors often decide not to prescribe an antibiotic unless they know one is required. If your illness is viral, help yourself and your family feel better in several ways.
To fight illness:
- Drink more fluids, including water, fruit juice, and clear soup.
- Sleep and rest more.
To relieve symptoms:
- For fever, aches and pain, take acetaminophen, ibuprofen or acetylsalicylic acid (ASA, Aspirin™).
Ask your doctor or pharmacist to recommend the best one for you. (Do not use ASA in a child under 18. It can cause a serious reaction called Reye’s Syndrome.)
- For ear pain, use pain relievers, ear drops, heat and oral medications.
- For nasal congestion, try saline nose drops/spray and a vaporizer.
- Soothe a cough with lozenges, cough drops and cough medicines (some require a prescription).• Sore throats may be helped by ice chips, lozenges, throat spray and gargling with mouthwash or salt water.
Use medicines as directed by your doctor or the package instructions.
See your doctor for a recheck if:
- new symptoms occur, especially vomiting, severe headache or stiff neck.
- your current symptoms become worse.
- fever persists for more than 48 hours.
- you are not improving in two to three days.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2018, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1 [FM_FHa09]