Antibiotic Misuse: Why You Need To Care

Antibiotic misuse, using antibiotics for the wrong sort of illness, or using the same antibiotics for the same ailment over and over again, is something you may have heard about. Still, you shrug off that thought as you consider your child, wailing in pain and tugging on her ear. You just want her pain to be over. You want her well again. Besides, you have a bottle of amoxicillin left over from last time and it worked magic.

Stop!

Don’t do that. Seriously do not use that leftover antibiotic to treat your child’s ear pain. That is the very definition of antibiotic misuse. In the long run, you may end up doing her more harm than good. And in fact, there may be consequences for the world at large.

Yes, really.

Antibiotics are, of course, an important class of medication. Before antibiotics some children with strep throat, died. Before antibiotics, 90% of children with bacterial meningitis died, and those who lived, had serious problems. They had problems like hearing loss and intellectual disabilities, just for instance.

Antibiotics not only treat bacterial infections, but prevent the spread of disease. Antibiotics may even make milder the complications of disease. But some antibiotics aren’t working as well as they used to. Worse yet, some no longer work at all. When antibiotics no longer kill a specific strain (type) of bacteria, those bacteria are then called antibiotic resistant.

What makes bacteria resistant to antibiotics? Bacteria can become resistant to certain antibiotics through antibiotic misuse. Antibiotic misuse means giving the same type of antibiotic for the same type of infection, too many times in a row. Bacteria are smart critters. They learn to outwit the medication. You may manage to kill them the first time with that medication, but by the second time, they’re already learning to beware and adapt.

They, the bacteria, actually change in response to medication so the medication may not work the next time. In fact, those bacteria may even teach other bacteria, how to neutralize that antibiotic. And of course, these bacteria spread, so that other children too, may end up being sick with the same bacteria that are resistant to the standard treatments.

So why then do parents give their children the same antibiotic again and again? Mainly because parents think that if the treatment worked once, it will surely work the second time, too. Antibiotic misuse is the furthest thing from these well-meaning parents’ minds.

A parent may not even consult the doctor before giving a child medication. The parent has seen those symptoms before and knows that the doctor prescribed a particular medication for that particular set of symptoms. The parent thinks that giving that medication again, is doing the right thing for the child’s welfare.

It’s understandable. But oh so wrong. It’s antibiotic misuse.

Now note that doctors expect bacteria to develop resistance to one drug or another. It’s just the way things work. But antibiotic misuse speeds that process, makes bacteria become resistant more quickly and more efficiently. And that’s a pity, because antibiotic misuse is so preventable, unlike some of the diseases those same antibiotics are meant to treat.

Antibiotic Misuse: Overuse

Probably the most common form of antibiotic misuse is antibiotic overuse, such as taking antibiotics for a sickness antibiotics can’t help. Antibiotics only work for bacterial infections. They don’t work for viral infections. So let’s say your child gets a sore throat. Your natural inclination might be to treat that child with antibiotics. You’re thinking she probably has strep throat.

Guess again. Most sore throats are caused by viruses. Antibiotics won’t do a thing against viruses.

Unless you know for a fact your child has strep throat (and that means doing a throat culture or rapid strep test and getting a positive result) giving your child antibiotics for a sore throat is plain old antibiotic misuse. Taking antibiotics for a virus not only won’t help a child with a sore throat get better, but will make it more likely that the child will develop a resistance to that antibiotic. That means that at some future time when the child really does have strep throat, the antibiotic may not work.

Taking antibiotic for the wrong reason, for instance, when there’s a viral infection, doesn’t mean the antibiotic isn’t doing anything. It just isn’t doing anything about the virus. What it is doing, that antibiotic, is attacking the bacteria in the body. The antibiotic may be killing good bacteria, or bacteria that at least for now, aren’t making your child sick.

This type of antibiotic misuse, taking antibiotics for something they can’t cure, like a virus, means teaching the harmless bacteria in the body how to resist antibiotics. Those harmless bacteria, in turn, may teach other, harmful bacteria in the body, how to resist that antibiotic. Here are some of the most common viral infections that cannot be cured with antibiotics:

• Cold
• Flu (influenza)
• Bronchitis
• Most coughs
• Most sore throats
• Some ear infections
• Some sinus infections
• Stomach virus

If we know that antibiotic misuse is causing antibiotic resistance, so why do people still overuse antibiotics?

• Doctors sometimes prescribe antibiotics without knowing for certain the infection is bacterial.
• Patients or parents of sick children may pressure doctors for prescription antibiotics because they want relief from their symptoms.
• Sick people or parents of sick children may decide to use antibiotics without first seeing a doctor or doing lab tests and then use leftover antibiotics they already have in the house, or purchase online.

Antibiotic Misuse: Not Following Directions

Another form of antibiotic misuse is not using antibiotics according to the doctor’s instructions. That could mean not taking enough of the medicine, taking too much of the medicine, or not taking the medication for as many days as directed. A doctor may tell you to give your child antibiotic medication for ten days. If your child begins to feel better after a day or so, you may forget to continue giving her the medication. It no longer seems so urgent because she isn’t crying and tugging on her ear. She’s sleeping better.

So you forget to give her the antibiotic or maybe you even think she doesn’t need the antibiotic anymore, since clearly, she’s feeling better.

BIG WHOPPING MISTAKE.

The antibiotics are working, but that doesn’t mean they have killed all the bacteria that were making your child sick. If your child stops taking the medication, the bacteria that are left may increase and her symptoms may begin again. Worse yet, the bacteria may have begun to adapt so that the antibiotic is no longer so effective as it was. It is so important to make sure that a child completes the entire course of treatment. It’s just so hard to remember, once your child is perky and happy again.

Do whatever it takes to help you remember to give your child her medication, all of it, at the right time of day, for as many days as instructed by the doctor.

Antibiotic Misuse: Consequences

It used to be that new antibiotics were being created faster than bacteria were becoming antibiotic resistant. That meant that if an infection didn’t respond to one type of antibiotic, there would always be another antibiotic to try. But these days, there is very little antibiotic development going on, meaning very few new antibiotics are being developed. As a result, antibiotic resistance has become a serious health issue.

In the United States, for instance, at least 2 million people develop a serious, antibiotic-resistant infection each year. That’s according to the Centers for Disease Control and Prevention (CDC). Here’s something even worse: 23,000 of those people will die, each year.

Now some of those people with drug-resistant infections won’t die, but they may end up with a disability, need to be hospitalized, or require a longer time to recover. Antibiotic misuse and antibiotic resistance means more visits to the doctor and more expensive treatments. In other words, antibiotic misuse leads to illness and disability, plus loss of time and money.

Antibiotic Stewardship: The Opposite of Antibiotic Misuse

Using antibiotics the right way is called antibiotic stewardship. Using antibiotics correctly and for the right reasons helps preserve the effectiveness of these drugs by preventing antibiotic resistance and antibiotic-resistant infections. Antibiotic stewardship is important because the ability to treat infections saves lives. Antibiotics can also help keep people safe from infections during chemotherapy for cancer, trauma surgery, and organ and stem cell transplants, for instance. Here are some of the ways you can avoid antibiotic misuse and help slow the development of antibiotic resistance:

• Use antibiotics only as directed by your doctor.
• Take the correct daily dosage and complete the entire course of treatment.
• If you forget to take a dose of antibiotic, pick up the phone and ask your doctor what you should do.
• If you have leftover antibiotics, throw them out. Don’t take leftover antibiotics for an illness you develop later. They may not be the right medication and you won’t have enough of it anyway to complete an entire course of treatment.
• Don’t take antibiotics prescribed to someone else.
• Don’t pressure your doctor to give you a prescription for antibiotics. Instead, ask your doctor how to treat the symptoms.
• Always use good hygiene. Wash your hands regularly with hot water and soap after you use the toilet, before you prepare or eat food and after handling fresh meat and poultry. Scrub fruits and vegetables and make sure that all kitchen work surfaces, such as counters and cutting boards, are kept clean.
• Make sure you and your children are vaccinated against bacterial infections like diphtheria and whooping cough (pertussis).
• If you suspect you’re allergic to penicillin, speak to your doctor about getting a skin test. Research shows that some allergies to antibiotics are over-reported. You want to know if you’re allergic to penicillin to make sure you get the right antibiotics when you need them.

Remember: antibiotics will not cure the most common infections, such as colds and sore throats and will not make your child feel better. Giving antibiotics for the wrong reasons—antibiotic misuse—may mean that at some time, when your child really needs those drugs, they won’t be as effective. Be smart and do the right thing for you, for your family, and for those who live around you, and be a force for good by being an antibiotic steward!