Battle of the Bug

HARLINGEN — “Kachoo!”

Oh, no. Another cold?

Probably, but don’t rush to take an antibiotic. Self prescribing is not the answer — you could risk building a resistance to meds you’ll need later, experts say.

And, colds are viruses. Antibiotics only work on bacterial infections such as strep throat and staph infection.

“That’s a concern because people getting that exposure to antibiotics, they are more likely to become resistant,” said Dr. Jose Campo Maldonado, infectious disease specialist at Valley Baptist Medical Center.

Maldonado, who is also an assistant professor at the University of Texas Rio Grande Valley, said antibiotic resistance has become a serious problem.

“This is a concern large enough that the CDC just released what is called the Antibiotic Resistance Threats in the United States,” he said. “They highlight their concerns and they divide the different organisms that have developed resistance already that could impact our society by level of threats.”

The Centers for Disease Control and Prevention report says antibiotic-resistant bacteria and fungi cause more than 2.8 million infections and 35,000 deaths in the United States each year. This means that someone in the U.S. gets an antibiotic-resistant infection every 11 seconds and every 15 minutes someone dies.

While self-medicating poses a special threat to antibiotic resistance in border areas with easy access to those medications, hospitals and physicians also misuse antibiotics, Maldonado said. Often, when a patient is sick, the impulse is to give an antibiotic; patients will even see the doctor with that request in mind.

Physicians will sometimes prescribe an antibiotic as a preventive measure without knowing the exact cause of a patient’s illness. While this can be acceptable, it should be done so with caution, experts say. There’s also the danger of a secondary bacterial infection along with a virus, in which case physicians prescribe both anti-viral and anti-bacterial medications.

Maldonado, who sits on the hospital’s antibiotic resistance committee, said the Rio Grande Valley has a high prevalence of MRSA (methicillin-resistant staphiloccocus aureus), better known as staph infection. Physicians had to switch from methicillin, a type of penicillin, to another form of the drug called vancomycin.

“Interestingly this organism was susceptible to penicillin back in the 1940s,” Maldonado said. “Now people won’t dream about using penicillin for that organism.”

Maldonado said that, locally, one of the organisms that has become resistant to antibiotics is acinetobacter. This bacteria is associated with hospital-acquired infections including pneumonia, meningitis and urinary tract infections. This is a prevalent problem across the United States as well as the Rio Grande Valley, as is also the case with clostridioides, which can cause severe diarrhea.

“We are always concerned about this bacteria,” he said, adding that misuse of antibiotics could allow this bacteria to infect people with life-threatening illness.

“That’s why we try to minimize antibiotic use,” he said.

Maldonado emphasized that antibiotics are crucial for the treatment of disease.

“There are some infections that do need antibiotics, that can kill you if you don’t use antibiotics, or will progress if you don’t give antibiotics,” he said.

However, even when antibiotics are used correctly, they can still become resistant to treatment.

“When you give it to a lot of people and expose a lot of germs to those antibiotics, those organisms will become resistant,” he said.

The process of natural selection factors into organisms becoming resistant to antibiotics, said Dr. Stephen Gore, infectious disease specialist at Valley Baptist.

“Antibiotics will put the pressure on organisms to become more resistant,” he said. “Whether it’s appropriate or not, it’s going to do it. Now if you’re using it inappropriately or unnecessarily, it’s going to do it faster.”

Gore also sits on the antibiotic stewardship committee which works to curb this trend.

“It’s our goal to slow things down,” he said. “We want to reduce or minimize the inappropriate use of antibiotics or unnecessary antibiotics. We incorporate evidence-based medicine to kind of provide the data to support either the reduction of antibiotics or shorten the duration.”

History of Antibiotics

The management of microbial infections in ancient Egypt, Greece, and China is well-documented. The modern era of antibiotics started with the discovery of penicillin by Sir Alexander Fleming in 1928. Since then, antibiotics have transformed modern medicine and saved millions of lives. Antibiotics were first prescribed to treat serious infections in the 1940s. Penicillin was successful in controlling bacterial infections among World War II soldiers. However, shortly thereafter, penicillin resistance became a substantial clinical problem, so that, by the 1950s, many of the advances of the prior decade were threatened. In response, new beta-lactam antibiotics were discovered, developed, and deployed, restoring confidence. However, the first case of methicillin-resistant Staphylococcus aureus (MRSA) was identified during that same decade, in the United Kingdom in 1962 and in the United States in 1968.

Unfortunately, resistance has eventually been seen to nearly all antibiotics that have been developed.

Source: National Center for Biotechnology Information

Key facts

Antibiotic resistance is one of the biggest threats to global health, food security, and development today.

Antibiotic resistance can affect anyone, of any age, in any country.

Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the process.

A growing number of infections — such as pneumonia, tuberculosis, gonorrhea, and salmonellosis — are becoming harder to treat as the antibiotics used to treat them become less effective.

Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality.

Source: World Health Organization

On CDC’s website, antibiotic resistance is also referred to as antimicrobial resistance or drug resistance.

Antibiotic resistance has the potential to affect people at any stage of life, as well as the healthcare, veterinary, and agriculture industries, making it one of the world’s most urgent public health problems.

Each year in the U.S., at least 2.8 million people are infected with antibiotic-resistant bacteria, and more than 35,000 people die as a result.

No one can completely avoid the risk of resistant infections, but some people are at greater risk than others (for example, people with chronic illnesses). If antibiotics lose their effectiveness, then we lose the ability to treat infections and control public health threats.

Many medical advances are dependent on the ability to fight infections using antibiotics, including joint replacements, organ transplants, cancer therapy, and treatment of chronic diseases like diabetes, asthma, and rheumatoid arthritis.

Source: Centers for Disease Control and Prevention