A closer look at antibiotic resistance: 5 things to know

When you’re feeling sick, antibiotics aren’t always the answer.

Every Nov. 18-24, we are reminded of the importance of appropriate antibiotic use during U.S. Antibiotic Awareness Week.

Antibiotics save lives and are critical for treating many common infections. However, the overuse and misuse of antibiotics leads to antibiotic resistance (AR), one of the most urgent threats to public health.

“Greater than 80% of antibiotic use in the U.S. occurs in the outpatient setting, but about 30% is considered not needed. Similarly, approximately one third of antibiotics used in the hospital setting are suboptimal or not needed at all. This leaves much opportunity for improvement,” said Mary Ellen Acree, MD, an infectious disease physician at Endeavor Health. “We're trying to protect our community from the serious dangers of increased antibiotic resistance.”

Antibiotic resistance happens when bacteria evolve to defeat the drugs designed to kill them. As a result, these bacteria continue to grow and spread. “When bacteria become resistant, antibiotics become ineffective, and the bacteria multiply unchecked,” said Dr. Acree. These infections can be difficult — and sometimes impossible — to treat.

In addition to losing effectiveness, antibiotics can also cause side effects. One serious example is Clostridioides difficile (or C. diff), a condition that causes severe diarrhea and often affects people who have recently taken antibiotics.

What should you know about the safe use of antibiotics?

1. Use antibiotics ONLY when needed. Antibiotics aren’t always the answer. Any time antibiotics are used, they can contribute to the development of drug resistance. Ask your doctor about whether antibiotics are needed and avoid requesting them.
2. Antibiotics do NOT work on viruses, like colds or the flu. Antibiotics only treat certain infections caused by bacteria, such as strep throat, UTIs and bacterial pneumonia. Taking antibiotics when you do not need them will not make you feel better.
3. Antibiotic resistance can affect anyone at any stage of life.
4. Drug-resistant infections are difficult to treat and often require extended hospital stays, additional follow-up doctor visits, and costly treatments.
5. Antibiotic resistance can move easily across the world.

Sometimes patients have doubts when they are told their illness is most likely a virus and antibiotics would not help, said Dr. Acree. That’s why it’s important to make a contingency plan with your doctor before you leave the office, so you know what to do and who to reach out to if symptoms fail to improve.

“Don’t feel like you’re leaving the office without a plan on how to handle things,” Dr. Acree said. “Talk to your physician about what you can do at home for symptom relief, the red flags for a bacterial infection, and what you should do if you don’t get better in a few days.”

Bacterial and viral infections can cause similar symptoms, such as fever, coughing, upper respiratory illness, vomiting or diarrhea. Your physician can help by listening to your medical history, doing a physical exam and sometimes ordering a test to identify the bacteria or virus causing your illness.

There are simple actions we can all take to prevent infections and stay healthy:

1. Keep cuts clean and covered.
2. Wash hands frequently.
3. Take proper care of chronic conditions, like diabetes.
4. Get recommended vaccines.

Everyone has a role in fighting antimicrobial resistance, including antibiotic resistance. Drug-resistant germs can quickly spread across communities, posing a threat to people, animals, plants, and their shared environment, such as soil and water.

Talk to your doctor about the right treatment for you when you are sick.