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Antibiotics: The good, the bad and the ugly

Written by Lauren Jennings, B.S. candidate at the University of Kansas & SPRITE Scholar in the 2020 Institute for Public Health Summer Research Program 

The topic of antibiotics and antibiotic resistance has become a key buzzword in science, politics, policy and public health. Think back to the last time you had typical cold-like symptoms, an annoying runny nose, cold chills, or a sore throat. Did you muster up some energy to visit a clinic and subsequently receive a magical medication to make your symptoms disappear?

This is the stereotypical scenario that comes to mind when I envision the creation of an antibiotic resistant “superbug”. In a lecture given for the by Sumanth Gandra, MD, MPH, Assistant Professor in the Department of Medicine, Division of Infectious Diseases, he describes the primary reason behind antibiotic resistant bacteria as being the overuse and misuse of antibiotics for symptoms that are caused by a virus, namely the common cold.

Before we delve into discussing antibiotics, it is important to know what we are talking about. an antibiotic is a drug that is taken to kill or inhibit the growth of bacteria to fight off bacterial infections. They belong to a larger class of antimicrobials which includes antibiotics, antivirals, antiparasitics, and antifungals. There are two types: narrow spectrum and broad spectrum. Narrow spectrum antibiotics act against a small group of bacteria, whereas broad spectrum antibiotics target a very large class of bacteria.

Antibiotics tend to get a bad rap, but the truth is that there are many benefits to their use. As a result of incorporation of antibiotics into regular medical practice, deaths from preventable illnesses have decreased. Antibiotics also have laid the foundation for modern medical therapies, such as chemotherapy and organ transplantation.

The reason behind the sudden concern over antibiotic use can be attributed to the discovery void that we are currently experiencing. This void is defined by the lack of new antibiotics being discovered. As bacteria are evolving and mutating, we are equipped with fewer new antibiotics to stop their spread. One of the key reasons behind this void boils down to a simple reason. The creation of new antibiotics are not profitable enough for Big Pharma, especially compared to other medications that a person takes for an entire lifespan. The economic incentive is driving lifestyle drugs rather than antibiotics, which are only taken for a few days to a couple weeks.

But the blame does not solely rest in the hands of Big Pharma. There are various other social factors influencing antibiotic resistance. Within the general public, concerns surround the tendency to self-medicate, low adherence to full antibiotic treatment, and easy accessibility to antibiotics. Medical professionals also play a key role. Within the private sector, medical professionals are faced with patient demands and expectations, economic incentives, high costs of diagnostic testing, and a lack of continuing medical education. Some overlap exists between the private and public sector, as professionals in the public sector face similar issues surrounding a lack of education and diagnostic facilities. In the public sector, these issues are also compounded with heavy patient loads.

So, where do we go now? Luckily, the continued awareness around antibiotic resistance has led the development of guidelines to improve our health. By improving access to clean water, sanitation, and vaccination we can reduce the need for antibiotics. Important strides are being made within antibiotic stewardship to improve hospital infection control. Changing political and economic incentives can encourage antibiotic development. By reducing the use of antibiotics in the agricultural industry, we are limiting the antibiotics we consume through our diet. Finally, education and accountability will keep us informed and responsible, ensuring the safety of our future health.