Antibiotic Overuse: Risks and Further Exploration

Excessive antibiotic use: Risks and additional concerns

In the realm of healthcare, the term "antibiotic misuse" refers to instances where a doctor might prescribe the wrong dose, duration, or type of antibiotic. Antibiotics, however, play a crucial role in treating certain life-threatening or serious bacterial infections such as sepsis, urinary tract infections (UTIs), whooping cough, and strep throat.

Common signs of a UTI include frequent urination, pain or a burning sensation while urinating, bloody urine, cramping or pressure in the lower abdomen or groin, and feeling a need to urinate even when the bladder is empty. If you develop an infection that does not go away or get better after a few days, it's essential to contact a healthcare professional.

Antibiotic resistance is a significant concern, with bacterial strains like Carbapenem-resistant Enterobacterales (CRE) posing a significant threat due to their resistance to powerful antibiotics. This resistance can lead to bacterial infections that no longer respond to antibiotics.

Researchers have discovered and modified several more antibiotics to help treat bacterial infections such as tuberculosis, cholera, and syphilis. However, some classes of antibiotics have unique side effects. For example, fluoroquinolones can lead to tendinitis, sulfonamides, penicillins, and cephalosporins to Stevens-Johnson syndrome and toxic epidermal necrolysis, and tetracyclines to tooth discoloration.

To combat antibiotic resistance, it's crucial to follow key guidelines. Antibiotics should be prescribed only when there is clear evidence of a bacterial infection that requires treatment, and avoided in viral infections where they are ineffective. Key guidelines for identifying when antibiotics are necessary include avoiding antibiotics for viral infections like acute bronchitis, colds, and flu, as antibiotics do not work against viruses and unnecessary use promotes resistance and side effects.

Proper diagnosis is crucial in distinguishing between bacterial and viral infections to avoid unnecessary antibiotic prescribing. Optimizing antibiotic choice and use by selecting the narrowest effective spectrum, prescribing the correct dose, route, and duration, and de-escalating therapy once culture results are available also helps.

Avoiding prolonged antibiotic courses is essential. For example, skin and soft tissue infections like cellulitis often need only 5-7 days of treatment, rather than unnecessarily long courses. Ongoing monitoring and feedback to prescribers on antibiotic choices, duration, and appropriateness help improve compliance with guidelines and reduce overuse.

Infection prevention and control measures reduce the incidence of infections that need antibiotics, indirectly decreasing antibiotic demand. DNA transfer, where a bacterium acquires DNA changes from another bacterium that is already antibiotic-resistant, is another concern that can exacerbate antibiotic resistance.

By reducing unnecessary antibiotic use, individuals may help to slow the development of new strains of antibiotic-resistant bacteria. It's important to remember that antibiotics cannot treat viral or fungal infections, such as most sore throats, runny noses, common colds, flu, most cases of bronchitis, and COVID-19 infections.

In some cases, a doctor may advise against using antibiotics for certain bacterial infections, such as certain ear infections and sinus infections, because they will likely get better on their own. Antibiotics can cause side effects like diarrhea, dizziness, rash, nausea, and yeast infection. More serious side effects include severe allergic reactions and Clostridioides difficile infection.

In summary, antibiotics should be prescribed only for confirmed or strongly suspected bacterial infections using evidence-based guidelines, with careful selection, dosing, and duration to minimize resistance and adverse effects. They should be avoided entirely for viral infections and other conditions that do not benefit from antibiotic treatment.