When Antibiotics Stop Working

 

Because We Need Antibiotics. Fight against AMR!

Formerly called World Antimicrobial Awareness Week, the name was changed this year to World AMR Awareness Week (WAAW), it is celebrated from 18–24 November every year to improve awareness and understanding of antimicrobial (antibiotic) resistance. In 2024, the theme remains ‘Preventing Antimicrobial Resistance Together’.Because We Need Antibiotics. Fight against AMR!

When Antibiotics Stop Working

Antibiotics are medicines that can inhibit the growth of bacteria and kill them. However, bacteria sometimes develop strategies to circumvent the antibiotic mode of action and become insensitive to antibiotics. The term used to describe this in medical jargon is antibiotic resistance. Unfortunately, in this situation most antibiotics are no longer effective against these bacteria, which then are called multidrug-resistant organisms (MDROs). The most well- known is methicillin-resistant Staphylococcus aureus — in short MRSA. This can lead to illnesses becoming life-threatening.

What Causes a Bacterial Infection?

Bacteria are known as disease-causing organisms. Some of them we only meet occasionally. In the middle east, most common bacterials infections are brucellosis, tuberculosis, and salmonellosis. A rare but dangerous thread to small children is menigococcus-meningitis.

But many bacterias we meet every day. They live with ust and normally protect our health. Many bacteria naturally colonise our skin and the mucous membranes of our mouth, nose, intestines and other organs. Together, they form a protective barrier, making it more difficult for disease-causing organisms to penetrate our bodies.

When the immune system is weakened or the skin and mucous membranes are damaged, both foreign organisms and the body’s own organisms can enter the body and trigger an infection. Frequent types of bacterial infection from usually harmless organism on our skin and mucous are pneumonia, infection of the urinary tract, wound or skin infections.

When the bacteria spread in the bloodstream through the body, the term used is blood poisoning, or sepsis. In the worst case scenario, organ failure may occur. This can be life-threatening. Antibiotics are normally effective in treating bacterial infections. They kill or weaken the bacteria.

What is Antibiotic Resistance?

Antibiotics combat bacteria by killing them or by inhibiting their multiplication and growth. But bacteria can adapt and are survival artists. When they multiply very rapidly in large number, changes in their genetic make-up may occur. Some of these changes render the bacteria insensitive (=resistant) to antibiotics.

Antibiotic resistance mainly occurs when antibiotics are not used correctly:

• People take antibiotics too frequently, over too short a period or at too low a dose.
• People take antibiotics although they are not effective, for instance to treat viral infections.

Antibiotic resistance also occurs apart from their use in human medicine. Intensive livestock farming involves a lot of animals kept in close containments and frequently requires use of antibiotics. This encourages the emergence of resistant bacteria. They are spread with the animal feces often used for the nutritional enrichment of agricultural soils. Within the framework of the One Health approach, which recognizes the interconnectedness of human, animal, and environmental health, there is a growing concern for antibotic resistance in farm waste and its dissemination risks.

What are Multi-Drug-Resistant Organisms (MDRO)?

When bacteria are resistant to several antibiotics, the term multiresistance is used. In principle, these bacteria are no more dangerous than any others, nor do they trigger infections more frequently. However, once an infection develops, it is far harder to treat. Laboratory tests can determine which antibiotics can still help and which can’t. In the worst case, no effective antibiotic is left. Multidrug-resistant bacteria are formed particularly when antibiotics are not correctly administered, this means too often, too short or at an insufficient dose.

Who Gets Ill with Multi-Drug-Resistant Organisms?

Multidrug-resistant organisms are normally harmless for healthy individuals with a good immune system. This means: the risk of disease on contact with these bacteria is usually very low. Healthy individuals may be carriers of multidrug-resistant organisms without becoming ill them-selves and knowing they are MDRO carriers. This becomes problematic when they unknowingly transmit these organisms to individuals with a weakened immune system who are particularly at risk of developing infections. That is why these patients are tested for MDRO or MRSA bacteria when they are admitted to hospital.

The following factors increase the risk of catching MDROs:

• Hospital stay during the previous 6 months
• Stay in a nursing home
• Need for permanent care
• Antibiotic treatment within the last 6 months
• Open, larger, poorly healing skin wounds
• Tubes (catheters) in the body, for instance in the bladder
• Diseases which weaken the immune system, for instance diabetes, hepatitis, HIV
• Medication that suppresses the immune system

For healthy MDRO carriers, the organisms can constitute a risk when they undergo surgery. The MDROs can enter the surgical wound and trigger an infection.

What Are Consequences of MDRO- Infections?

The more frequently antibiotics are prescribed and taken, the higher is the risk of resistant bacteria developing and spreading. This can have serious consequences particularly for small children, the elderly or the sick:

• Infections last longer.
• Illnesses are more difficult to treat.
• Infections that had been easy to treat in the past may become life-threatening.
• For a few bacterial illnesses there are scarcely any antibiotics that still work.
• Infected people need special antibiotics that may have more side-effects.
• Hospital stays last longer and become more frequent.
• Patients have to be isolated more frequently from other people.

Important to Know: Antibiotics Don´t Work on Viruses

Antibiotics are not effective against illnesses caused by viruses. For instance, viruses trigger most common colds. Antibiotics do not alleviate common colds and won’t help you to recover more quickly. Therefore, don’t expect to be prescribed an antibiotic every time you fall ill. Do not take any antibiotics prescribed for someone else and do not give your antibiotics to anyone else. Often, it is enough to rest and wait and see.

What You Can Do Against Antibiotic Resistance

The best protection against infections is not to spread germs further. Experts estimate that even in countries with high hygiene standard up to 30 out of 100 infections could be avoided by hygiene measures. You, for instance, can help by doing the following:

• Regular and thorough washing of your hands with soap and water. This is because many germs are spread through direct contact with the hands. It is particularly important to wash your hands before eating, and after going to the toilet, changing nappies, contact with animals or handling raw meat.
• Always use paper tissues when blowing your nose and discard them safely in a bin immediately. If possible, wash your hands right away to avoid transferring germs to other people.
• If possible, don’t cough into your hand but into your sleeve. This keeps your hands clean. Keep your distance from other people when you cough.
• Try and stay home if you have an infectious illness. Avoid touching other people, for instance shaking hands.
• If your doctor prescribes antibiotics, take them as instructed. Don’t stop too early or use lower doses.
• Do not dispose of old or unused medicines in the toilet or washbasin. This places a burden on the environment and could contribute to the develop- ment of resistance. You can discard medicines in household waste.
• Towels, flannels and hygiene articles such as toothbrushes should be for your personal use only and changed regularly.
• Wash raw fruit and vegetables thoroughly. When preparing food, be sure to clean chopping boards and knives with washing-up liquid and water, especially when you are handling raw meat.
• In enclosed spaces the number of germs in the air may increase. Air rooms several times a day for a few minutes.
• If skin is damaged, bacteria may penetrate. Cover wounds or injuries with a plaster or dressing.
• If you are healthy, you can have normal contact with MDRO carriers. You can also hug them. The risk of infection is extremely low. But be sure to wash your hands thoroughly afterwards.

If Antibiotics Don´t Work on Virus, Why Does Vaccination Reduce Antibiotic Resistance?

Research studies have shown, that expanding vaccine use has the potential to reduce the administration of up to 2.5 billion doses of antimicrobials per year, making a significant contribution to the fight against antibiotic resistance.

This information is included in a new World Health Organization (WHO) report on the subject, which estimated the potential impact of increases in immunization rates. How vaccines aid in reducing antibiotic resistance has not been fully demonstrated so far. However, vaccines can “train” the immune system to better defend against various pathogens before an infection begins or worsens.

“Vaccinated people will have fewer infections and thus will also be protected against potential complications from secondary infections that may trigger the use of antibiotics or require admission to hospital,” the report stated.

Therefore, make sure that you and your family have the recommended vaccinations. Remember to get the necessary booster inoculations.

Your Health Matters!