Warning: Superbugs and Antibiotic resistant bacteria are on the increase.

According the World Health Organisation (WHO), by the year 2050 Antimicrobial Resistance (AMR) and Antibiotic resistant bacteria (AMR) will be the leading cause of death worldwide with an estimation of 10 million deaths a year. These drug-resistant bacteria are responsible for at least 700 000 deaths each year, and infects more than 2 million people according to the U.S. Centers for Disease Control and Prevention (CDC).

This is alarming, especially as antibiotics have been a standard treatment for bacterial infections since the early 1940’s after Bacteriology Professor Alexander Fleming, discovered antibiotics in 1928. He had been growing  Staphylococcus bacteria in Petri dishes at his laboratory at St Mary’s Hospital in London, when he decided to go on holiday. When he returned he noticed that green mould called Penicillium notary had contaminated the Petri dishes that he had accidentally left open, and were killing some of the bacteria that he had been growing. This accidental discovery lead to a breakthrough in the medical field and the development of Penicillium antibiotic medication to treat respiratory infections like Pneumonia, Scarlet fever, and ear, skin, gum, mouth and throat infections. Penicillium was widely used to treat infections of troops during world war two and by the end of the war Penicillium, that had saved many lives, was nicknames ‘the wonder drug’. Alexander Fleming received the Nobel Prize in 1945 and shared it with Howard Florey and Ernst Chain for their rile in creating the first mass-produced antibiotic medication. 

Since then more classes of antibiotics had been developed to treat different strains fo bacteria including Tetracyclines, Cephalosporins, Quinolones, Lincomycins, Macrolides, Sulfonamides, Glycopeptides, Aminoglycosides and Carbapenems. Before the discovery of antibiotics, infectious diseases caused about 40% of deaths per years in the UK only, compared to the current rate of only 7%. Antibiotics are crucial in the treatment of many conditions including the treatment of conditions such as cancer to help chemotherapy patients avoid infection, and surgical procedures like organ transplants and caesarean sections.

Even though antibiotics offer great healing properties, there is an even greater risk in the misuse and overuse of antibiotics which is the main cause of the much feared Superbug! Superbugs are strains of bacteria, viruses, parasites and fungi that are resistant to most of the antibiotics and medications commonly used in the treatment of infections. The antibiotics that were once effective treatments no longer works in every instance to fight bacterial infections in the body. The abuse of antibiotics, mostly because of lack of education about the risks factors, gives the bacteria a chance to become drug resistant. Infectious diseases like Tuberculosis, Gonorrhoea, MRSA (also known as The Hospital Bug) and other infections are on the rise due to antibiotic resistance. Staphylococcus aureus (also known as MRSA) is a common cause of  skin infections, pneumonia and infections of the bloodstream, has become resistant to Methicillin. The MRSA bacteria can enter the body through even a small scrape on the skin and appear as pimples or boils that are swollen and painful. According to the CDC there are about 80 000 MRSA infections and 11 000 related deaths each year in the USA only. Although MRSA infection can be life threatening, many people can fully recover. The evolution of superbugs are happening rapidly and new treatment are not being developed fast enough. Over the past 30 years, only one new class of antibiotics has been approved. 

The full effects and risks of alternatives to Antibiotics have not yet been completely accessed by scientific studies, but many natural remedies can be useful for some milder infections.  Natural antibiotics like Oregano, Olive leaf extract, Ginger, Garlic, Echinacea, Goldenseal, Clove and honey have been used for centuries. The Ancient Egyptians had also known about the phenomenon. They used a poultice of mouldy bread that was applied to infected wounds. 

Natural antibiotics can also be dangerous if not used properly. They can interfere with medication, reduce the effectiveness of certain medications (including HIV medication), cause blood thinning and increase the risk of bleeding. It is however believed that natural antibiotics do not pose the same risk of developing ARB so some people choose to use them for milder infections. As medicines, and even if natural, have health risks associated, your doctor should be consulted who will prescribe and recommend the best available treatment for your condition.

Even though natural antibiotics have been used for centuries it wasn’t until Alexander Flemming’s discovery of Penicillium that it became known that the actual cause of infection was bacteria. More potent antibiotics were then developed to target specific bacteria to clear infections quicker and more effectively as different types of Antibiotics target different types of bacterial infections. One cannot just take any antibiotic for any infectious condition. The specific bacteria has to be identified and treated with the correct antibiotic medication. Using antibiotics create an imbalance of the natural flora in the body which can potentially lead to other complications or diseased states. Antibiotics only work for bacterial infections and are not effective against viruses. However, doctors often prescribe antibiotics for serious flue like symptoms that are caused by viruses, as the antibiotic can assist in quicker recovery by fighting the secondary chest infection associated with the diseased state, which is usually bacterial.

Antibiotics must be used with care and to this is why they are strictly only available on prescription by a Medical Doctor after proper diagnosis. Your doctor may even have a lab test done to establish the type of bacterial infection a patient has, in order to administer the correct type of antibiotic to target a specific bacteria. 

Never self medicate on antibiotics and do not take pills from partially used antibiotic courses. There is a risk of forming Antibiotic Resistant Bacteria (ARB) in the body that can lead to the inability of the antibiotic to work properly and fight future infections. When the Antibiotic has stopped working for certain bacterial infections that have developed resistance, there may be no alternative cure available and this is the risk the world is facing by misusing antibiotics. 

The main contributing factor to ARB is that the public and healthcare workers are not aware of what they can do to prevent ARB. For instance, many people stop taking antibiotics in the middle of a course or as soon as they feel better, but there are still bacteria present in the body that then have an opportunity to build resistance against the antibiotic. If the bacteria that causes the infection is not completely destroyed it can lead to dangerous ARB (Antibiotic resistant bacteria) that then become even more difficult for the body to fight. When serious life threatening conditions need to be treated with antibiotics they may fail to work effectively, due to Antibiotic Resistant Bacteria that are now stronger than the Antibiotic that was meant to kill them. These Antibiotics used to work very well, until they were misused and the bacteria started fighting back. It is therefore extremely important that when antibiotics have been prescribed by your doctor, to complete the entire course. Follow the instructions of your doctor and book another consultation (either telephonic or in person) after the antibiotic course have been completed so that your doctor may establish whether infection have been eradicated.  

The way Antibiotics work is they block the bacteria’s ability to make proteins and regenerate and multiply. According to Science Daily, New research is currently being done to develop alternatives to antibiotics in the form of bacteriophages, which are viruses that kill bacteria. Still in the experimental stage, they have been used successfully to treat ARB, including severe lung infection, and skin and liver infections. Although proper scientific studies are still to be completed, there is great hope for the Bacteriophage treatment in the future.

It is critical that we realise that we all have to take responsibility in curbing the spread of ARB. It is extremely important that antibiotics are used only as prescribed by a medical doctor. Antibiotics should never be used unnecessarily or misused. We can prevent certain infections by taking good care of ourselves and having regular dental and medical checkups. Doctors usually prescribe antibiotics for serious bacterial infections like bladder infection, chest and ear infections, as well as pneumonia and diarrhoea which claims 1.1 million lives each year as the second most common cause of death in children. When prescribed, the entire course of antibiotics must always be completed. Doctors should discourage the overuse of the most powerful antibiotics to slow the evolution of ARB. These antibiotics should only be kept for severe infections. “Treating infections with antibiotics is something we want to preserve for generations to come, so we shouldn’t misuse them,” says Dr. Julie Segre, a senior investigator at NIH.

To prevent ARB or The Hospital Bug from spreading to patients, medical staff and hospital workers, patients who are hospitalised should be routinely screened to detect antibiotic resistant microbes. This strategy is very important to curb the formation and spreading of ARB and can limit ARB in a hospital, many hospitals and clinics, or even the infection of an entire city! More than 70% of all antibiotics used globally are given to farm animals to prevent disease and promote meat growth for more profits.  Antibiotics are given to the animals to prevent and treat infections caused by animals living in unnatural environments under huge stress; living in close contact with one another during mass meat production where diseases are easily spread. These antibiotics are ingested by humans who eat the meat contributing to even exposure to antibiotics leading to the formation of antibiotic resistance in humans. Farm workers who simply handle the animals are particularly at risk of being exposed to ARB.  Good sanitisation is very important as the antibiotic-resistant bacteria can be passed from animals to humans through their meat, manure, and even in airborne particles. The WHO recommends that farmers stop the use of antibiotics globally and in some countries it has already been banned.  The care and welfare of animals is clearly beneficial to the environment and the wellbeing of humans.

Antimicrobials used in agriculture are another driver for the proliferation of ARB’s (also known as AMR – Antimicrobal Resistance).  Another big contributor to the super-speed spreading of superbugs is the improper treatment and disposal of medical and pharmaceutical waste that contain high levels of antibiotics. Hospitals and farms in poorer countries do not dispose of their waste ethically and with proper care as to not contaminate our rivers and the environment. These wastes contain antibiotics, microbes and other harmful substances that are irresponsibly pumped into the environment at shocking quantities which contribute to the rise of the Superbugs. 

To reduce risk of the evolution of the Superbug the use of antibiotics as a generalised treatment must be reduced and this potent medicine must only be used when necessary to stop serious infection. Doctors are urged to do a swab test of the infected area and have it tested in a laboratory to establish which bacteria is present in the infected area and treat the infection accordingly and correctly to reduce unnecessary exposure to antibiotics. Once a lab test have been done the infection can be treated correctly first time with the right antibiotic (if necessary) to effectively treat infections and stop the spreading to other parts of the body. With a lab test your doctor will also be able to establish the dosage and correct type of antibiotic required to fight the specific bacteria. Antibiotics kill both bad and good bacteria in the body. This creates an imbalance of the microbiome, the community of bacteria, fungi, microbes, and other micro organisms living in our body and on our skin, functioning together in harmony to maintain a healthy body.

To help the body recover the balance of its natural flora after a course of antibiotics, a medical doctor may prescribe a probiotic to support the growth of good bacteria and increase immunity.

At the UN General Assembly in 2016, a UN declaration on combating antimicrobial resistance was signed by 193 countries who committed to develop regulatory systems on the use, sales and disposal of antimicrobial medicines. Everyone together agreed to contribute to finding innovative ways to develop antibiotics, improve rapid diagnostics and increase awareness on the prevention of drug resistant infections. 

To help fight drug resistant bacteria (ARB) from developing and spreading globally, which inhibits the effectiveness of Antibiotic medication, “always use antibiotics responsibly and only as and when prescribed by your medical doctor when absolutely needed. Don’t insist on an antibiotic if your doctor does not prescribe it. Once started, complete a course of Antibiotics.” (Dr. Walter Ward, Medical Doctor, Advance Medical Centre, South Africa).  Avoid the consumption of farmed meat and animal products where possible and maintain good hygiene by washing your hands regularly and properly with soap and clean water, keeping social distance and reducing exposure to possible environmental contaminants.

“We owe it to our children and grandchildren to make sure we have effective antibiotics in 10, 20 and 50 years’ time. We want the drugs to still work.” – Dame Sally Claire Davies (chief Scientific Adviser at the Department of Health, England).

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