Episode 9 – Antibiotic resistance: what’s the deal?

Aleena was recently offered antibiotics by a doctor, for a situation where antibiotics were completely inappropriate. She immediately called Janine and it was settled; they just had to do an episode on this massive issue. Meanwhile, Aleena has been partnering with her cat and doing some citizen science experiments, while Janine is stuck in another research rabbit hole: this time about counterfeit fruit and fruit piracy (of course!).

Antibiotics – a total game changer

The first antibiotic was discovered by Alexander Fleming in 1928. He identified that the penicillin fungus had an inherent ability to kill or slow down bacteria. Antibiotics have since become lifesaving medications, providing an effective treatment for bacterial infections that previously could have been life and death situations.

So what’s the issue then?

Fast forward to today and, while we still have antibiotics, and they are still lifesaving, sadly a new threat has emerged: antibiotic resistance. This is a situation where the bacterial organisms responsible for some infections stop responding to antibiotic treatment because they have become resistant or immune to it.

How does antibiotic resistance happen?

All organisms change over time due to random evolutionary change, such as mutation and natural selection. If any organism develops a beneficial mutation, this organism may survive more so than its neighbours and go on to reproduce more. Since bacteria reproduce incredibly quickly, evolutionary change is rapid and antibiotic resistance can develop fast.

What does antibiotic resistance lead to?

Why is the resistance developing so fast?

It’s crucial to understand that antibiotics only kill bacteria. They do not work on fungal infections or viral infections or any other type of infection. And this gets at one of the reasons resistance is evolving so fast: prescribing antibiotics in situations where it is inappropriate. This is because every time bacteria are exposed to antibiotics, we give them a chance to evolve resistance in response. Other key factors include dosages that are too high, taking antibiotics too frequently or for too long, sub-standard hygiene, slow diagnostic testing, antibiotic use in meat production industry, and patients requesting antibiotics from their doctors when antibiotics are not appropriate.

What needs to be done?

“Antibiotic de-escalation” is the key to tackling this the problem. What does this look like? Wherever possible prescribe only when appropriate; use diagnostic tests to confirm the nature of infections; use “narrow spectrum” (less full on) agents first; reduce duration of treatment; and instigate overarching “antibiotic stewardship programs” from local through to global levels.

Your gut bacteria are at risk too!

Every time you take antibiotics, the diversity of bacteria in your gut is dramatically reduced and it can take up to 4 years to get back to what was normal to you! Yikes! There is solid evidence behind the importance of gut bacterial diversity for the digestive and immune systems, but also emerging research on the links between gut bacteria, mood and mental health.

What do healthcare workers think about antibiotics and antibiotic resistance?

The bottom line? We all have a role to play in stopping antibiotic resistance!!!

What brought out our inner square?

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