Wellness Wednesday - Superbugs vs antibiotics. Who will win the fight?

Apologies for not posting on Monday! I was sick in bed with a nasty bout of flu. I haven't been hit that hard in a long time! I put it down to the travelling I was doing and a total lack of sleep for several days in a row. Plus it's really hard to eat properly on the road. Even if I stick to real, healthy food, it's seldom organic and free range and, thanks to my IBS, my body doesn't take that so well! Put all that together with the fact that both my mom and sister were sick, AND I spent a lot of time around them, and you have a perfect breeding ground for a virus.

So, I have been out of sorts since last Wednesday, but FLAT on my back since Saturday evening and only finally managed to drag my body back to my desk today. Despite the flu being great content for a health blog, I STILL wasn't sure of what to post about today until I heard a discussion on Talk radio 702 this morning in the healthy lifestyle slot, about antibiotics and superbugs. It also has a lot to do with the flu, and there was my topic for the day:) I know that I've spoken about this before, but, to be honest, I don't think it can be spoken about enough. Especially since things have reached crisis level around the world with the World Health Organisation finally making the distant fears, a current, and very scary reality.

An article released on New Scientist yesterday has been receiving a lot of attention today. This is how it begins:

"A post-antibiotics era in which common infections and minor injuries can kill, far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century."

It sounds overly dramatic but I can assure it, it isn't merely sensationalism on the part of the journalist. This is straight from the World Health Organisation's website, WORD FOR WORD.

The problem has now become so urgent that, this week, the World Health Organisation's 194 member states are meeting in Geneva, Switzerland, to endorse a proposed action plan to SAVE antibiotics. Part of the plan is to find a new way to research and market future antibiotics.

There isn't big money in antibiotic research. At the moment, because profit is dependent only on the amount of antibiotics sold, the research and marketing of these medications is powered by marketing alone, and how many sales can be made. When money alone is the focus, that is NEVER going to lead to responsible use of antibiotics.

A big problem is also that older antibiotics are obviously still around. They're off-patent, which means that cheaper, generic versions can be made and they end up taking the place of the more expensive ones. So the newer ones have to be priced lower, even though they cost more to research and make, and that means that, the only way for the companies to recoup their costs is to sell in VERY large quantities. Unfortunately, the more antibiotics that are out there, the faster the development of resistance becomes.

Because of the lack of money in antibiotics, companies have gradually stopped researching and making them. In fact, only two new classes of antibiotics have been brought to the market in the last 30 years and many medication developers have left the field. That's pretty scary when you think of all the new superbugs out there and how ineffective our current antibiotics are becoming. We need constant, and new research to prepare us for the onslaught of the superbugs that have ALREADY developed.

There are many reasons that bacteria are developing more and more resistance to antibiotics. The main ones being the fact that they are administered too readily, and that there is simply too much of them out there for us to be exposed to, and another one being that people don't take them correctly. I'm sure you've all taken antibiotics at some point in your life, and you've been told by your doctor to finish the course? The problem is that a lot of people don't listen to that because they don't know the importance of it. They start to feel better and they think they've taken enough to beat the bug and they put them in their medicine cupboard for the next bout of flu.

Let's just put aside the fact that antibiotics don't work against flu viruses, for now, and talk about a bacterial infection. If you don't finish the course of antibiotics, and some of the bacteria survive, they will have the time to build up a resistance to that antibiotic which will make it as effective as a sugar tablet the next time you get the same infection. And you WILL get the same infection again, because that bacteria is still alive in your system.  But this time it will be worse. Then you'll have to go back to the doctor and get a different antibiotic to try and fight off that stronger bug. If you don't finish THAT course, the cycle continues.

I don't understand why doctors don't really STRESS the importance of finishing a course. I think they should actually TELL people why. It's a general rule we all seem to know but no-one knows why really. It takes on "Fish-wives tale" status and that means it's a rule that can probably be disregarded. But honestly,  if you are going to mess around with something as strong as antibiotics, then you need to act responsibly, especially as a doctor. Patients are less likely to act responsibly regarding medication than doctors are (although sometimes I wonder about that...) I think a big part of the problem is that, as with most things in life, people become complacent. They have forgotten just how powerful antibiotics are. They are taken for granted and treated like headache pills. Nothing could be further from the truth. Those pills are what stand between us and a return to a post-antibiotic era where something as small as a cut could lead to an infection, and death.

Not finishing the course of antibiotics, and being exposed to so many of them via our meat supply, will all lead to the same result: an antibiotic resistant group of superbugs. Even without these issues to deal with, all living organisms, bacteria included carry resistance genes for self-defence. One good thing is that those defences suggest there are plenty more potential antibiotics out there, if someone would just take the time to develop them. We've only touched the tip of the iceberg with antibiotics. Existing antibiotics come from the 1% of soil microbes we can culture. That means there's a whopping 99% still left to explore. Imagine the possibilities.

The World Health Organisation says that we especially need antibiotics that target specific bacteria, instead of broad-spectrum antibiotics that attack all the bacteria in your body. That ALSO promotes resistance. It messes further with your health because your body NEEDS the good bacteria. Killing them all means you are left with no defence whatsoever.

This is just SOME of what we have in store for us if we don't start acting responsibly now:

• Multi-drug resistant tuberculosis (MDR-TB) is growing. Existing drugs for TB cure only about half of those treated for MDR-TB. Only one new antibiotic has been introduced in 40 years, despite global efforts.
• MRSA, or methicillin-resistant Staphylococcus aureus, has been joined by a staph that resists another last-resort antibiotic, vancomycin. Livestock reared using antibiotics can develop MRSA infections. These strains can spread among humans, as shown by recent human cases in Denmark even though it has banned antibiotic growth-promoters in livestock.
• CRE, or carbapenem-resistant Enterobacteriaceae, is a group of gut bacteria that resists carbapenems, which are last resort antibiotics. One set of CRE genes was first seen in India in 2009 and has since been found around the world. The bacteria can cause urinary tract infections, and the resistant strain is making this widespread ailment untreatable.
• Gonorrhoea, a sexual infection also known as "the clap", is becoming increasingly resistant to antibiotics. Untreatable cases have emerged.

Scary stuff folks. You may be saying, "Well, the World Health Organisation is on it so why should we worry? You know how these things can go. It could take months, or even years for them to hash it out and decide how money can still be made while doing the minimum requirement to make things "better".

It's up to us to start being responsible:

• Stop expecting, and requesting, antibiotics when you go to the doctor. Ask for a blood test to check if it's bacterial or viral. It's your right, as a patient, to get the best healthcare you can. How can you know for sure what it is without the right tests? Medical aid will cover it so just take the tests. If your doctor says it's not necessary, fire them and move on to the next one. There are so many out there.
• If your doctor simply offers you antibiotics without you even asking, tell him you'd like to know more about your illness before taking them, and his reasoning behind giving them. "Covering all the bases" isn't a good enough reason for him to give. You want solid proof. Again, if you don't like his reasoning, fire them and move on.
• If you start a course of antibiotics, FINISH THE COURSE no matter how healthy you feel.
• Always take probiotics when you've had antibiotics to try and restore some balance to your colon and put the good bacteria back.
• Stop eating meat and dairy products that contain antibiotics. That will allow bad bacteria to build up more resistance. Stick to free range and organic meat and dairy.

For me, first prize is to avoid those antibiotics altogether. But I also know that there is a time and a place for them. If you are gravely ill, with a bacterial infection, THAT is the time and place. Never for flu virus, never as a preventative measure and never if you are not sure what you have. 

Don't be scared to question your doctor. They are not gods, they are just people. Fallible people. And sometimes they need to be reminded of what their job is actually about. Remind them.