When the antibiotics stop working

17/06/2020

What would happen if the usual colds, diarrhoeal infections or fevers became untreatable, or if a simple outpatient operation became infected, putting people's lives at risk? These would be apocalyptic moments. Although we are not there yet, we are close to the so-called "miracle drugs", antibiotics as we know them today, no longer working.

If the antibiotics stop working. Stock image
If the antibiotics stop working. Stock image

Antibiotics, used since the 1940s, have saved millions of lives thanks to their ability to stop the progression of pathogenic bacteria, preventing them from generating infections. However, this accelerated way of life that we have, where there is no time for rest or for confirmatory laboratory tests to identify the causal agent, where what prevails is self-medication, has led to the development of bacteria that do not respond to previously effective antibiotics.

These bacteria have developed genetic and metabolic strategies to counteract the action of antibiotics, acquiring resistance, including multi-resistance to these drugs, and we have fewer and fewer options for curing infections.

The data provided by scientists estimate that, if new drugs are not available by 2050, ten million people could die every year in the world due to the action of resistant bacteria. In fact, we're already experiencing this. Sepsis caused by methicillin-resistant Staphylococcus aureus (MRSA), tuberculosis caused by Mycobacterium tuberculosis and kidney failure caused by Escherichia coli O104: H4 are some of the multi-resistant bacteria that cause death.

Scientists have been warning for years about the risk of staying are effective antibiotics, and also trying to identify the mechanisms that bacteria use to develop resistance.

However, beyond science, there are the customs and traditions that we have built up over the years. In other words, you cannot understand bacterial resistance without the misuse we give to antibiotics. A large proportion of people with diarrhea, fever, or respiratory disease self-medicate using antibiotics kept in the home medicine cabinet, while people who attend the doctor's office expect to receive a dose of antibiotics, so they are surprised, even angry, if they leave the office empty-handed. With every infection we treat without needing these drugs, with every treatment we do not take as directed, we are making antibiotics less and less effective.

Mexico is one of the few countries in Latin America that has established a national plan to combat antibiotic resistance. This is through the regulation of the sale of antibiotics without a prescription. However, self-medication is still prevalent, especially by people living in remote areas who do not have access to a doctor for treatment but do have antibiotics at home.

It is therefore very important that any regulation of antibiotic sales is accompanied by a permanent awareness campaign. The population, doctors, and pharmacists must be educated.

It is suggested that you do not follow the advice of family members to take any antibiotics. Remember that any symptom, no matter how mild, is a response to a problem, so antibiotics should not be used without a doctor's prescription, as they may mask other symptoms and make it difficult for the medical professional and clinical laboratory staff to act.

The best way to use an antibiotic (if necessary), is to assist the doctor to order the relevant clinical analysis which includes the isolation of the causal agent and the antibiotic test to identify the antibiotic to be prescribed.

Patients should follow the doctor's recommendations and the doctor should observe the results of the clinical tests carried out to issue the appropriate treatment and, finally, the patient should finish the treatment even if the symptoms have ceased before the end date.

By Dr. Cristóbal Chaidez Quiroz