LETTER: Antibiotics have their limits, said Sault doc


SooToday received the following letter to the editor from Dr. Lucas Castellani, an infectious disease doctor in Sault Ste. Marie, regarding the Global Antibiotic Awareness Week:

Antibiotics are one of the best medical inventions of all time. Their discoveries have saved a lot of life over the past century. If not for antibiotics we might not progress so fast in the field of transplantation and cancer treatment. But unfortunately, like all medical therapies, they have limitations.

Since Penicillin's discovery 90 years ago it has become an arms race between the development of antibiotics and microbial resistance. However, until recently, we did not have new antibiotics for organisms that continued to evolve. Even today, very few antibiotics have been developed to fill this gap. This is scary. In 2014, the World Health Organization (WHO) stated that more people would die globally from organisms that are resistant to cancer itself. We see bacteria and fungi that are resistant to almost all known antibiotics.

So what can someone do to help in this matter – to try to make a curve in a seemingly gigantic task? This is the Global Antibiotic Awareness Week (12-18 November 2018), and I will outline some of the things that everyone can do to make a difference:

Don't take antibiotics "just in case". There are many diseases that require antibiotics. However, more than 50 percent prescribe antibiotics is not appropriate. Patients receive antibiotics that are not suitable for anything from cloudy urine to colds and they are not always safe. For example, some cancer drugs do not work well in patients who have taken antibiotics. Please ask your doctor if you really need this antibiotic and that the benefits outweigh the risks.
Avoid "sharing" antibiotics. Don't use it again for family members or other friends because you are never sure it's safe. Because antibiotics have many side effects and risks, including worries about resistance, always ask for advice when considering taking antibiotics.
Clarification of your penicillin allergy. If you have penicillin allergies then you are more likely to receive treatments that are less effective when you actually have an infection. By discussing with your health care professional, you might be able to debunk the allergy. This will allow your health care professional to use alternatives that are more effective and less risky.
Wash your hands. Resistant microorganisms usually spread from person to person, or from contaminated environments to others. By washing hands and / or using hand sanitizers, you can prevent yourself and your loved ones from contracting one of the hard-to-treat microorganisms, and spread them to others.
Get vaccinations – especially flu shots. Immunization is the most important in preventing treatment for infection. Every year many people die from influenza, but there is still concern that it is not effective enough. When you compare it to drugs such as aspirin for heart attacks and statins for cholesterol, it's actually quite effective. Also, diagnostic tests to distinguish bacteria and viruses have not been very effective. So, by preventing influenza, you prevent people from needing antibiotics "just in case" when health care providers cannot distinguish them from other types of infections.
Be aware of the use of antibiotics outside of health care. This is a global problem and because we continue to use antibiotics inappropriately in veterinary medicine and veterinary medicine, and continue to dispose of these drugs improperly, we will continue to see ongoing problems with resistance. Efforts can be as simple as limiting the antibiotics your pet receives and buying antibiotic-free foods.

Like most things in science and medicine there are no black and white ones. There is complexity here which cannot be denied. However, unless we all make a concerted effort to influence positive change, we may see this problem reaching a critical point without turning back. Antibiotics, miracle treatments in our day, may not be effective.

Lucas Castellani is an Infectious Disease Specialist in Sault Ste. Marie. If you want to know more about this growing problem, you can access the WHO website or contact Dr. Castellani with questions at [email protected]


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