Antibiotic Resistance and the One Health Approach

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Antibiotic resistance occurs when bacteria change so that antibiotic medicines can’t kill them or stop their growth. As a result, bacterial infections become extremely difficult to treat. Antibiotic resistance is a type of antimicrobial resistance. Fungi, parasites and viruses can also develop drug resistance.

Your body doesn’t develop antibiotic resistance — bacteria do

When antibiotic resistance happens, fewer antibiotics are effective against a particular bacterium. Other antibiotics often help, but it’s important to have as many treatment options available as possible. It’s also important to begin effective treatment as quickly as possible for serious infections. If it takes longer for providers to find a medication that will treat an antibiotic-resistant infection, the outcome can be more serious. Antibiotic resistance is dangerous because it reduces treatment options for people who are sick. It may also delay effective treatment.

As a result, you may face:

• Increased risk of severe, extended illness or death.

• Severe medication side effects.

• Longer hospital stays.

• More medical appointments.

• Increased medical costs.

Public health experts and policymakers are working on solutions to antibiotic resistance. But there’s no easy fix, and it takes collaboration from a large number of people to make effective change. Learning about antibiotic resistance can help you take action to protect yourself, your loved ones and many others you’ll never meet.

What causes antibiotic resistance?

Bacteria naturally become resistant to medications over time. But certain factors can speed up the process, including:

• Overuse of antibiotics. Taking antibiotics when you don’t need them contributes to antibiotic resistance. For instance, viruses cause most sore throats. Antibiotics won’t help. It’s important only to take antibiotics when your provider says they’re necessary and prescribes them.

• Misuse of antibiotics. Bacteria take advantage of any opportunity to multiply. If you forget to take one or more antibiotic doses, stop treatment too soon or use someone else’s medicine, bacteria start reproducing. As they multiply, they can change (mutate). Mutated bacteria become increasingly resistant to medicine. Antibiotics can kill the bacteria that haven’t mutated to resist treatment, but they leave the resistant bacteria behind.

• Spontaneous resistance. Sometimes, the genetic makeup (DNA) of a bacterium changes or mutates on its own. The antibiotic doesn’t recognize this newly changed bacterium and can’t target it the way it should. Or, the change helps the bacteria fight off the medicine’s effects.

• Transmitted resistance. You can pass a contagious drug-resistant bacterial infection to someone else. That person now has an infection that won’t respond to an antibiotic. Usually, there’s a treatment that will work. But as time passes, the resistant bacteria may be harder to treat. Who is most at risk for antibiotic-resistant infections? Antibiotic-resistant infections can affect anyone. But certain groups are more at risk due to their health status or living environment. People more vulnerable to these types of dangerous infections include:

• Babies, especially those born early. • Adults over age 65. • People experiencing homelessness or living in crowded conditions.

• People who have compromised immune systems.

• People who take antibiotics long term.

Why is antibiotic resistance a problem?

Antibiotic resistance is a concern because it removes tools from the toolkit healthcare providers use to treat you when you’re sick. If certain bacteria can resist certain medications, providers need to find other medications to help you get better. And this isn’t always easy. But to fully understand why antibiotic resistance matters, it helps to learn how it affects us all on a global scale. Antibiotic resistance is a global public health problem. That means it can affect you because it can affect everyone. But individual people don’t become resistant to antibiotics. Specific types of bacteria do. That’s because, as we all use antibiotics to treat bacterial infections, those bacteria start to adapt. Think of a friend who likes to throw surprise parties. The first time, they could easily surprise you or someone else in your group. But after a while, you pick up on their plans and can sense when a surprise is coming. So, your friend has to work really hard to make a surprise happen — and they might not be able to at all. It’s similar with bacteria. The more we “surprise” bacteria with an antibiotic, the more they become wise to it. They can see it coming, and they don’t like surprises. So, they find ways to dodge it (resist the antibiotic’s effects). That doesn’t mean your body is becoming resistant to antibiotics. It means bacteria out there in the world (which may at some point affect your body) aren’t as easily tricked by antibiotics as they once were. So, healthcare providers must work harder to find other antibiotics to treat certain infections.

Which antibiotic-resistant bacteria are deadliest?

These bacteria are associated with the most deaths from antibiotic-resistant infections globally:

• Escherichia coli (E. coli).

• Staphylococcus aureus (S. aureus).

• Klebsiella pneumoniae (K. pneumoniae).

• Streptococcus pneumonia (S. pneumoniae).

• Acinetobacter baumannii (A. baumannii).

• Pseudomonas aeruginosa (P. aeruginosa).

What are superbugs?

Superbugs are bacteria, viruses or other germs that have adapted to the medicines that typically kill them. They grow wise to the drugs. Instead of going away, they continue multiplying and causing infections despite treatment. There’s a chance that no antibiotic will work. Some bacterial infections with superbug status include:

• C. diff (Clostridioides difficile).

• Drug-resistant gonorrhea.

• Methicillin-resistant Staphylococcus aureus (MRSA).

• Multi-drug-resistant Myobacterium tuberculosis (MDR-TB).

• Vancomycin-resistant Enterococci.

How can we combat antibiotic resistance?

Healthcare providers and policymakers must do a good amount of the heavy lifting to change things on a global scale. But that doesn’t mean you’re powerless.

There’s a lot you can do, too. Here are a few tips:

• Practice good hygiene. Protecting yourself from infection can help you avoid bacterial infections that need antibiotics. The more we use antibiotics as a society, the more the problem of antibiotic resistance can grow. Handwashing is one important step you can take. Your healthcare provider can offer additional advice.

• Only take antibiotics when you need them. Antibiotics don’t work against viral infections. But sometimes, bacterial and viral infections can have similar symptoms. So, you might think you need antibiotics when you don’t. If you’re sick, talk to your provider about the type of medication you need and why.

• Get the vaccines your healthcare provider recommends.

Five things to know

1. Antimicrobial resistance occurs when germs defeat the antibiotic or antifungal drugs designed to kill them. It does NOT mean your body is resistant to antibiotics or antifungals.

2. Antimicrobial resistance can affect people at any stage of life. Infections caused by resistant germs are difficult—sometimes impossible—to treat. In many cases, these infections require extended hospital stays, additional follow-up doctor visits and treatments that may be costly and potentially toxic.

3. Healthy habits can protect you from infections and help stop germs from spreading.

4. Talk to your healthcare provider or veterinarian about whether antibiotics or antifungals are needed. Antibiotics and antifungals do not work on viruses, such as colds and the flu. These drugs save lives but can lead to side effects and antimicrobial resistance. If you have been taking these drugs, tell your doctor if you have three or more diarrhea episodes in 24 hours.

5. Tell your healthcare provider if you recently traveled to or received care in another country. Antimicrobial resistance has been found in all regions of the world. Modern trade and travel mean it can move easily across borders and can spread in places like hospitals, farms, the community and the environment.

A note from Reprospot

When you get sick, one of the first things you might wonder is what kind of medicine you can take to feel better. Thankfully, antibiotics are still powerful tools in the fight against many bacterial infections. They’ll improve your symptoms and lower the risk of serious complications. But as time goes on, more bacteria are developing resistance to medicines that have worked for years. This situation can be scary but learning more about antibiotic resistance can help you protect yourself and those you love. Talk to your healthcare provider about ways to stay healthy. They can provide advice tailored to your unique medical needs.

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