When do we Need Antibiotics?

Appropriate Use of Antibiotics Keeps us Free from Infections

The discovery of antibiotics has been one of the most important reasons of fall in mortality rates. It was the effect of antibiotics and vaccines that actually raised the life expectancy, allowed people to have smaller families and in more ways than one, changed the way we live. It is time we know some basics of antibiotics, so that we are aware of their potential as well as limitations, and avoid blind self medication.

Role of Antibiotics

Antibiotics, along with vaccines, are the primary reason for the fall in death rate during the last century. Thanks to the efficacy of modern antibiotics, bacterial infections and epidemics, which had always been the greatest scourge of human civilization, have today been reduced to a far less common cause of human mortality and morbidity.

Antibiotics : an Overview

Antibiotics are substances, which in very small quantities, can kill bacteria without damaging human cells. They do not affect virus or fungus and are usually not effective against other parasites like those causing Malaria and Amoebiosis. Thus their use is limited to bacterial infections.

Every antibiotic is not equally effective against every bacteria. A small group of antibiotics are effective against a large range of bacteria, and hence called 'broad spectrum antibiotics'. These broad spectrum antibiotics can be effective in multiple infections, but that does not necessarily make them the treatment of choice in every infection. For most bacteria, there is some particular antibiotic that is most effective, and hence used as treatment of choice.

History of Antibiotics

One of the first antibiotics discovered by humanity was Penicillin. Discovered by Sir Alexander Fleming in 1928, it is a substance secreted by ‘Penicillium’ fungus, and has a capacity to destroy bacterial cells without adversely effecting human cells. However, the first group of antibiotics that caught our fancy and became very popular were the Sulfonamides. They were synthetically prepared and have been heavily used since 1930s.

These two groups of antibiotics changed the course of medical history by providing effective cure against a large number of infections, and it was their extraordinary efficacy in preventing infections that prompted further research and development of many more antibiotic substances.

Conditions that Need Use of Antibiotics

1. Bacterial Diseases:

There are many bacterial diseases, that grow very fast, and would be very difficult to treat without antibiotics. They range from a common boil to chronic diseases like Tuberculosis, to lethal pandemics like Plague. In fact many of the most lethal and scary diseases of yesteryears have all but disappeared, thanks mainly to the use of antibiotics. Even today, there are many diseases that cannot be managed without antibiotics. Pneumonia, Cellulitis, Urinary Tract Infections, Leprosy, Meningitis, Anthrax, Gonorrhea and Syphilis are all examples of such diseases which are no more considered scary because of the availability of antibiotics that can easily treat them.

2. As a Preventive Prophylactic in Viral infections:

These days, the frequency of bacterial infections has significantly come down because of improved standards of hygiene, and antiseptics available with both medical and non-medical professionals. Hence bacteria are no more the predominant infective agent. Most infections are caused today by viruses, yet many a times physicians prefer to give an prophylactic antibiotic cover in these viral infections as well, to avoid the possibility of bacterial super-infections of a body already weakened by the virus.

3. Antibiotic Cover in Surgery:

Many viral exanthema in childhood, which are self limited and recover on its own after time, may need antibiotic cover. A similar antibiotic cover may also be required in cases of Asthma or Allergic respiratory diseases to prevent bacterial infections. Most cases of Surgery are also prone to bacterial infection and hence need antibiotics, to prevent infection of parts undergoing surgery. Minor surgery can be conducted without antibiotic cover but most major surgery will need some antibiotic cover.

Side Effects of antibiotics

Antibiotics kill bacteria, but they also have some minor adverse 'side effects' on the human body. Most important of these effects is damage to the normal bacterial flora of the intestines, which prevent local infection by disease-causing bacteria, apart from producing certain vitamins. Hence, whenever antibiotics are administered, it may be preferable to give some vitamins, along with them. Other side effects of antibiotics include allergies. Some people have even died by a single dose of penicillin, otherwise a very safe antibiotic, because of sudden and massive allergic reaction to it. Many antibiotics are given only after testing for allergy, and history of allergy to antibiotics is an important part of one's medical history.

Dangers of Overuse of Antibiotics

One great danger of indiscriminate use of antibiotics is the development of ‘resistance’ to them in the target bacteria. Whenever an antibiotic is used, it kills most bacteria, but a few of those bacteria may develop some genetic mutation and become 'resistant' to the effect of that antibiotic. Then because other bacteria cannot grow, they only will grow and replace the rest of the bacterial population with their progeny in a matter of hours. They may then spread to other humans and become the prevalent strain of that bacterium in the society. As a result, the antibiotic will no more be effective against those resistant bacterial strains spread in the society.

This growth and spread of resistance can be prevented by using antibiotics selectively, in proper doses and for full course, and by tackling resistance with multi drug treatment.

Avoid Self Medication

Antibiotics save life, and are an essential part of medical tools available against infection, but that is not sufficient justification for experimenting with them. There is nothing wrong in knowing when antibiotics may be needed, but that may still not be enough to substitute your physician. Casual self-medication with antibiotics should preferably be avoided.