Antibiotics

Antibiotics - also known as antimicrobial medicines - are medicinal products that inhibit the growth of, or kill, bacteria, and are used to treat infections in humans, animals and sometimes plants. Antibiotics are used to treat bacterial infections (e.g. pneumococcal pneumonia or staphylococcus infections). Medicinal products that are used to combat viruses are general referred to as antivirals (e.g. for flu, HIV or herpes). Not all antibiotics are effective against all bacteria. There are 15 classes of antibiotics with different chemical structures and different modes of action against bacteria. An antibiotic can attack a single bacteria or different types of bacteria.

Bacteria are said to be resistant to antibiotics when specific antibiotics are no longer able to inhibit their growth, or kill them. Some bacteria are naturally resistant to certain antibiotics. This is known as intrinsic resistance. The problem becomes more of a concern when bacteria that are normally sensitive to certain antibiotics become resistant to them, due to genetic modifications. This is known as acquired resistance. Bacteria that are resistant to certain antibiotics continue to survive and multiply when exposed to the antibiotics in question. As such, the illnesses caused by the bacteria can worsen, and even result in death. Infections caused by resistant bacteria require more treatment, as well as the use of other, more expensive antibiotics, which can have more severe side effects.

Antibiotic resistance is a natural phenomenon caused by mutations in bacteria's DNA. However, the inappropriate use and misuse of antibiotics accelerates the emergence and spread of antibiotic-resistant bacteria. When exposed to antibiotics, sensitive bacteria are killed, while resistant bacteria continue to develop and multiply. These resistant bacteria can then spread and cause infections in other people who have not taken antibiotics.

If antibiotic resistance continues to develop, serious bacterial infections will be increasingly difficult to treat in the future. Currently, in the European Union, over 33,000 people die each year due to infections caused by multidrug-resistant bacteria, against which antibiotics have become ineffective.

This is when antibiotics are used when they should not be: most colds and flus are caused by viruses against which antibiotics have absolutely NO effect. Treating them with antibiotics will not improve your state of health. Antibiotics do not bring down a fever, and do not relieve symptoms such as sneezing.

It is also when antibiotics are used incorrectly, for example:

• when treatment is stopped too early;
• when doses are reduced;
• when antibiotics are shared;
• when dose regimens are not adhered to (for example, taking the medicine once a day, instead of two or three times a day, as prescribed by the doctor). In this case, there is not enough medicine in the body, which allows the bacteria to survive and develop resistance.

The doctor's recommendations regarding the administration of antibiotics should always be followed.

Multidrug-resistant bacteria can cause a wide range of infections, including urinary tract infection, pneumonia, skin infections, diarrhoea, and septicaemia. The seat of the infection depends on the bacteria and the patient's state of health.

In hospitalised patients, there is a risk of infection, regardless of the reason for their admission. These 'hospital-acquired infections' include septicaemia and surgical site infections caused by methicillin-resistant Staphylococcus aureus (MRSA) bacteria – methicillin is an antibiotic in the class of antibiotics that are normally effective against Staphylococcus aureus); septicaemia caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria – ESBLs are enzymes capable of destroying certain antibiotics; infective endocarditis caused by vancomycin-resistant enterococci; and surgical site or wound infections caused by carbapenem-resistant Acinetobacter baumannii bacteria.

Treating infections caused by resistant bacteria is a real challenge: the antibiotics that are currently used are no longer effective, and doctors have to prescribe other antibiotics. This can lead to delays in patients getting the right treatment, which in turn can lead to complications, and even death. Furthermore, patients may need more care, and other antibiotics may be more expensive and have more severe side effects.

The situation is exacerbated by the emergence of new strains of bacteria that are resistant to several antibiotics at the same time. These are known as multidrug-resistant bacteria. These bacteria could end up becoming resistant to all existing antibiotics. Without antibiotics, we run the risk of returning to the 'pre-antibiotics era'. Organ transplants, chemotherapy, intensive care and other medical interventions would no longer be possible. Diseases caused by bacteria would spread, and since it would no longer be possible to treat them, they could be fatal.

Before the discovery of antibiotics, thousands of people died of bacterial diseases, such as pneumonia or post-surgery infections. Since the discovery and use of antibiotics, more and more bacteria have become resistant. Previously sensitive to antibiotics, these bacteria have developed different ways of fighting them. Given that resistance is increasing, and that only a few new antibiotics have been developed and brought to market in recent years, antibiotic resistance is now generally accepted as a major public health issue.

Preserving antibiotic effectiveness is everyone's business. Using antibiotics responsibly can help curb the development of resistant bacteria, and preserve antibiotic effectiveness for future generations. As such, knowing when antibiotics should be used, and how to use them correctly, is of utmost importance. Owing to successful public awareness campaigns in some countries, we are already seeing a reduction in the use of antibiotics.

Everyone has an important role to play in reducing antibiotic resistance.