COVID-19. Influenza. Respiratory syncytial virus.
Seasonal viruses are in full force – and clinical pharmacist Becca Capshaw wants people to know antibiotic resistance and the proper use of antibiotics.
Capshaw leads the antibiotic stewardship program at Morris Hospital.
“We have this need to receive something when we feel bad,” Capshaw said. “I go to quick care with a sore throat and I expect them to provide me with an antibiotic to fix it.”
Overreliance and overuse of antibiotics can lead to antibiotic resistance, also called antimicrobial resistance, Capshaw said.
The Centers for Disease Control called antibiotic resistance “an urgent threat.” Antibiotic resistance killed at least 1.27 million people worldwide in 2019 and was associated with nearly 5 million more deaths, the CDC said.
More than 2.8 million antimicrobial-resistant infections occur in the U.S. each year, killing more than 35,000 people, the CDC also said.
Capshaw said antibiotic resistance typically occurred in long-term care facilities. Capshaw said. But now it’s in the community and more challenging to treat.
Antibiotics are appropriate for bacterial infections, such as strep throat. But antibiotics won’t work on viral infections, such as the common cold, influenza, RSV and COVID, Capshaw said.
[ Experts say less exposure to respiratory syncytial virus the past 2 years may be driving the surge. ]
Now viruses may lead to secondary bacterial infections. That’s when doctors may prescribe antibiotics, not to treat to the virus but to treat the secondary infection, such as an ear or sinus infection, Capshaw said.
“[People may say] ‘Oh, the antibiotics fixed my COVID’ when that’s not at all the story,” Capshaw said.
How antibiotics work
Capshaw said antibiotics work either by killing the bacteria causing the illness or inhibiting the bacteria’s growth.
Antibiotic resistance doesn’t mean the person taking the antibiotic becomes resistant. It means the actual bacteria or fungi resists — even outsmarts — the very drugs that should combat them, she said.
Moreover, the resistance bacteria can share their resistant genes with other bacteria, even bacteria that haven’t encountered antibiotics, she said.
“It’s terrifying,” Capshaw said.
When doctors prescribe antibiotics, they consider multiple factors, such as the type of infection, the patient’s age, other medications the patient takes, Capshaw said.
But when the optimal antibiotic doesn’t work, other antibiotics are tried, she said. This may prolong the infection and lead to side effects and complications, she said.
Some infections are resistant to multiple antibiotics, she said, leaving the body to fight the infection on its own – if it can.
The World Health Organization said certain infections are becoming more challenging to treat – blood poisoning, foodborne diseases, gonorrhea, pneumonia and tuberculosis – due to antibiotic resistance.
Unfortunately, there really aren’t that many classes of antibiotics.
“It takes a long time to develop new ones,” Capshaw said.
Taking antibiotics responsibly
Capshaw suggested ways people can prevent infections. Wash cuts thoroughly with soap and water. Wash hands often. Get vaccinated.
“If you seek medical treatment and it’s determined an antibiotic is necessary, take it as prescribed for the full course of therapy,” Capshaw said. “That’s also important to prevent resistance.”
Don’t use leftover antibiotics, even if the new illness feels a lot like the old one, she said. And don’t accept your friends’ leftover antibiotics, either.
“It makes us really nervous,” Capshaw said.
Capshaw said there’s a perception that cleaning products with antibiotics kill more bacteria.
“There’s no reason to add antibacterials to hand soap,” Capshaw said, adding that soap and water do the job just fine.
Be sure you’re genuinely allergic to an antibiotic before refusing it. Side effects are not the same as allergic reactions and not all reactions are allergic, Capshaw said.
Because when patients can’t take an entire class of antibiotics, it “limits the antibiotics we can give you,” she said.
“On our end, we need to make sure we’re asking the right questions,” Capshaw said.
Capshaw said she’s not trying to be “gloom and doom” about antibiotic resistance. But the problem is serious.
“I think about it at night,” Capshaw said. “I do very much wonder what it will look like if we don’t curtail our antibiotic use.”