On Antibiotic Resistance

You might have the question, “Why do I need a prescription if I want to buy antibiotics?”

There’s actually a broad history to this. In essence, i’s all about antibiotic resistance, but I was thinking you’d appreciate it more if there was more detail on why prescriptions are necessary.

There’s a TLDR at the end if you’d like to check it out. 🙂

HISTORY
The classic antibiotic penicillin was developed long ago as a remedy to bacterial infection. It’s a beta-lactam antibiotic, meaning it ruins the bacteria’s cell wall which makes it easier to kill. Penicillin was hailed as a “miracle drug”, and it was often used for bacterial infections. However, because it was rampantly used, bacteria also began developing resistance to the drug.

SCIENCE
In a lot of cases, antibiotics are not necessary for patients’ treatment. Doctors avoid prescribing due to factors like allergies and side effects. (Look up Steven Johnson Syndrome, it’s scary.) And when antibiotics are necessary, there is an entire plethora of antibiotics that can be prescribed. Each antibiotic targets a certain type of bacteria/fungus/virus. Medical students spend at least two years studying drugs in the classroom setting, and even more after that, just so they can find out which drugs are appropriate for particular diseases. In addition, data is continually updated as per which species develop resistance for certain antibiotics, so doctors in turn update the way they give prescriptions with the emergence of new research.

How do bacteria develop resistance? Well, bacteria multiply in a way far different from humans and animals. Instead of just copulation, bacteria make clones of themselves and make copies of themselves at exponential rates. This is an advantage for them because it makes it much faster for them to grow their population and transfer their genes.

In addition to their core DNA, they also have another kind of DNA that’s called plasmids, which allows them to exchange new information with each other. For example, if just one individual bacteria mutates in such a way that it becomes resistant to a certain drug, it can easily transfer its newfound genes to other bacteria.

Because of these mechanisms, entire populations of bacteria can become resistant to certain drugs in a short matter of time. Self-medication of antibiotics, stopping your antibiotics prematurely, or over-dosage of your antibiotics can contribute to the process of developing antibiotic resistance.

Drugs like Amoxicillin and Coamoxiclav (which itself is a combination of amoxicillin and clavulanic acid) are given as if a bacteria is no longer susceptible to certain drugs (such as methicillin resistant Staphylococcus aureus bacteria), or if a patient has allergies to first line drugs. Giving these prematurely is like sending a blueprint of a weapon of mass destruction behind enemy lines, giving them a strategic advantage in the overall war.

PRACTICAL TIPS
Self-prescribing antibiotics (a.k.a., buying antibiotics without a prescription) is not advisable because just giving the wrong/unnecessary antibiotic can strengthen your bacteria and will make your body more susceptible to systemic (widespread) infection. Things can get worse if these bacteria spread to other people, as these have the potential to create entire pandemics, wiping out great portions of the earth’s population.

Stopping antibiotics prematurely will give your bacteria a “strategic advantage” when their populations are still not completely wiped out, and will help them to strengthen their arms using what remains of the antibiotic in your system.

Finally, over-dosage of antibiotics can result in development of resistance in other bacteria, making a patient worse off than he was when he first consulted.

TLDR?
In a nutshell, there’s a whole host of things that doctors consider when prescribing antibiotics: the bacteria in question, condition of the patient, the potency of the drug, the duration of dosage, and possible side effects. You can trust your doctor that he will give you the correct prescription, and you can be happy if he does not prescribe you antibiotics. If the latter were true, it’s good and it probably means that you’re in a much better condition than if you would need them in the first place.

https://www.cdc.gov/drugresistance/about.html

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