CATES: Antibiotic Awareness Week – Odessa American

Carol A. Cates, MSN, MBA, RN, NEA-BC, is the chief nursing officer at Odessa Regional Medical Center. You can reach her via e-mail at [email protected]

By Carol A. Cates, MSN, MBA, RN

Chief Nursing Officer

Odessa Regional Medical Center

I have a picture in my office of my dad when he was three. In that picture, he is sitting next to my aunt, Gertrude Ann, who was 18 months old at the time. I never met Gertrude Ann, because not long after that picture was taken, she died. She died from croup, something now we don’t really even think of as serious. The reason croup is so different now is antibiotics. If antibiotics had existed when Gertrude Ann was sick, more than likely, I would have met my aunt.

Antibiotics, in so many ways, are quite literally “miracles in a bottle.” Unfortunately, with the rise of Multi-Drug Resistant Organisms (MDROs) in the last few decades, the miracle antibiotics can provide is waning. That is why Antibiotic Awareness Week was added to the health awareness calendar. It gives all of us the opportunity to become more educated about how to use antibiotics wisely, so they continue to provide miracles every day.

MDROs are bacterial illnesses that over time have become resistant to multiple antibiotics. The one people probably recognize the most is Methicillin-resistant Staphylococcus Aureus (MRSA). Staphylococcus Aureus (staph) is a bacterium that we all carry around on our skin every day. It is part of the many bacteria that form our “normal flora”. On our skin, staph for the most part is harmless. Unfortunately, when staph gets in other parts of our bodies, like a wound, or into the lungs, it can cause infections which can be quite serious. When it’s MRSA, that level of seriousness goes up, because most antibiotics cannot kill MRSA. Unfortunately, it’s not just staph that has developed resistance, now we are seeing multi-drug resistant versions of bacteria that are really concerning, like tuberculosis and syphilis, because they aren’t ever harmless.

Drug resistance happens because bacteria can reproduce rapidly. It’s almost like the selective breeding we have done for centuries in animals to bring out desirable qualities, like breeding racehorses for speed and endurance or dogs for their abilities to detect scents, help us hunt game, and to be our companions. Say you get a cut, and staph gets into that wound, and it gets infected. You go to the doctor, and they prescribe an antibiotic. You take it for a few days, and the cut gets better, so you stop taking the antibiotic. The problem is, if you haven’t taken the full course of the antibiotic, some of those infectious bacteria have been weakened but they aren’t dead. Those bacteria then start reproducing as part of the normal flora on your skin. Later, you get an upper respiratory infection and decide to take the left-over antibiotics. But those bacteria that are still alive on your skin are affected, and just like last time those bacteria that survive, reproduce, but since they’ve survived the antibiotic twice now their descendants are less and less weakened by the bacteria. Touch someone and share your bacteria with them, and they take antibiotics in the same way and eventually over generations and generations of bacteria (which for them can be an amazingly short period of time) they aren’t affected by the antibiotic at all (AKA resistant) and that resistance eventually happens with many antibiotics.

This is why it is so important to take antibiotics only for bacterial infections and that you take them as they are prescribed. When we take antibiotics for viral illnesses, we create resistance in our normal flora. We have normal flora not just on our skin, but in our mouths and in our gut, too. For instance, another serious MDRO is vancomycin resistant enterococcus (VRE), which is for the most part harmless in our bowels, but when it gets elsewhere, can cause very serious illnesses. When we stop antibiotics early, or don’t take them at the frequency they are prescribed that also causes resistance. The worst thing abut MDROs is there are very few new antibiotics being discovered. So, we have to be very careful with the ones we do have so we can stay ahead of bacterial infections and keep the miracles that antibiotics happening.

Please, when you are sick, don’t insist that your provider give you an antibiotic prescription, ask them why they aren’t. If it’s because you have a virus, an antibiotic is not going to help you anyway. If you are prescribed antibiotics, take them exactly as they are prescribed and until they are gone. And never take antibiotics prescribed to someone else or that you have saved. By taking those precautions, we can all make a big difference and keep receiving miracles that antibiotics give us every single day.

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