Dr. Kevin Kavanagh: Overuse of antibiotics aids attacks of deadly bacteria

May 9, 2014 

Dr. Kevin Kavanagh of Somerset is board chairman of Health Watch USA.

It is counterintuitive and tears at a basic tenet which many of us have lived by: antibiotics, that security blanket we all have enjoyed, can actually cause infections.

We have all reached for these wonder pills at one time, hoping for that magic cure, with the belief that if they did not work, no harm would be done. Even the cost was paid for by our insurance.

However, nothing can be further from the truth, especially in today's world of aggressive, hard-to-treat bacteria. Antibiotics can cause infection in two ways.

The first is in the community at large. Almost all antibiotics have a broad spectrum and even the most common ones can cause bacteria to become resistant to them. Once this happens, the next time you or your loved ones gets an infection it will be much harder to treat.

But the problem is much worse than simply resistance to one antibiotic in the bacteria that was treated. The bacteria becomes resistant by acquiring a gene or a code that allows it to produce an antidote to the antibiotic.

These genes can then be passed to another bacteria, even a more aggressive bacteria of a different species. And often these genes are passed in groups, giving resistance to many types of antibiotics at the same time.

As a response to the growing problem of antibiotic resistance, some doctors have resorted to using even stronger antibiotics, such as carbapenem, on hospitalized patients. Carbapenem kills almost all superbugs including MRSA, which causes deadly staph infections.

However, bacteria are becoming resistant even to this drug, and once resistance develops, these bacteria are virtually untreatable. Some are totally untreatable to all antibiotics and in others, the only treatment causes kidney failure all too often. Patients who carry these resistant superbugs are much more likely to develop these severe infections than non-carriers.

The second way antibiotics cause infection is by killing off the good bacteria in your gastrointestinal tract, allowing the emergence of even deadlier bacteria. This is what happens with Clostridium difficile or C. diff, a deadly spore-forming bacteria. According to the Centers for Disease Control and Prevention, C. diff. is currently the most common health-care associated infection in the United States. It has surpassed MRSA.

If you try to kill this bacteria with antibiotics, it can hide in a fortress called a spore. It just waits for the antibiotic to go away and then re-emerges. Although antibiotics may not get rid of C. diff, the other bacteria in the gut can hold it in check. This is an example of how we live in harmony with and actually need these other bacteria. Collectively, these bacteria are called an individual's microbiome. And as pointed out in the recent book, Missing Microbes, the overuse of antibiotics may be fueling our modern plagues.

Thus, taking an antibiotic for a cold (an ailment caused by viruses which are totally resistant to antibiotics) may kill off the beneficial bacteria, allowing C. diff. to emerge and cause an infection.

Taking a probiotic (a pill filled with beneficial bacteria) may help but there are no guarantees.

The CDC has reported that a 30-percent decrease in some types of antibiotics will result in a 26 percent decrease in deadly C. diff. infections. When very severe and unresponsive infections occur, sometimes a fecal transplant, or recolonizing a patient's microbiome with bacteria from another individual, is the only treatment option left.

You should only take an antibiotic when you absolutely need one. If you have a serious infection, even a strep throat, antibiotics are necessary, since treating an active severe bacterial infection trumps concerns over the possibility of a future infection.

Thus, taking an antibiotic for every sore throat and cold causes a grave risk of creating antibiotic resistant bacteria, and may even cause more harm than good in the patient taking the medication. Both patients and doctors need to conserve antibiotic usage and only use them when absolutely necessary.

In this way, when we or our families truly need antibiotics, they will still be available as a lifesaving treatment.

Dr. Kevin Kavanagh of Somerset is board chairman of Health Watch USA.

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