Arizona Daily Wildcat

Issue date: 9/25/07 Section: Opinions

Lauren Myers columnist

When was the last time you worried about dying from a cut or scrape? It's hard to imagine, but less than a 100 years ago people could and did die from infected wounds. In this pre-antibiotic age, medicine was essentially helpless in the face of bacterial infection. But when penicillin was discovered in 1928, humanity's fortunes started looking up.

The discovery of penicillin sparked an explosion of antibiotic development that revolutionized the relationship between humans and germs. Antibiotics conquered a vast range of old afflictions, from infected cuts to great scourges like tuberculosis. In 1969 then-U.S. Surgeon General William H. Stewart smugly declared it was "time to close the book on infectious diseases, (and) declare the war against pestilence won."

He could not have been more wrong.

Microbes are master survivalists. In fact, they're the best on the planet - almost four billion years of natural selection have shaped them into ruthless adapters. Modern medicine underestimated the hardiness of these simple creatures. Doctors assumed bacteria would simply accept defeat at the hands of the new antibiotic arsenal.

Antibiotics seemed like an infallible silver bullet, so people have outrageously abused them. Many doctors, for instance, routinely prescribe antibiotics in inappropriate circumstances, and some physicians will even give these drugs to anxious patients with viral infections - despite the fact that antibiotics are completely ineffective against viruses. Often, doctors practicing defensive medicine may unnecessarily prescribe antibiotics to insulate themselves from potential lawsuits.

Of course, patients deserve just as much blame as doctors for the sad reality of antibiotic abuse. Many patients aggressively pester their doctors for antibiotics, but don't understand when these drugs are an appropriate treatment strategy and when they are not. Furthermore, patients often fail to take their full course of treatment because they begin to feel better before their pills run out. This behavior is one of the single most important factors in the emergence of drug resistance. Failing to complete an antibiotic regimen allows a few of the hardiest, most resistant bacteria to survive and infect someone else. Let the cycle repeat a couple of times, and boom! Resistance takes root.

Perhaps most egregiously, antibiotics are widely and routinely abused in agriculture. Instead of raising animals in clean and sanitary conditions, many farmers pump their animals full of antibiotics to stave off disease and maximize growth. Almost half of all antibiotics used in such agricultural applications are chemically identical or similar to human antibiotics. Thus, the misuse of antibiotics in agriculture is directly compromising medical applications of these drugs.

The tragically near-sighted behavior of doctors, patients and farmers alike ignores the fact that the discovery of antibiotics did not suspend the laws of natural selection and evolution. Instead, facilitated by our gross misuse of antibiotic drugs, many microbes rapidly evolved into drug-resistant strains that are impervious to treatment. The first penicillin-resistant bugs appeared in 1947 - a mere four years after widespread use of penicillin began.

Today, hospitals have become breeding grounds for drug-resistant strains of strep, staph, enterococci and other pathogens. To illustrate the problem, 1.7 million Americans contracted hospital-acquired infections in 1995, and a terrifying 70 percent of these illnesses were caused by drug-resistant bacteria. Incidence of vancomycin-resistant enterococci increased twenty-fold between 1989 and 1993. MRSA, the drug-resistant form of staph, increased from two percent of all staph infections in 1974 to 22 percent in 1995, and then to 63 percent in 2004.

Unfortunately, the problem is only getting worse. Through our over-prescription and misuse of antibiotic drugs, we seem to be doing everything within our power to expedite the evolution of drug resistance. In the war on microbes, we are proving to be germs' best ally and our own worst enemies.

The solution to the mass emergence of drug resistance should be straightforward. Doctors must stop indiscriminately prescribing antibiotics to every patient with a sniffle or a sore throat. Patients must complete their full course of therapy, never pressure their doctor for antibiotics and never take these drugs without a doctor's supervision. Farmers should stop using antibiotics as a substitute for humane conditions for their animals.

UA students can do their part by educating themselves and others about appropriate and inappropriate uses of antibiotics. All students should understand that the flu, colds and other viral infections cannot be treated with antibiotic drugs.

Unfortunately for global public health conditions, the medical system is not aggressively pursuing these options. The small efforts that have been made have been largely ignored by an apathetic public. As a consequence, we may soon see a day where there's not always a pill to take when you get sick, a day when medicine can no longer fight off every bacterial attack. We have been lazy and complacent, and we are quickly approaching the post-antibiotic age.

Lauren Myers is a sophomore majoring in math and microbiology. She can be reached at letters@wildcat.arizona.edu.

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