Antibiotic use has been formed by decades of success in improving medical care through the treatment of bacterial infections and controlling the transmission of disease. While the discovery of antibacterial agents has transformed modern medicine, our reliance on them has led to the inevitable evolution of bacteria, bringing greater threats to public health.
Despite their revolutionary benefits in the clinical setting, antibiotics have their fair share of disadvantages. Bacteria that were once susceptible to antibacterial agents can adapt to these agents when routinely exposed to them. As such, the emergence of antibiotic-resistant pathogens continues to pose a threat to public health, requiring strategies that mitigate its spread and optimize antibacterial use.
At a glance
Antibiotics are substances that act upon bacteria and are intended to treat and control bacterial infections. Compounds like broad-spectrum antibiotics intend to “kill all and inhibit all [bacteria]”, while narrow-spectrum antibiotics only target “certain groups [of bacteria]”, explains Dr. Marlien Balolong, a professor of microbiology at the University of the Philippines.
Its fundamental mechanism focuses on inhibiting the formation of specific structural components, such as the cell wall that protects bacterial cells from external stressors and confers strength. Antibacterial agents may also arrest processes like DNA synthesis to inhibit its proliferation or protein synthesis to prevent cellular transport and metabolism.
The discovery of antibiotics led to the production of different classes of antibacterials that are publicly available. These classifications are “dependent on the particular aspect of the pathogen you’re trying to either control or eradicate,” says Dr. Elis Maghirang, a professor of the Biology Department and an emergency medicine physician.
Its widespread application as a medication regimen has led to a healthier world but because of its popularity, it continues to exert its own influence on personal and cultural beliefs individuals may have regarding healthcare. Balolong explains that in far-flung rural areas, some believe these drugs to be the last resort to a very serious infection and that one could simply drink or take them at any time they decide.
Advancements in science and medicine are not without societal pressure. Decisions related to one’s health may be swayed by the pervasive effects of medical populism, which thrives on the politicization of complex health issues. For Maghirang, the prevailing attitude toward antibiotic use is susceptible to “cherry-picking data to be used for other interests’’ and that its foundations may be rooted not in credibility but in medical popularity.
A change of behavior
When antibiotics are used to kill bacteria, some resistant bacteria are left behind to proliferate as a result of spontaneous mutations that yield a competitive advantage. The inappropriate use and overprescription of antibiotics as a treatment have increased the occurrence of resistant bacteria and have contributed to the difficulty in managing disease.
Maghirang describes the present circumstance of antibacterials in clinical practice as a “shotgun instead of a sniper rifle” to stress that no one size fits all approach will work. When combined with “poor implementation of regulatory methods,” antibiotic resistance may be the reality for patients in the 21st century.
Progressive action, thus, is essential in preserving the effectiveness of current antibacterial therapies and reducing the occurrence of antibiotic-resistant infections. According to Balolong, the Food and Agriculture Organization launched iAMResponsible, a campaign to urge the livestock sector, human sector, and environment sectors to come up with responsible antibacterial use.
Additionally, in order to correct and reduce inappropriate medical practices around antibiotic use, Balolong suggests that individuals should “go to your doctor and ask if it’s time for antibiotics or if it’s just rest,” to prevent resistance against medication.
Increasing awareness for proper antibiotic use calls for a holistic approach. Maghirang stresses that it is “pointless to treat and kill the bacteria if it’s not on an appropriate timing, environment, and setting.”
Curbing old habits
Antibacterial drugs have become a standard for the treatment of infections, but irrational practices continue to pose mounting threats to global public health. Reducing misuse by improving how antibiotics are prescribed by physicians and used by patients can alleviate the burdens of medical costs, prolonged care, and increased mortality—leading to better public welfare.