Antibiotics are potent medicines which kill bacteria or retard their growth and multiplication, pathogen ones (pathogen – cause diseases) as well as non-pathogens, while they have no effect on viruses and most fungi. With their invention, at the beginning of the last century, many lives have been saved and one can rightfully say that antibiotics discovery represents a historic moment for the modern medicine.

Antibiotics are the most prescribed medicines of today. What is specific for antibiotics is that they are the only medicines which affect the entire community since we exchange our micro flora with the people we meet every day. Therefore every unwarranted use of antibiotics may be harmful not only to us, but our families and the entire community.

When are antibiotics useful and when not?

Antibiotics cure bacterial infections if and when: they are correctly chosen (if the bacteria present is vulnerable to the antibiotic), administered in proper dosage, administered in proper time intervals which ensures effective antibiotic concentration in the blood and if the therapy lasts long enough. In cases of virus infections (cold, most sore throats, most earaches, and cough) antibiotics not only don’t help, but prolong healing because they kill the “good” bacteria which are important for the proper immune function. Every use of antibiotics increases organism sensitivity on microorganisms from the environment, and it frequently causes intestinal micro flora disruption and fungi infections. The most serious unwarranted and improper antibiotic use is the appearance of bacterial resistance.

What is bacterial resistance?

It is the very reason why it is said that the use of antibiotics by and individual affects the entire community. Resistance, is, plainly said, a highly intelligent bacterial survival system. It represents the bacteria evolutionary adaptation, the development of various resistance mechanisms to know antibiotics. The development of resistance changes the genetic structure, which means that the offspring is also resistant to some, and in some cases, several antibiotics (multi-resistance). An example of such super-bacteria is MRSA (Methicillin-resistant Staphylococcus aureus) and VRE (Vancomycin-resistant Enterococcus). What does all this mean for us, humans? It means that we can contract some of the well known bacteria, and that no known antibiotic will have any effect on it. Remember the plague which took almost 75 million lives throughout history. The discovery of antibiotics saved millions of lives from that wicked bacteria (Yersinia pestis), but the life of a young man from Madagascar who died in 1995 from the same disease couldn’t be saved because no known antibiotic could help exactly due to the built up resistance.

The use of antibiotics in animal farming and intestinal infection prevention also contributed the development of resistant bacteria breeds. The same adaptation mechanism occurs among farm animals as well, and then their meat and milk with traces of antibiotics ends up on our plates. The consequence of everything listed is that very powerful antibiotics are no longer effective.

When should we really take antibiotics?

The decision of antibiotics treatment should always be left in the hands of a doctor. Even if prescribed antibiotics, thoroughly discuss the justification of its use. It is certainly recommended to choose an effective antibiotic according to the antibiogram, and the doctor should always recommend a narrow-spectrum antibiotic because the specter of activity is directly linked to the resistance development possibility.

What to be careful of when taking antibiotics?

Some antibiotics (tetracyclines, fluoroquinolones, some penicillin varieties) mustn’t be combined with milk, dairy, products or medicines containing iron, calcium, magnesium and aluminum (aluminum and magnesium are the ingredients to some antacids – stomach acid neutralization medicines). A time interval of at least 2 hours should pass between their uses.

There are indications that antibiotics (ampicillin, tetracyclines) reduce the effectiveness of oral contraceptives, therefore, during the use of these antibiotics, additional pregnancy protection is recommended.

Antibiotics operate, not only on infection causing bacteria, but healthy bacteria in our intestines as well. This increases the risk of fungal infections, especially in women, so special dietary care is recommended during antibiotics use in the manner of avoiding fungi stimulating foods.

Foods like sugar, white flour and other refined carbohydrates, industrial fruit juices, fermented food, dried meat and fruit, mushrooms, pistachio and peanuts should all be avoided. As help in damaged intestine flora, probiotic therapy is recommended. Alcohol must absolutely be avoided during antibiotics treatment because it may cause nausea, vomiting, headache and even convulsions.

What can you do to prevent resistant bacteria development?

Talk to your primary healthcare doctor, as well as your pharmacist, about resistance development. Never take antibiotics for viral infections like the cold, flu or cough.

If antibiotics are prescribed to you:

• Take the medicine EXACTLY as prescribed by the doctor and explained by the pharmacist. Finish the therapy, for as long as instructed, no matter is you started feeling better. If you do not finish your therapy, a part of the bacteria may survive and cause another infection. This applies to children as well.
• Never skip your dose
• Do not save antibiotics for when you feel sick again.
• Do not borrow antibiotics from other people. Those may turn out to be antibiotics unsuitable for your condition, and the use of the wrong medicine may prolong the healing process.
• Dispose of leftover antibiotics at the end of your therapy (in a manner suitable for medical waste disposal)

And remember, antibiotics are not antipyretics and antibiotics are not analgesics!

What does the competent ministry do about bacterial resistance?

The bacterial resistance to antibiotics problem must be seen as a global problem which knows no country borders. The Republic of Croatia supports collaboration with other countries in their joint efforts to stop resistance spread. In order to put into place a strategy and activities directed towards stopping the bacterial resistance to antibiotics spread  and equal representation of all interested parties, the Ministry of Health and Social Welfare has founded the Intersectoral Society for Antibiotic Resistance Control (ISKRA).

More about the topic on:

National program for bacterial antibiotics resistance control 2009-2014 ISKRA

The vulnerability and resistance of bacteria to antibiotics in the Republic of Croatia