What you need to know about antibiotic resistance
Tuesday 19 November 2019
If you’ve ever been sick with a bacterial infection, you might have been given antibiotics by your doctor that helped you to get better. Antibiotics are an amazing type of medicine that can destroy certain types of bacteria that make us sick. But across the world, bacteria are becoming resistant to antibiotics, which stops the medications from working.
Dr Kathryn Wilks is an infectious diseases physician and medical microbiologist at Sunshine Coast University Hospital. She is also the director of the Antimicrobial Resistance Committee at Sunshine Coast Hospital and Health Service and spends a lot of her time talking to doctors and patients about how to use antibiotics properly and prevent antibiotic resistance from developing.
We spoke with Dr Wilks about what antibiotic resistance is and what you can do to help stop it.
What are bacteria?
Bacteria are tiny little creatures that can live in and on your body. They also live in the world around you; they are everywhere! In fact, there are trillions of bacteria on you right now. But don’t worry, most of the time bacteria are either harmless or really helpful for your body.
“Bacteria are a part of our body,” says Dr Wilks. “They help us with digesting food; they're part of what we call the microbiome. They have a very important role in our health, but sometimes they get in the wrong places and cause infections.”
There are lots of different bacteria. Some you might have heard of, like E. coli that can cause food poisoning symptoms, or lactobacillus bulgaricus, which are the bacteria that are found in yoghurt and help with your digestion.
What is a bacterial infection?
Usually, all the types of bacteria, along other organisms like viruses and protozoa, and your immune system, keep each other in check. This means that there’s not too many of one type of bacteria, or too few of another. But sometimes, one type of bacteria can grow out of control or get into an area they’re not meant to be. This is called a bacterial infection.
You’ve probably had a bacterial infection before. If you’ve ever had a nasal infection that gave you bright green snot, a cut on your foot that got red and gooey, or a UTI that made it hurt to pee, that was a sign you had a bacterial infection.
What are antibiotics?
Bacterial infections can make you really sick. Sometimes, your body’s immune system will fight off the bacteria by itself, but other times it needs medicine to help. When this happens, your doctor can give you antibiotics to help stop the bacteria from spreading and causing the infection.
Dr Wilks says, “I always think of antibacterials as the icing on the cake. Most of the work has to be done by your own body to get rid of the infection, but the antibiotics just are there to help finally get rid of those bugs and help the whole system along.”
There are a few different ways antibiotics can attack bacteria that are causing infection.
“Antibiotics destroy bacteria in several different ways,” says Dr Wilks. “One of the ways is by breaking the walls down. Bacteria have little outside capsules or walls and the antibiotics can actually go in there and pull that apart and then the bacteria just disintegrate. Sometimes they stop them from reproducing or they stop them from producing important things that are needed for them to survive.”
Antibiotics only work on bacteria – they are no help at all against viruses or other types of illnesses. This is why your doctor can’t give you antibiotics to help with an illness caused by a virus, like a cold or influenza.
What is antibiotic resistance?
Bacteria are living creatures. It’s normal for living creatures to adjust to their environment, so if something is hurting them, they have a way to fight back. When bacteria keep getting killed by the antibiotics used to stop infection, they’ll change so that the antibiotics can’t harm them anymore. Once bacteria have adjusted to the antibiotics, we call this antibiotic resistance, and it means the medicines don’t work as well – sometimes they don’t work at all.
Antibiotic resistance can also be called antimicrobial resistance or drug-resistant infection. Dr Wilks says she often talks to her patients about drug-resistant infection, so that they know it’s not their body that is resistant to the medicine, but the actual infection itself.
Why is antibiotic resistance bad?
Antibiotic resistance is a dangerous thing for everyone, because it means that simple bacterial infections can become hard to treat. Dr Wilks says that she sees patients whose infections just won’t respond to any of the antibiotic medicines available, which can mean they get really sick, or even die.
“It sounds awful, but there are situations where people die because they have serious infections that can't be treated. In the first instance, if we have somebody who's been given an antibiotic and it's not working and we've got the bug and we know that the antibiotic's not working, we can try and put them across to another antibiotic. But we're getting fewer and fewer choices because of the increase in this resistance.”
Antibiotic resistant infections can affect anyone, no matter how old they are or where they live, and it’s up to all of us to help prevent antibiotic resistance from becoming an even bigger problem.
What can you do to help prevent antibiotic resistance?
Antibiotic resistance is on the rise across the world, but Dr Wilks says there are simple things everyone can do to help prevent it.
Limit your use of antibiotics
You don’t always need antibiotics if you have a bacterial infection. Sometimes, your body’s immune system will fix the infection by itself.
“When you're really, really sick, you're in hospital, you've got fevers and all these other things happening, then antibiotics can be complete lifesavers,” says Dr Wilks. “But in some situations, you may want to weigh it up and say, ‘Do I really need to take this antibiotic?’
“Have a good discussion with your doctor about it and ask your doctor whether it’s really needed. It's not an easy thing to question your doctor, but they expect it more these days. So, if you're not sure, you can ask the doctor, ‘Do I really need this antibiotic, or do you think I'll get over it without it?’"
Sometimes your doctor will say yes, you definitely need the medicine. But sometimes you might be able to wait and see if your immune system fixes the infection. You can find more information about having these kinds of conversations with your doctor on the NPS Medicinewise website.
Only take antibiotics when a doctor prescribes them for you
It’s really important that you only ever take antibiotics when your doctor prescribes them for you. Don’t take leftover tablets that you’ve kept in the cupboard next time you feel sick, and don’t take medicine that was prescribed for someone else.
Don’t keep your antibiotics for later and don’t share them around
You should always take the full set of antibiotics you are prescribed, which means you shouldn’t have any leftover. But if you do happen to have a half a packet of tablets left, don’t keep them for later. You can return any leftover medicine to a pharmacy who will dispose of them properly.
It might seem like a nice idea to share your antibiotics with someone else if you think you have the same sickness. But the truth is, you have no idea what kind of infection they have, and your medicine might not help them at all. Antibiotics can also cause side-effects, so it can be dangerous to give them to someone else.
“That's not a good idea because not all antibiotics work the same way,” says Dr Wilks. “It might just lead to more problems, because things like rashes and other stuff can happen with antibiotics too. So always keep your own prescriptions.”
Don't ask for antibiotics – especially for colds or flu
Sometimes when you’re feeling really sick, all you want is for your doctor to give you a magic pill to make you feel better. But if you have a virus, like the ones that cause a cold or influenza, antibiotics won’t do a thing. In fact, they might make you feel even worse, because they can cause side effects like nausea, diarrhoea or skin rashes. So, next time your doctor tells you the best thing to do is rest up and drink plenty of fluids, don’t pester them for a prescription.
Keep your hands clean
It might sound basic but keeping your hands clean is one of the best ways you can prevent the spread of bacteria. Dr Wilks says you don’t need anything fancy, or a soap that claims to kill 99.9% of germs, for handwashing to be effecting.
“Good old soap and water is more than enough for what happens in the community. In hospitals it's different. In hospitals we have to use alcohol hand rub and other things like that, but that's because we're in an area where we really have a lot of contact with sick patients and we don't want to be spreading anything around in the hospital. But in the community, soap and water is the best. You can use an alcohol hand rub if you're on the go or if you're traveling. But generally ordinary soap and water is the key to getting rid of most of these important bacteria and leaving the good bacteria alone.”
Vaccinate to prevent infections
“Vaccination can stop an infection from happening in the first place, then you don't need to go through being sick and having to get treated,” says Dr Wilks about getting your recommended vaccinations.
You can find out what vaccinations you and your family should get and when from the Queensland Immunisation Schedule.
What have you done to help prevent antibiotic resistance?
For Dr Wilks, antibiotic resistance is a problem that’s always on her mind.
“I think about it all the time because I can see it in action,” she says. “I can see antimicrobial resistance in the hospital and I can see what it does, the impact it has on patients and decisions around what we can and can't do with things like surgery and transplants.”
What steps are you taking to help prevent antibiotic resistance? Join the conversation on our Facebook page.
You can find more information about antibiotic resistance, antibiotics and bacterial infections at the links below.
Many thanks to Dr Kathryn Wilks and the team at Sunshine Coast Hospital and Health Service for providing expertise and guidance for this article.