Change of season: ARE THE ANTIBIOTICS BLUNT WEAPONS TO DATE?

4 Jun 2019 News 6

 

THE EXCESSIVE AND INDISCRIMINATE USE OF ANTIBIOTICS NEUTRALIZES THE EFFECT, ENHANCING THE CAPACITY OF MICROBES TO “RESIST”. AN ALARMING PHENOMENON TO WHICH DOCTORS AND SCIENTISTS DRAW THE ATTENTION OF PATIENTS

Author Dr.Davide Maged MSc, Ph.D. in Biomedical Science and Public Health, Department of Public Health, Faculty of Medicine, Università Cattolica del Sacro Cuore Roma (Italy)

The word antibiotic comes from ancient Greek and literally means “against life”; in reality they are drugs, of natural or synthetic origin, capable of killing certain types of microorganisms that, if pathogenic, can threaten our organism.

The mechanism of action of antibiotics has been fully understood only during the twentieth century, in fact, even if in ancient times people used substances with an antibiotic effect to treat infections that were found in nature, such as raw plant extracts or molds derived from particular cheeses, it was only in 1928, with the random discovery of penicillin by Sir. Alexander Fleming, that we entered the antibiotic era, with a sharp drop in mortality from infectious diseases which was, until then, very high (think how many deaths in the past were caused by pneumonia and tuberculosis).

However, studies have made it clear over time that there is no “all-rounder” antibiotic, that is, one that can neutralize all infectious agents: each type of antibiotic has its own precise spectrum of action and is able to fight only a certain type of microbe; for this reason, in the presence of an infection, it is necessary to try to identify the pathogen responsible on the basis of clinical and laboratory data and choose the most effective antibiotic among those available.

It is important to remember, however, that not all infections need to be treated with antibiotics. For example, viruses are insensitive to antibiotics and it is therefore completely useless to treat colds and flu with them.

On the contrary, the use of an antibiotic for a viral infection could even be harmful; like all drugs, antibiotics can have even serious side effects and can cause allergic reactions in predisposed subjects.

The indiscriminate use of antibiotics has also caused a serious phenomenon, which is assuming alarming dimensions at a global level, that of the so-called “resistance”.

In fact, microorganisms, increasingly in contact with antibiotics, have become capable, thanks to mutation phenomena and selection of resistant strains, to “get used” to many types of antibiotics becoming immune to their presence in the human body.

As a result, the number of antibiotics that can effectively fight a wide range of infections is dangerously decreasing and at the same time the number of resistant microbes is increasing.

Fortunately, doctors and patients are not alone in this war on pathogenic microbes: scientific research and pharmaceutical companies are making considerable efforts to produce new types of antibiotics to replace those that are no longer effective.

It is clear, however, that even if these new antibiotics are used too inappropriately, it will not be long before the microbes develop resistance to them.

That is why it is a good thing that the indication for the use of an antibiotic always starts with the doctor and that this decision responds to real health needs.

One final point: it is by no means true, as many people think, that an antibiotic administered intravenously or intramuscularly is more valid, in terms of effectiveness, than an antibiotic administered by mouth; in fact, to treat an infection it is not so much the route of administration that is important as the ability of the drug to be active against the microbe responsible for the infection itself.

The exception is obviously serious infections that endanger the life of the patient and that require intensive treatment of several antibiotics only intravenously, to be carried out in hospital.

Some antibiotics cannot be sold in pharmacies, but are only available to hospitals. In conclusion, the development of bacterial resistance to antibiotics has meant that the problem, which was initially only a health problem, is also taking on social connotations.

It will be necessary to educate both doctors and patients on the appropriate use of antibiotics to avoid that prodigious “weapons”, made available by scientific progress, become useless as unloaded rifles, leaving us defenseless against the microbes “invaders”.

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