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Health Matters: Antibiotic Resistance And What You Can Do About It

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The introduction of antibiotics in the late 1930s decreased U.S. infection deaths by 73 percent in the first 15 years. Antibiotics have enabled complicated surgery, chemotherapy for cancer, care for premature babies, organ transplants and more. As a result, many claim that antibiotics are the most important medical advance of the 20th century.

What's troubling about antibiotics is that scientists are discovering fewer antibiotics than ever, and those we have are losing their effect. Bacteria and other microorganisms, which cause infections and disease, use several ways to impede antibiotic action and thus become "resistant" to the antibiotic. They can change themselves by mutating their own DNA, share DNA between different bacteria, change their structure to be less porous for antibiotics to be absorbed, create proteins which inactivate the antibiotic itself, among other ways to evade the action of antibiotic to kill a microorganism.

In fact, the time between when a new antibiotic is introduced and when resistance starts to be noticed among bacteria has fallen from 10 years to just 1. These developments have given rise to the "super bugs." These bacteria can be resistant to nearly every antibiotic developed to kill them.

There are about 15 known super bugs. They go by unusual names, like C. Diff., CRE and MRSA. These super bugs show resistance to the types of antibiotics that would normally kill them and return the infected person to health. When untreated, bacterial infections can cause serious prolonged illness and even death. If we continue on our current path, it is predicted that deaths attributable to antibiotic resistance will surpass those caused by cancer by 2050. The cost of treating a patient with an antibiotic-resistant infection is an estimated $20,000 to $30,000 more expensive than normal treatment, and hospital stays for those with antibiotic-resistant infections are an extra six days long.

This is scary, but we can fight back. The most effective way to fight back is to work together. Medical and pharmaceutical researchers are working to discover and develop new antibiotics. The Infectious Disease Society has launched a campaign to develop 10 new antibiotics by the year 2020. They have discovered eight so far, and seven have been FDA-approved. This effort was initially supported by the Obama administration and so far has been continued with monetary support from Congress. The plan is called the National Action Plan for Combatting Antibiotic Resistant Bacteria and was initiated in 2015.

Local doctors are working to fight antibiotic resistance too. While many of the most common infections are caused by bacteria, and can be helped with an antibiotic, others are viral. And antibiotics do not work on viruses. They don't cure the infection, prevent the spread of the illness, or make you feel any better. Taking an antibiotic for a virus may provide exposure that bacteria can use to develop resistance. Local doctors are working to prescribe antibiotics only for bacterial infections.

In this arena of complex science, the average person might think that there's not much she can do. In this case, there is. In fact, individuals' participation might be the most powerful in reversing this dangerous trend.

The first and easiest thing you can do to is to get vaccinated. You might think at first that getting vaccinated for a viral disease, like the flu, for instance, shouldn't have any effect on antibiotics. But it does. Those who get the viral flu often get bacterial infections like strep or staph as complications, each of which require an antibiotic. With each prescription we save, we decrease the likelihood that resistance will develop. So every person who doesn't get the flu is a win in the fight against antibiotic resistance.

The second thing to do is to practice good hygiene. Wash your hands frequently, cover your coughs and sneezes. If we all followed these rules, we would decrease the instance of both viral and bacterial infections and greatly reduce the demand for antibiotics.

Educate yourself about which infections are related to bacteria and which to viruses. The CDC's Viruses or Bacteria Fact Sheet, available online, is a great resource for this information. Work with your doctor to ensure that you are prescribed an antibiotic only if you are reasonably sure the infection is bacterial. If you do have an illness that requires a prescription, take it exactly as prescribed.

While the widespread adoption of these actions alone would make a tremendous difference, there is more for those who are interested in making a greater impact. You can learn the effects of antibiotics in agriculture and make wise purchasing decisions. You can use social media and the CDC's antibiotic resistance social content to educate others. Finally, you can also visit here to review current legislation and support politicians who take this issue seriously.

Together — the researchers, the doctors and associate providers, and patients — can ensure that our antibiotics remain effective and restore us to good health for many, many years to come.

Dr. Marie George is the medical director for Infectious Disease at Southwestern Vermont Medical Center. Her practice is within the SVMC Multispecialty Practice. "Health Matters" is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care. For more columns like this one, visit svhealthcare.org/wellnessconnection.





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Protecting Children and Others During a Measles Outbreak

Dr. Marie George

Once a common childhood disease, measles was almost an expected part of growing up. But it wasn't without consequence. Worldwide, up to 2.6 million people died annually from measles every year up until a vaccine was introduced in 1963.

In recent years, some parents have refused to vaccinate their children based on misinformation about side effects of the vaccine.  As a result, the number of unvaccinated children, teens and adults in our communities is on the rise. While those making the choice to not vaccinate believe they're making this decision solely on behalf of themselves or their children, they're actually impacting the health of others. Sometimes with deadly consequences.

How is it spread? Who is at risk?

The measles virus is highly contagious and spreads easily. Spread by close personal contact, coughing, or sneezing, the virus can remain active in the air or on a surface for up to two hours after it has been transmitted.

That means that any unvaccinated individual — including infants and those with compromised immune systems — can get sick when entering a space where an infected person was even hours before. Infected individuals can then go on to spread the illness days before they show any signs of the disease.

How to protect those at risk

Measles vaccines are by far the best possible protection you can give your child. Two doses are 97 percent effective and the potential side effects are rare and not nearly as scary as suggested by a lot of popular media. If they appear at all, side effects are usually a sore arm, a rash, or maybe a slight fever. Claims that the vaccine causes autism have been undeniably proven to be false.

As for when to get your child vaccinated, the American Academy of Pediatrics, the Centers for Disease Control and Prevention and the American Academy of Family Physicians all recommend children receive the measles vaccine at age 12 to 15 months and again at 4 to 6 years old. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

How about adults?

Because the risk of death from measles is higher for adults than it is for children, teens and adults who have not been vaccinated should take steps to protect themselves. "The vaccine can be provided in two doses within 28 days of each other. This is particularly important for those planning travel overseas or to areas in the United States where outbreaks are occurring.

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