Prudent use of antibiotics is vital
The ability of antibiotics to cure previously fatal infectious diseases has led to the notion that they are ‘miracle drugs’ with ‘powers’ that widely exceed those which can be attributed to their actual pharmacological properties. In most European countries, antibiotics are the second most widely used of drugs after simple analgesics. Unfortunately, we are now beginning to pay a very high price for this approach to antibiotic use. An excessive, and in many cases, inappropriate use in human and veterinary medicine, and agriculture, has led to a rapid increase in the prevalence of drug-resistant micro-organisms. In fact, many of the older antibiotics have become either ineffective of far less reliable than they used to be. For instance, resistance to penicillin – the former preferred treatment for infections with Staphylococcus aureus – is now commonplace in many countries.
Resistance to antibiotics results from the transfer of genetic resistance traits among bacteria of the same or of different species. In general, the more a specific antibiotic is used, the greater the risk of emergence and spread of resistance against it, thus rendering the drug increasingly useless. To avoid such resistance, new antibiotics with similar, but not identical, chemical properties were developed which remained effective until resistance emerged and spread to these new drugs, too.
The most severe consequence is the emergence of new bacterial strains that are resistant to several antibiotics at the same time. Infections caused by such multi-drug resistant pathogens present a special challenge, resulting in increased clinical complications and the risk of serious disease that previously could have been treated successfully, longer hospital stays and significantly higher costs to society. The worst scenario which, unfortunately, is not an unlikely one, is that dangerous pathogens will eventually acquire resistance to all previously effective antibiotics, thereby giving rise to uncontrolled epidemics of bacterial diseases that can no longer be treated.
It is inevitable that new drugs need to be developed to ensure access to effective treatments against aggressive bacterial infections. Likewise, it is inevitable that these new drugs in particular, but also the old ones, should be used more restrictively and only on sound medical grounds.
Moreover, many antibiotics are stable chemical compounds that are not broken down in the body, but remain active long after being excreted. At present, antibiotics make a considerable contribution to the growing problem of active medical substances circulating in the environment.