Superbugs and Kryptonite

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Peds Geek M.D.

Superbugs and Kryptonite

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Although they sound science-fictiony, when we talk about “superbugs,” were not talking about these guys. Superbugs are the slang name given to bacteria that have become resistant to one or more important antibiotics. But like the bugs from Starship Troopers, the invasion of drug-resistant bacteria is a global threat.

The Emergence of Superbugs

How do superbugs develop? Well, when antibiotics are used, they should kill the bacteria they are intended for. But sometimes, a bacterium carries a gene that allows it to resist the antibiotic. And while that bacterium’s neighbors are wiped out, it has the opportunity to multiply, and possibly spread to others. Over time, this can happen to more than one antibiotic, and the resistant bacteria become more common. Thus, a superbug is born.

If we’re going to call them superbugs, then we can think of antibiotics as Kryptonite, a substance that finds a weakness in bacteria and exploits it. There’s no question that antibiotics have saved lives for many decades and changed medicine and health as we know it. But the more we use them, the more we run the risk of cultivating superbugs that aren’t vulnerable to our Kryptonite.

A Post-Antibiotic Era?

It’s abundantly apparent that the increase in antibiotic resistance is more than a minor problem. In fact, in a recent report, the WHO characterized antibiotic resistance as an “accelerating global health security emergency.” In the United States, 2 million infections and 23,000 deaths from antibiotic-resistant bacteria occur annually. And if we can’t take steps to stop it, we may find ourselves living in a “post-antibiotic era,” where our best weapons against infection are useless.

“Bacteria that are resistant to multiple antibiotics are often more aggressive and tend to cause severe infections in children,” said Dr. Amaran Moodley, pediatric infectious disease specialist at Blank Children’s Hospital, “Over time, as MRSA (Methicillin Resistant Staphylococcus Aureus) and other bacteria become increasingly resistant to antibiotics, there may be few or no antibiotics left to treat these bacterial infections.”

Fighting Back

There are steps that need to be taken on a national level (for example, reducing the use of antibiotics in livestock, and developing new antibiotics), but the front line in the war on superbugs consists of doctors and patients. Dr. Moodley works on the physician side of this issue, as he heads the Antimicrobial Stewardship Program at Blank Children’s, developed to optimize appropriate antibiotic use, and reduce unwanted adverse outcomes like side effects and bacterial resistance. I talked with Dr. Moodley about the ways that parents and physicians can help reduce antibiotic overuse, and we agreed the biggest issue when it comes to doctors and patients is understanding when antibiotics are appropriate, and when they are not.

“Sometimes parents are concerned when the recommended treatment for a viral respiratory infection is only fluids, rest and medicines to bring down fever if the child is uncomfortable,” said Dr. Moodley. “I think if parents are made aware that antibiotics are not always needed and that antibiotics do not make viral infections get better any faster, they will feel more comfortable with using these simple but effective measures to treat the symptoms of their child.”

It’s difficult to have a sick child, and your pediatrician realizes that. But viral illnesses are not improved by antibiotics. Not at all. Using an antibiotic in these situations does nothing for the kiddo, but might give them side effects, or set the stage for antibiotic resistance in the future. A surprising number of illnesses are best treated with rest and fluids, and time.

Other “Knowing is Half the Battle” pointers:

  • Practice good hygiene to prevent a possible infection. Likewise, make sure you and your family are up to date on recommended vaccinations. An infection you don’t get is one you don’t have to treat with antibiotics.
  • For washing, stick with regular soap and water. Studies have not shown that antibacterial hand soaps (outside healthcare settings) are better than regular soap, and may contribute to antibiotic resistance.
  • Ear infections caused by bacteria often clear up on their own, and don’t always need antibiotics, according to AAP guidelines. Ask your doctor if waiting a couple of days before treating is an option.
  • Never take antibiotics without a doctor’s prescription.
  • If you are prescribed an antibiotic, follow the prescription and your doctor’s advice. Don’t stop the antibiotics early if your child is feeling better, unless instructed by the doctor. Don’t save antibiotics that aren’t used.

So remember, when your child’s doctor recommends that antibiotics not be given for your child’s illness, he (or she) isn’t under the influence of a powerful rest and fluids industry. He’s doing his part to save the world, and doing your child a favor, too.

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