Assessing Antibiotics

In a recent interview with PBS, Dr. Arjun Srinivasan, a top Center for Disease Control (CDC) official, made an appalling and outright bone-chilling comment about the state of our medical system:

“For a long time, there have been newspaper stories and covers of magazines that talked about ‘The end of antibiotics, question mark,’” Dr Arjun Srinivasan said. “Well, now I would say you can change the title to ‘The end of antibiotics, period.’”

That last quote should really scare anyone right about now.

I hate to say I told you so, but I told you so. I’ll use a personal anecdote to illustrate.

Whenever someone gets sick in my house, regardless of severity, that person immediately goes to the doctor. With every doctor’s visit is a guaranteed prescription of some type of medication, potent or not, to help the treatment process.

Sometimes it’s just a simple prescription of ibuprofen, something most would consider rather benign since it is commonly sold over the counter. Then, every once in a while with a stroke of luck, you could get something special, something more potent, something actually worth going to the doctor’s office for. Every once in a while you get something like amoxicillin. Sure, it’s not the holy grail of antibiotics but at least it’s a step up from Advil and Tylenol right?

In most cases where any one of my family members was prescribed amoxicillin, the situation was rather severe. I once had a throat swollen to the point that I could barely swallow water — that required an amoxicillin prescription from the doctor.

Since it is a broad spectrum antibiotic, there is one specific rule that has to be followed for proper treatment: finish the entire bottle and don’t fall off the drug schedule. My family, though, is quite different. We have a medicine cabinet full of medications never finished, never opened, etc. I’m sure most houses have something like this.

My parents never finish their antibiotics and leave them as soon as they start feeling better. Fast forward in time to the next sickness, my parents take the amoxicillin back out and continue.

What’s the danger? Antibacterial resistance as a result of mutation and tolerance.

Bacteria have the capacity to resist specific stressors because of their unique biology. That is why antibiotics are required to be finished, to ensure that all the harmful bacteria are completely wiped off, leaving no room for the possibility of resistance from a few.

I am one to avoid the doctor’s office; I don’t like doctors. I don’t know enough about their trade to be able to objectively comment about their daily responsibilities, but I know for a fact that I don’t like doctors. However, one can claim this to be a patient problem, mainly the problem that the patient did not comply with the orders that the doctor gave when taking medication. In that sense, yes it is the patient’s fault.

But let us step back for a second. We can blame doctors for a small fraction of the problem that Dr. Srinivasan described because from my experience most doctors are quick to fill out a prescription. Yes, many doctors are more conservative with their prescription pads but the sheer amount of medication being fed to the American public is absolutely appalling and rather grotesque. Some of the blame has to be put on the doctors.

But if we peel back the story even more, we find ourselves at a much different conclusion: the blame is solely on the society itself.

The society that we live in is trigger-happy when it comes to medicating themselves. I used to be like this as well. Back in high school the moment I felt a headache coming on I would pop a Tylenol or an Advil.

It is the way in which our culture views medication and its explicit and implicit uses. We as a nation are too quick to medicate. As a Public Health major, I am always taught to educate, not medicate. There is much gravitas in respect to that phrase. Civilians are too in tune with the idea of finding the miracle cure, the easy way out.

It isn’t just the notion of antibiotic resistance. It’s medication dependence. We find ourselves in an imbalanced situation where we are literally dependent upon medication to simply survive. Within that paradigm, antibiotic resistance is merely an expected result, an anticipated outcome of the grander scheme.

It is high time we realized that medication is NOT the only tool we need to establish the difference between curing and healing. Curing is what is, or really isn’t, happening in modern medicine today. Healing is activating triggers within the body to allow it to heal from sickness on its own because the human body is such a wonderful machine.

I am not here to outright denounce all medication, that isn’t the goal. If it weren’t for modern medicine we wouldn’t be living as long and we wouldn’t have the standard of living that we currently enjoy. There are many fruits to medicine.

What I am arguing is that there needs to be a change in the ideologies and views of medicine. Medicine shouldn’t be the only solution, shouldn’t be the first thing we seek when ill. Medicine should be a last resort, something that we look to when we are in dire need.

The human body has the modalities to heal itself from most of the illnesses that we fall victim to today. Provide the body with what it needs (proper nutrition, sleep, relaxation, etc) and it will pay you back by protecting you from illness. We have already fallen victim to the evaporation of effectiveness of antibiotics against infection. Look towards medicine as a last resort lest we fall victim to a more catastrophic outcome.

 

David Vu is a third-year public health policy. He can be reached at davidnv@uci.edu