The role of drug resistance

Drug resistance is a term you have likely heard. It may make you think of bacterial infections that no longer respond to antibiotics. You would be correct; however, many other microbes, such as viruses, mycobacteria and parasites can also become resistant to the specific medications we have developed to combat infections.

Depending on the severity and type of infection, drug resistance can be fatal.

Developing drug resistance is a survival mechanism for microbes, and there are different ways it can happen. A microbe may develop a mutation that allows it to survive exposure to a drug, or it may pick up a gene that conveys resistance from some other microbe. Indiscriminate use of antimicrobial medications contributes to drug resistance. This includes not taking all of the medication prescribed, using antibiotics (meant only for killing or suppressing bacteria) for a viral infection, using a broad-spectrum antibiotic when a more specific antibiotic is more effective, as well as excessive use in hospitalized patients and overuse in agricultural settings.

Outbreaks of drug resistant infections (such as the one at the National Institutes of Health Clinical Center in 2011 that took six lives) are scary, but there are steps you can take to protect yourself and your family. Practice good hygiene like hand washing and do not share glasses and eating utensils with people outside of your family or with a family member you suspect is ill. Treat all open wounds carefully with antibiotic ointment and adhesive bandages. Get your annual flu shot to boost your immunity. Avoid people who are coughing or otherwise ill when possible.

If you get sick, do not take leftover medication (antibiotics, antivirals, antifungals, etc.) prescribed for someone else or for a sickness you had previously. These medications may not be appropriate for your current symptoms.

When you have an infection of any kind (bacterial or otherwise) and it requires a prescription from your health care provider, use the medication exactly as prescribed. Do not discontinue treatment when you start to feel better or when symptoms start to disappear.

Sometimes a lot of patience is required to fully get rid of an infection. I have a friend who had athlete’s foot that returned every winter for years (when she had to abandon her flip-flops and go back to socks and shoes). She was only able to get it to truly go away by continuing treatment for several months after her symptoms had disappeared.

If your health care provider tells you that you have a viral infection and no amount of antibiotics is going to shorten your suffering, believe it and do not pressure him or her for a prescription.

While you are doing your part to discourage drug resistance, researchers are working diligently on the problem too. Hopefully the agricultural industry will soon limit the use of broad-spectrum antibiotics that appears to be contributing to the problem. Meanwhile, the usual recommendations for avoiding illness, especially during flu season, are the best things we can do to stay infection free.

Dr. Alisa Hideg is a physician at Group Health’s Riverfront Medical Center in Spokane. Reach her at drhideg@ghc.org.

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