Those little bugs...and what we do about them.
Wow. Time flies. Obviously I've been neglecting my blog for far too long, and I'm hoping to get back into the blog routine now that the majority of "busiest semester of med school" is over and done.
This semester we're taking a class called "Principles of Infectious Disease," which basically amounts to a microbiology class. We're learning about bacteria, viruses, parasites, yeasts, etc etc etc. We go to lab twice a week and do things like swab bacteria onto plates and wait for them to grow. We're studying not only the diseases caused by these little bugs, but also how they grow and replicate, and a bit about how to stop them (though the antibiotics overlaps with our pharmacology class, and its our final unit, so we haven't covered them all thoroughly yet).
The point is, I have a little PSA about antibiotics here.
First, what exactly is an antibiotic and how do they work?
Antibiotics in their most strict form are compounds made by other organisms that interfere in some way with bacterial growth or replication. In the soil, or on our skin, there are multitudes of different organisms that must compete with each other for nutrients. Therefore, if some of the organisms have some gene that allows them to make some protein or molecule that inhibits the growth of some of the other organisms around, they're at an advantage to grow. So antibiotics are very Darwinian in that way: They truly are made to help out with survival of the fittest.
Now what we didn't understand as well when antibiotics were first isolated for therapeutic use as we do now is that bacteria have an incredible ability to do a couple of things:
a) They replicate very, very quickly (on the order of minutes to hours) and
b) They have an large capacity to change genetically.
When you put those two things together, you get a very rapidly evolving, changeable target. This is how "antibiotic resistance" emerges. When antibiotics are used in the wrong situations (the common cold, for example, which is viral, not bacterial, or to simply fight off an infection that an otherwise healthy body will likely clear, abeit not as quickly as the modern American may deem acceptable) resistance can emerge.
How does this happen? First, it is important to keep in mind that our bodies are teeming with bacteria at all times, especially in our gut, where some of them actually perform essential tasks for our health. When we take an antibiotic, ALL kinds of bacteria that contain the target enzyme or molecule begin to die off. This means that more dangerous organisms can now compete more easily for this living space, and these can cause disease. Alternatively, an organism that was not antibiotic resistant can change, or mutate, and become resistant. Now these organisms can grow, and these could potentially cause disease. Some professors even like to refer to antibiotics instead as "resistance selective compounds" to express their hesitance about the broad use of antibiotics.
While there are certainly MANY instances where antibiotics are perfectly appropriate, tempering their use to only those circumstances will increase the longevity of their ability to be used AT ALL in the future. Keep this in mind the next time you have that cold that your doc says "lets wait this out for a few days," or does not want to prescribe antibiotics for an illness. I know as well as anyone that it can be very difficult to find the time (before getting sick or after) to sleep, eat well, take your vitamins, etc etc, but it truly is the best idea for those little bugs that will certainly get us all down at some point this winter. Also, I'm personally filtering out my anti-bacterial soaps in favor of disinfectant such as those that use alcohol, or just plain old soap, which has been used for years with great success.
This semester we're taking a class called "Principles of Infectious Disease," which basically amounts to a microbiology class. We're learning about bacteria, viruses, parasites, yeasts, etc etc etc. We go to lab twice a week and do things like swab bacteria onto plates and wait for them to grow. We're studying not only the diseases caused by these little bugs, but also how they grow and replicate, and a bit about how to stop them (though the antibiotics overlaps with our pharmacology class, and its our final unit, so we haven't covered them all thoroughly yet).
The point is, I have a little PSA about antibiotics here.
First, what exactly is an antibiotic and how do they work?
Antibiotics in their most strict form are compounds made by other organisms that interfere in some way with bacterial growth or replication. In the soil, or on our skin, there are multitudes of different organisms that must compete with each other for nutrients. Therefore, if some of the organisms have some gene that allows them to make some protein or molecule that inhibits the growth of some of the other organisms around, they're at an advantage to grow. So antibiotics are very Darwinian in that way: They truly are made to help out with survival of the fittest.
Now what we didn't understand as well when antibiotics were first isolated for therapeutic use as we do now is that bacteria have an incredible ability to do a couple of things:
a) They replicate very, very quickly (on the order of minutes to hours) and
b) They have an large capacity to change genetically.
When you put those two things together, you get a very rapidly evolving, changeable target. This is how "antibiotic resistance" emerges. When antibiotics are used in the wrong situations (the common cold, for example, which is viral, not bacterial, or to simply fight off an infection that an otherwise healthy body will likely clear, abeit not as quickly as the modern American may deem acceptable) resistance can emerge.
How does this happen? First, it is important to keep in mind that our bodies are teeming with bacteria at all times, especially in our gut, where some of them actually perform essential tasks for our health. When we take an antibiotic, ALL kinds of bacteria that contain the target enzyme or molecule begin to die off. This means that more dangerous organisms can now compete more easily for this living space, and these can cause disease. Alternatively, an organism that was not antibiotic resistant can change, or mutate, and become resistant. Now these organisms can grow, and these could potentially cause disease. Some professors even like to refer to antibiotics instead as "resistance selective compounds" to express their hesitance about the broad use of antibiotics.
While there are certainly MANY instances where antibiotics are perfectly appropriate, tempering their use to only those circumstances will increase the longevity of their ability to be used AT ALL in the future. Keep this in mind the next time you have that cold that your doc says "lets wait this out for a few days," or does not want to prescribe antibiotics for an illness. I know as well as anyone that it can be very difficult to find the time (before getting sick or after) to sleep, eat well, take your vitamins, etc etc, but it truly is the best idea for those little bugs that will certainly get us all down at some point this winter. Also, I'm personally filtering out my anti-bacterial soaps in favor of disinfectant such as those that use alcohol, or just plain old soap, which has been used for years with great success.