Antibiotic resistance: what to know and what to do about it

Among the great advances in modern medicine, antibiotics have been one of the biggest success stories. Numerous illnesses that would have been deadly hundreds of years ago have been rendered manageable with these treatments.

But today we’re facing a new challenge, one in which many types of infections are resistant to the effects of even our strongest antibiotics. The Centers for Disease Control and Prevention (CDC) has noted that we live in a “post-antibiotic era,” meaning that some infections are resistant to existing antibiotics.

A September 2024 study published in The Lancet cautions that antibiotic-resistant infections could result in more than 39 million deaths by 2050. It’s the first analysis of the global health effects of antimicrobial resistance (AMR)—when germs like viruses and bacteria become resistant to the drugs that treat them.

Researchers examined trends from 1990 to 2021 and found that more than one million people around the world died from a drug-resistant infection each year between 1990 and 2021. One notable shift is that deaths among children younger than 5 fell by 50 percent due largely to vaccinations and other infection prevention measures.

But while deaths among kids declined, deaths among people ages 70 and older surged by more than 80 percent. The researchers pointed out this is tied to the aging population (the number of people ages 65 and older is going to increase dramatically over the next few decades). The fact that the immune system tends to weaken with age and older people are more vulnerable to infection and other diseases like cancer and diabetes, also plays a role in this worrisome trend.

Why are germs becoming drug-resistant?

Antibiotic medicines are less effective than they have been in the past due to a combination of factors, including:

• Antibiotics are over-prescribed. This means they may be given to people who do not need them and will not benefit from taking them. Antibiotics only treat confirmed bacterial infections. Specific antibiotics target specific types of bacteria. So, it’s important to take the “right” antibiotic, at the “right” dosage, for the “right” length of time. But remember, antibiotics will not help manage any infection that is not caused by bacteria, such as a viral infection like a cold, the flu, or COVID.
• Antibiotics are overused in healthy food-producing animals.
• Patients may not complete their full antibiotic prescriptions. People with bacterial infections usually start feeling better quickly after starting an antibiotic. They may think they can stop taking it. But stopping early just gives bacteria a chance to come back stronger and with the ability to evade existing drugs or our available defenses. In some cases, people may take someone else’s prescription, or may save leftover antibiotics and take them again the next time they get sick without getting a new prescription.

All of these practices have serious consequences. They give bacteria the opportunity to adapt and mutate—so the drugs we have to destroy them are no longer effective.

What can we do about antibiotic resistance?

The best approach is to avoid getting sick in the first place. Practice good hygiene, wash your hands well and often with soap or use alcohol-based hand sanitizer, get all vaccinations recommended by your healthcare provider (HCP), and avoid contact with others when you or they are sick. When you prepare meals, don’t forget to keep your work area clean, keep raw meats away from other food, and cook meat all the way through.

In the meantime, follow these guidelines for smart antibiotic use:

Use antibiotics only when necessary. Many conditions—such as ear, upper respiratory, and throat infections—will resolve on their own without an antibiotic since they’re caused by viruses rather than bacteria. In these cases, the only thing you’re getting with an antibiotic prescription is an increased risk of side effects and a chance of contributing to resistance. Remember, all antibiotics come with certain risks.

Take the full course of an antibiotic. That means taking every pill as prescribed by your HCP, even if you start to feel better before taking your last dose. If you are getting stomach irritation or other side effects, along the way, talk with your HCP before stopping the antibiotic.

Never take an antibiotic that has not been prescribed precisely for your current condition. You might feel tempted to use up a half-empty bottle in your medicine cabinet from a previous prescription, but remember that different antibiotics have different uses, and taking one for a throat infection when you have a leg infection is unlikely to resolve your condition and is likely to create more issues.

Ways to ease symptoms when antibiotics aren’t the answer

If you’re suffering from a range of symptoms, including a runny nose, cough, low-grade fever, sore throat and other flu-like symptoms, you may have a virus. If so, antibiotics won’t help, but there are some things you can do to ease your discomfort, including:

• Rest as needed
• Stay hydrated, drink plenty of fluids
• Gargle with saltwater for temporary relief of a sore throat
• Use a cool mist vaporizer or humidifier to reduce congestion

When you’re sick, speak to your HCP about your symptoms and the best course of treatment. Depending on your situation, you may be advised to try standard over-the-counter therapies, such as:

• Acetaminophen or ibuprofen for pain and fever
• Pseudoephedrine, loratadine, nasal saline sprays or lavage, oxymetazoline, or phenylephrine for nasal congestion
• Dextromethorphan (cough suppressant) or guaifenesin (expectorant) for cold and flu symptoms

Unless you have a high fever, significant pain in any one area, difficulty breathing with productive cough, or other significant discomfort, many of these common symptoms will improve with these non-prescription treatments.

The CDC, researchers, and HCPs everywhere are taking steps to help reduce the spread of antibiotic resistance. The UN General Assembly will also convene in New York to discuss antimicrobial resistance for the second time in September 2024 and plans to reduce related deaths by 10 percent by 2030. The UN notes that drug-resistant infections “know no borders.” It takes everyone’s help and cooperation to address this global health threat.