Ladies and gents, I won’t lie to you. I won’t sugar coat it and I won’t beat around the bush. There is a war going on. A war on germs. And, frankly, it isn’t looking too good for team homo sapiens.

As in any conflict, there is escalation, a phenomenon by which the intensity of the conflict increases gradually when both sides step up the gadgets. In real life, this can be seen in drug wars. The police puts up pressure on drug cartels, the criminals start carrying guns. The police starts wearing body armor, the drug lords begin arming their underlings with military grade weapons. And so on and so forth.

This is also highly relevant in the field of medicine. Every single day, around the world, the human body is pitted against bacteria, fungi, viruses and all sorts of nasty little bugs. Usually, our amazing immune system stands the test and we live. However, very often, our defenses are overwhelmed and we get in trouble. That’s when we need to call in the big guns: antibiotics (and other agents like antivirals and antifungals).

Antibiotics. In a nutshell.

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Without going too much into the technical details, antibiotics are (in the traditional definition), agents used to delay bacterial growth or outright kill them. Note that the keyword here is anti-bacterial (more on this later). There are many mechanisms by which antibiotics work: some poke holes in bacteria, others do fancy things like prevent their DNA from replicating and so on and so forth.

The most famous modern antibiotic is probably penicillin, which came about in the early 20th century. Like many antibiotics, it was discovered in molds and other fungi when scientists like Fleming noticed that bacterial colonies would not grow near patches of fungi in the lab. Since then, many other antibiotics have been discovered in nature and we are now even able to modify their structures at the molecular level in order to yield ever more efficient substances. Remember escalation? Well, hold onto your pants.

We tend to think of bacteria as simple little creatures and one of the most basic forms of life. In fact, we don’t think about it at all usually unless we are cleaning our house or have fallen sick. It turns out that bacteria are not that simple. They really are heavy-weight champions of life that have colonized virtually every nook and cranny of the planet; they thrive even in the most hostile of environments like radioactive waste and volcanic hot springs. Most are benign, do not interact with us much or may be even protective (like the bacteria that colonize our gut and skin), but there are those that are less than friendly.

4 billion years old and kicking.

When we escalate antibiotics against these evolutionary marvels, their response is to evolve. Now, evolution and natural selection is the method by which all living organisms deal with challenges; the only thing is that bacteria are surprisingly good at it. In fact, due to rampant use of antibiotics (which almost seemed too good to be true) in the last few decades, a variety of antibiotic-resistant strains of bacteria have evolved and are now running wild in our hospitals and causing havoc.

Having said that, antibiotics are still very important in medicine today and chances are, we have all had to rely upon them at some point in our life (or will in the future). Here are some things that are important to know.

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1. Antibiotics are strictly anti-bacterial!

Remember that point earlier in the post? Well, antibiotics like penicillin and amoxicillin are strictly anti-bacterial. This means that they do NOT, and I repeat, do NOT work against viral and fungal infections. As such, taking antibiotics for the flu, the cold or any other form of viral infection is about as useful as trying to desperately drown a fish. You may still feel slightly better after taking the antibiotics, but that is most likely attributable to the placebo effect.

Furthermore, antibiotics are not benign either. It’s not like you can pop them like sugar-coated vitamins for health benefits. In fact, like any strong drug, many antibiotics have side-effects that can range from slightly unpleasant to hell-on-Earth. For example, as previously mentioned, our guts are colonized by a whole ecosystem of benign bacteria. Some strains are even beneficial in that they can break down certain foods for us, synthesize various vitamins and even fight off invasion by the bad bacteria. In general, antibiotics tend not to be that specific in their action; your gut flora can often suffer if you take antibiotics randomly (especially orally). The result is like ridding a village of its native citizens and then be surprised that mean scavengers and marauders have colonized it. Once our gut gets hijacked by the “bad” bacteria, get ready for a terrible evening spent in the bathroom.

What’s more, this wrongful overuse of antibiotics is contributing directly to the development of antibiotic-resistant strains of super bacteria (as if the vanilla variant was not enough). Catching these superbugs (as millions around the world will this year) can turn a simple trip to the emergency room into a life-and-death battle. Together, we can make a difference. Spread the word. And next time you visit the doctor for the flu or cough, do not ask for antibiotics. A sad reality is that some irresponsible doctors may prescribe these to insistent patients simply to get them off their backs.

To sum it up, here is a poster from our buddies at the Center for Disease Control:

From the people who brought you Zombie Safety & Preparation!

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2. Finish that antibiotic therapy!

When you do get down with a bacterial infection and are prescribed with oral antibiotics, be sure to follow the guidelines carefully. Take them as often as it is prescribed and finish the course that the doctor prescribed! Too often, patients will either overdose on the medication or stop the course prematurely once they feel better. There are many reasons why this may not be the best course of action.

First, overdose is fairly self-explanatory: don’t overuse drugs.

Second, stopping the therapy before finishing the course prescribed may not be the best thing to do. A general rule of thumb is that just because you feel better, doesn’t mean you cleared the bug. The feeling of sickness is usually a reaction TO the bacterial infection BY your body. Fever, fatigue, weakness, etc. are all defense mechanisms mounted by our body in an attempt to slow the bugs while our immune system revs up for an ass-kicking. By making us feel terrible, our body is telling us to stay in bed in an effort to conserve energy and avoid spreading the disease to other people. When we start feeling better, it only means that the level of bacteria in our system is low enough that the red alert has been lifted; our immune system is simply mopping up any stragglers.

This, however, does NOT mean that there are no more bacteria in the body. This also doesn’t necessarily mean that the person is no longer contagious (assuming the disease was contagious in the first place). When the bacteria realizes it is losing the battle against your immune system, it decides that it is time to haul ass off of this sinking ship and onto another host if possible. Also, the bacteria that will have survived are most likely those that were slightly resistant to that antibiotic to begin with; you want to be sure to kill it as much as possible before the resistant trait consolidates and spreads.

Having said that, I would like to point out that if you ever experience unusual or severe side-effects to the antibiotic, contact your doctor at once (i.e. don’t blindingly finish that bottle of antibiotics). Use common sense. =)

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3. Dispose of unused drugs

Our last point for today. Once the therapy is over, make sure to properly dispose of any leftover pills at your nearest pharmacy (they usually have containers specifically designed for that). This is also true for any other medication that may be sitting in the medicine cabinet. For obvious ecological reasons, do not dump these medications down the drain or into the toilet bowl. Most medications have expiration dates so it is not a good idea to keep unused prescription drugs; it may, in fact, be dangerous if they fall into the hands of children or pets.

For the same reason, it is strongly discouraged to use the same drugs (like the leftover antibiotics) to treat other family members even if you think they have the exact same symptoms as the disease you experienced. Always seek professional medical help!

In short:

• Drug therapy finished?
• Drug expired?
• Drug has been sitting in your medicine cabinet for so long that the label has become painfully illegible?
• Drug that you don’t remember having in your cabinet?

Drop them off safely at the nearest pharmacy! =D

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