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Old January 24th, 2013 (04:45 PM).
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Quote originally posted by Sweets Witch:
the responsibility is going to fall in equal halves upon the drug companies and the common citizens.
This is something which I cannot agree with enough. I feel like people are heavily under-educated in general about not only personal hygiene, but also in the use of drugs, how they work, and why it's so important that they be respected. The main three ways in which people misuse antibiotics which spring to mind for me are:

-the use of antibiotics against non-bacterial diseases.
-the ignorance of the guidelines regarding the use of antibiotics - namely, "complete the prescribed course" or something along those lines.
-the improper disposal of antibiotics.

The first of these should hopefully be obvious; in general, transient diseases are caused by bacteria, viruses or parasites - only one of which is actually harmed by antibiotics and even then, usually only specific antibiotics. I've seen a lot of people come down with things like the flu - caused by the influenza virus - and throw antibiotics at it. For starters, that's a perfectly good waste of antibiotics but that's not the real problem here; the problem is that any harmful bacteria in your body which have not yet got to the stage of causing disease are being unnecessarily exposed to antibiotics. While they could be destroyed by the antibiotic, they're also here given the opportunity to become resistant to that which is being wrongly used. Antibiotics are being subscribed less and less over time because this is what's causing the resistance - bacteria which, through exposure to an antibiotic, become resistant to it. Using an antibiotic when it is neither prescribed nor necessary is simply asking for this problem to be made worse. Antibiotics should be used as sparingly as possible in the sort of situation we're in here.

The second often confuses people a tad. They take the antibiotic, their infection dies off, and they feel fine again. Should the antibiotics be expensive or have unpleasant side-effects, they want to be rid of them so they stop taking them, thinking that their disease has been cured. The problem here is that rarely when you feel better after an infection is the species causing the infection totally removed from your body. The likelihood is that there's simply not enough of a species to be causing symptoms present any more, thus making you feel better. If, at this point, antibiotics are to stop being taken, you're opening up a huge window of opportunity for the bacteria to become resistant to it. The antibiotic will linger at very low concentrations for a long while and, as above, the bacteria will continue to be exposed to it and will potentially take advantage of that. They're then able to become resistant and transmit to other individuals. A real example of this I can think of is the use of antibiotics treating tuberculosis - these medications have some particularly nasty side-effects which really discourage people from taking them after symptoms have cleared up, but the causative species is pretty well-known for being able to develop resistance to the antibiotics used to treat it, become resistant, and come back later as a more dangerous, drug-resistant form of TB. Worse still, since it's such a hard to detect and easy to transmit bacterium, it spreads silently and quickly to others - infecting them too with the drug-resistant TB. By not completing the course, and ensuring as far as is reasonable that bacteria are completely destroyed, people open up this veeeery nasty can of worms. It really needs to be made more clear why people are required to continue treatment, even if they feel better. It's not for only their good.

As for the last one, the proper procedure that I'm aware of for disposal of antibiotics is to bring them back to where they were purchased from and they'll be properly destroyed. However, a lot of people think that their kitchen sink does the job just as well. It doesn't. What it does do, however, is exposes the God-knows-how-many species of infectious bacteria present in sewers to very low antibiotic concentrations. They will absolutely thrive on this in terms of resistance; by exposing them to such low concentrations of antibiotics you're giving them ample opportunity to resist those antibiotics. A seriously dangerous move with potential implications for so many people.

So... yeah. None of these three things are at all down to drug manufacturers and none of these are things which I feel the general population is properly educated on. Indeed, the research is more than there into new forms of antibiotics - at university I'm involved in some of that myself and I know a lot of work is going on in general regarding new types of antibiotic altogether which bacteria are unable to resist. A really popular and interesting one right now is the use of 'phage' therapies - where bacteriophages, harmless viruses which are able to infiltrate bacterial cells, are used to combat bacteria without harming human cells. It's sort of like fighting fire with fire except the fire we're using isn't going to burn anything but the bacteria. It's a really interesting and potentially extremely effective method of treating bacterial infections.

This is definitely a war not lost by a long shot, but we're going to have to change what sorts of antibiotics we're making and we're going to have to educate people properly on their use. Right now things are looking bad for antibiotics as we generally know them, and indeed a "post-antibiotic era" in that sense would be an apt description, but we're not going to lose to bacteria just yet.
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