Seven hard facts we all need to swallow about antibiotics

World Health Organisation director-general Margaret Chan at the launch of a new global campaign against antibiotic resistance. Reuters/Pierre Albouy

The global public health crisis of antibiotic resistance is in the spotlight. What’s at stake is the impending loss of antibiotics that threatens modern medicine as we know it.

There has been a dramatic increase in multi-drug-resistant bacteria in the last few years. This is happening in the community, with examples such as gonorrhoea, and in hospitals where some “superbugs” are now either virtually, or completely, untreatable. Currently 700,000 people die each year from resistant infections. That number is set to rise to ten million by 2050 if no action is taken.

Far from being someone else’s problem, the release of a World Health Organisation (WHO) multi-country survey describes public awareness around antibiotic resistance, and highlights common misconceptions that are driving the current crisis. Here are seven of them.

1. Antibiotics won’t cause resistance if I take them correctly


Antibiotic resistance is all about Darwinian natural selection. For thousands of years bacteria have had to protect themselves from chemical substances produced by other bacteria and fungi, designed to kill them. Since 1928, when Alexander Fleming discovered penicillin, we have harnessed these substances as antibiotics.

The bacteria that are able to resist have a survival advantage and will survive an attack by an antibiotic. Some sensitive bacteria can also acquire resistance genes from other bacteria, also rendering them resistant. Whenever we use an antibiotic it kills all the bacteria that do not have a resistance mechanism – that is, those that are sensitive, but leave any that are resistant.

Given the right circumstances, the resistant bacteria will replicate and can either cause infection in the treated person, or colonise the skin and body surfaces. They are then able to be transferred to another person, for example by touch. This is one way in which antibiotic-resistant bacteria are spread, especially in healthcare settings, if healthcare professionals do not practice good hand hygiene.

However well you take an antibiotic, it can still cause resistance.

2. It’s our bodies that become resistant to the antibiotic

Nope, sorry, it’s the bacteria, not our bodies.


3. Antibiotics are the cure for the common cold and flu


Antibiotics are only active against bacteria. The common cold and flu are caused by viruses against which antibiotics have absolutely no effect. And the more antibiotics we use, the more resistant bacteria will be selected out and will increase in number.






4. If I feel better, I can stop my antibiotics





5. I can take leftovers, or some from family or friends





6. Resistance only happens from repeated courses



On top of that, a single course of antibiotics can lead to life-threatening unwanted side effects and potentially catastrophic changes to the normal bacteria that live in our guts. The imbalance can allow dangerous bacteria like Clostridium difficile to predominate and cause severe diarrhoeal illness.

7. It’s the medical professions fault

It is fair to say that the medical profession has failed the general public. We need to do a lot more to educate and raise public awareness around the problem of antibiotic resistance and the appropriate use of antibiotics.

