Throughout human history, bacteria have been a leading cause of disease and death. The 20th century marked a turning point in the struggle against bacterial diseases, with improvements in water sanitation, implementation of vaccine programs and the discovery of antibiotics. In 2010, pharmacists filled more than 211 million prescriptions for antibiotics in the United States, according to the health care analytics company SDI. Appropriate use of antibiotics saves individual lives and helps protect the population from bacterial diseases.
Immune System Allies
Your body possesses several defenses against bacterial diseases. Your skin serves as a formidable physical barrier. Your mouth, nose, airways and stomach provide a second line of defense, with site-specific mechanisms to prevent bacterial invasion. When your surface defenses fail, your immune system enters the battle, seeking out and destroying bacteria. Although your immune system is highly adept at bacterial killing, germs possess numerous mechanisms to escape or overcome your immune defenses. Until the advent of antibiotics in the mid-20th century, bacterial infections that overwhelmed the innate human defenses commonly led to death.
Antibiotics are powerful immune system allies. These chemicals disrupt the structure or function of bacteria, leading to direct killing or interruption of replication. Thus, antibiotics reduce the number of bacteria in the battle, which allows your immune system to regain the upper hand.
Reduced Mortality
Deaths due to infectious diseases dropped dramatically during the 20th century in the United States and other developed countries, attributable in part to the introduction of antibiotics. Dr. Gregory Armstrong of the Centers for Disease Control and Prevention reported in a January 1999 article published in the "Journal of the American Medical Association" that the death rate from infectious diseases among Americans plummeted more than thirteenfold from 1900 to 1996. Dramatic reductions in death rates from tuberculosis, pneumonia and syphilis corresponded chronologically to the increasing use of antibiotics to treat these bacterial diseases.
Breaking the Chain of Infection
Bacterial diseases spread by what health care professionals call the chain of infection. Briefly, bacteria must have a place to actively multiply — a reservoir — and a way to invade another person. People with bacterial diseases are reservoirs of infection within their community. When a person afflicted with a bacterial disease takes an antibiotic, the chain of infection is broken because he is no longer a reservoir for the disease-causing bacteria. Therefore, antibiotics help control bacterial diseases in both individuals and communities.
A Slippery Slope
Antibiotics have revolutionized the medical treatment of bacterial diseases. Widespread use of antibiotics, however, has led to an increasing level of antibiotic resistance among common disease-causing bacteria. When bacteria develop resistance to an antibiotic, they are no longer susceptible to killing by that agent. Thus, the pervasive use of antibiotics has led us to a slippery slope.
Health care providers and patients share responsibility for stemming the tide of antibiotic resistance and preserving the medical advantage afforded by these drugs. Health care providers are responsible for prescribing antibiotics only when the likelihood of benefit is clear. This means that antibiotics are generally not needed for ailments usually caused by viruses, such as sore throats, earaches and chest colds. As a health care consumer, you can help limit antibiotic resistance by taking all of the medicine when your doctor prescribes an antibiotic. Stopping an antibiotic prematurely may promote the development of antibiotic resistance among residual disease-causing bacteria in your body.
References
- Centers for Disease Control and Prevention; "MMWR"; Achievements in Public Health, 1900-1999: Control of Infectious Diseases; July 1999
- Drug Topics: 2010 Top 200 Generic Drugs by Total Prescriptions
- "Principles and Practice of Infectious Diseases, Sixth Edition"; Gerald L. Mandell, M.D. et al, editors; 2004
- "Journal of the American Medical Association"; Trends in Infectious Disease Mortality in the United States During the 20th Century; Gregory L. Armstrong, M.D. et al; January 1999
- Wisc-Online; Chain of Infection; Diane Cozzi, F.N.P.; 2004
- "Todar's Online Textbook of Bacteriology"; Bacterial Resistance to Antibiotics; Kenneth Todar, Ph.D.; 2011
