Happy Antibiotic Awareness Week 2020!!
What you say, you don’t know what Antibiotic Awareness Week is? Oh my goodness – we must correct that immediately.
Sarcasm aside. We are in the middle of Antibiotic Awareness Week 2020. This is a week to consider how to safely use antibiotics. The Center for Disease Control (CDC) sponsors the U.S. Antibiotic Awareness Week, while the World Health Organization (WHO) promotes the World Antimicrobial Awareness Week.
From just that previous statement, you may be asking, “What is the difference between an antibiotic and an antimicrobial?” Antibiotic is a term directed towards medications that can be used to treat bacterial infections. Antimicrobial is a broader term that actually includes any of the medications (or compounds) used to fight against infection-causing agents, which can include antibiotics (more precisely called antibacterial agents) used to fight bacterial infections, antivirals which treat viral infections, antifungals used against infections caused by the eukaryotic fungi, and antiparasitics including antihelminthic drugs used against parasitic worms like roundworm or tapeworm. All of these compound categories are important for maintaining human health.
SO WHY ANTIMICROBIAL AWARENESS WEEK?
It is a time for those working with antimicrobials to reflect about how we can help the public understand how to use antimicrobials properly. It is also there to remind health professionals about when a patient might need an antimicrobial and it is not when a patient wants one. I know that might sound harsh, but the issue is that we, as a society, have been abusing antimicrobials since they have widely available. In this year of a pandemic caused by a virus, it is an important thing to understand that antibiotics do not treat viruses.
Some antimicrobials became so popular that they have lead to significant increases in antimicrobial resistance. Antimicrobial resistance is when an antimicrobial medication or compound no longer is effective against the agent it is designed to treat. As the WHO states, “AMR occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making common infections harder to treat and increasing the risk of disease spread, severe illness and death.” This should make us concerned, but often our answer has been – “I’ll take something else.” The problem is that the “something else” category is getting a little empty. We have been using a number of agents quite regularly and it is leading to unnatural levels of selection pressure for these microbes and they are getting better at fighting our efforts.
Some of you may be old enough to remember “Antibacterial soap or hand gels”. Bath and Body Works had a wonderful line of these nice smelling products. Antibacterial soap was not only in their wheelhouse, but also in dish detergent brands. Hand gels were not like the hand sanitizers so popular now that contain 62%+ of ethanol, for instead these products contained the same active ingredient that the antibacterial soap did – triclosan. It was very “cool” for young people to have a bac pack of these products at the ready to make their hands smell nice and kill germs too. It was awesome (speaking as a young person of the late 1990s and early 2000s). However, triclosan, a regularly used antimicrobial, started showing antibiotic resistance, as well as some health effects on people. Most companies actually banned its use in the years that followed. For more information, check out this CDC fact sheet on triclosan.
The compound was effective for a number of years, but what effects remain? We are not sure. When the novel coronavirus (SARS-CoV-2) hit earlier this year, disinfectants, alcohols, etc. flew off store shelves and became hard to find. The cost of these products also skyrocketed as demand increased and supplies decreased. In some places, the issue remains, but it is mentioned here because people did not care what compound they found that could “kill” the disease, as long as it did. The problem is how many of these products actually contained antimicrobials that were so strong they did not only kill coronavirus, but a whole slew of other microbes. That might not seem like a problem, but are we actually leading to another wave of antimicrobial resistant organisms because we were scared and just really need some good soap and water and maybe a little ethanol solution to clean up? That is a question for the future, but what is the lesson right now?
Right now, we need to make sure that it is not just a cold or flu or even coronavirus that is making us sick. We do not have treatments for these diseases, so using an antimicrobial against them would be futile. We need to know if we have a bacterial or viral infection before moving towards treatment. In many healthy individuals, the immune system will catch up and fight the infection. There are tests in the pipeline that can help speed up these diagnoses, as we have seen happen with COVID-19. We need to use the right tool for the job, which CDC so rightly portrays in their Antibiotic Smart campaign.
Be Antibiotic Smart! Only use the right medication for the right infection.
Happy Antibiotic Awareness Week! Happy Thanksgiving.
