Have Antibiotics Reached Their Expiration Date?

Antibiotic resistance makes it harder to treat infections—and it’s a growing problem. Here’s what you need to know.

Medically reviewed in November 2021

In many ways, antibiotics have been one of the great success stories of modern medicine. Numerous illnesses that would have led to death hundreds of years ago have been downgraded to a “nuisance” with the use of these treatments.

But today we’re facing a new period—one in which infections are resistant to even our strongest antibiotics. It’s not unusual for me to clock an ER shift and find myself struggling to find an antibiotic that will work for a patient’s infection. At times I have had to order a large combination of antibiotics; the overlap is necessary to try to overcome the bacteria’s resistance.

The Centers for Disease Control and Prevention (CDC) has noted we are already in a “post-antibiotic era,” meaning that some infections are resistant to any existing antibiotics, period. Why is this happening? It’s a combination of factors:

  • Patients are sicker in general and are more likely to develop more infections.
  • Antibiotics are over-prescribed.
  • Antibiotics are overused in food-producing healthy animals.
  • Patients may not complete their full antibiotic prescriptions, may take someone else’s prescription or may save leftover antibiotics and self-start them the next time they get sick.

The consequences are severe. Each year, antibiotic-resistant bacteria cause at least 35,000 deaths and more than 2.8 million illnesses in the United States, according to a 2019 report from the CDC.

I had a patient come into the ER once with a bad leg infection. When it started, she decided to take the leftover antibiotic prescribed for a sinus infection. This not only worsened the leg infection (since the sinus antibiotic wasn’t appropriate for a skin infection), she suffered bad side effects from the unnecessary medication. This was (and is) a well-educated, smart lady who had made a very un-smart decision.

In light of this frightening resistance, what can you do?
Prevention is still number one. Practice good hygiene, get the vaccinations recommended by your healthcare provider (HCP) and avoid contact with others when you are ill. When you prepare meals, don’t forget to keep your work area clean, keep raw meats away from other food and cook meat all the way through.

In the meantime, follow these guidelines for smart antibiotic use:

  • Use antibiotics only when necessary. Many conditions—such as ear, upper respiratory and throat infections—will resolve on their own without an antibiotic since they’re caused by viruses. In these cases, the only thing you’re getting with an antibiotic prescription is an increased risk of side effects and chance of resistance. Remember, all antibiotics come with certain risks. We’re seeing this more and more with findings of increased risk of heart arrhythmias, even with traditional antibiotics.
     
  • Take the full course of an antibiotic. Period. If you are getting stomach irritation or other side effects, talk with your HCP before stopping the antibiotic.
     
  • Never take an antibiotic that has not been prescribed precisely for your current condition. Different antibiotics have different uses, and taking one for a throat infection when you have a leg infection will just set you up for problems.

Protect yourself
When you’re ill, speak to your HCP about your symptoms and the best course of treatment. Depending on your individual situation, you may be advised to try standard over-the-counter therapies for pain and fever (acetaminophen, ibuprofen), nasal congestion (pseudoephedrine, loratadine, nasal saline sprays, oxymetazoline, phenylephrine), cough suppressants (dextromethorphan) or expectorants (guaifenesin) to treat your symptoms. Unless you have a high fever, significant pain in any one area, difficulty breathing with productive cough or other significant discomfort, many of these common symptoms will improve with these non-prescription treatments.

The CDC, researchers and physicians everywhere are taking steps to help reduce the spread of antibiotic resistance, and with smart changes, we can succeed. But we’re going to need your help.

Sources:

Centers for Disease Control and Prevention. “Antibiotic / Antimicrobial Resistance (AR / AMR): Biggest Threats and Data.” October 28, 2020. Accessed December 18, 2020.
Centers for Disease Control and Prevention. “Antibiotic Resistance Threats in the United States 2019.” December 2019. Accessed December 21, 2020.
American Hospital Association. “Are Medicare Patients Getting Sicker?” December 2012. Accessed December 21, 2020.
W Raghupathi & V Raghupathi. “An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach.” International journal of environmental research and public health. March 2015. 15(3), 431.
Centers for Disease Control and Prevention. “CDC: 1 in 3 antibiotic prescriptions unnecessary.” January 1, 2016. Accessed December 21, 2020.
Mayo Clinic. “Antibiotics: Are you misusing them?” February 15, 2020. Accessed December 21, 2020.
Centers for Disease Control and Prevention. “Livestock and Poultry Producers: Protect People and Animals.” June 18, 2020. Accessed December 21, 2020.
Centers for Disease Control and Prevention. “Antibiotic Do’s & Don’ts.” January 31, 2020. Accessed December 21, 2020.
Centers for Disease Control and Prevention. “Antibiotic Resistance Questions and Answers.” January 31, 2020. Accessed December 21, 2020.
World Health Organization. “Antibiotic resistance.” July 31, 2020. Accessed December 21, 2020.
Centers for Disease Control and Prevention. “Antibiotic Prescribing and Use in Doctor’s Offices.” October 30, 2019. Accessed December 21, 2020.
American College of Cardiology. “Common Antibiotics Increase Risk of Cardiac Arrhythmias, Cardiac Death.” November 9, 2015. Accessed December 21, 2020.
G Trifirò, M de Ridder. “Use of azithromycin and risk of ventricular arrhythmia. CMAJ: Canadian Medical Association journal = journal de l'Association medical Canadienne.” April 17, 2018. 189(15), E560–E568.
Centers for Disease Control and Prevention. “Protecting Patients and Stopping Outbreaks.” February 12, 2020. Accessed December 21, 2020.
Centers for Disease Control and Prevention. “Food Safety: Antibiotic Resistance, Food, and Food Animals.” November 2, 2020. Accessed December 21, 2020.

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