The good news about antibiotics is that they have caused a revolution in modern medicine over the past century. The long night of human beings' subjugation to tiny microscopic organisms has broken finally. Where earaches, earaches, toothaches, broken bones and minor scratches could once carry the same serious risks to chances of survivability as could heart attacks, strokes, gunshot wounds and car accidents, with the world-changing health care technology of antibiotic medication we don't need to be under the constant threat of infections and the pain, death and disfigurement microbial infections can cause.
But there is unfortunately still a bit of bad news. Because antibiotics have led this revolution in health care they now seem to be such an automatic part of any treatment regimen that they are often over used - even in cases where they have no therapeutic benefit. The current challenge now that we all rely on the miraculous boon that these medicines have been to health care, has become to use them judiciously, only as cautious physicians would recommend, and of course only when they will actually help. If we don't practice this restraint, we risk increasing more frequent incidents of antibiotic-resistant bacterial strains that could one day reverse the great forward strides that medicine has taken to ensure our freedom from the many horrors of microbial disease.
HISTORY OF ANTIBIOTIC MEDICINE
Crude forms of antibiotic treatments have been used for thousands of years, taken initially from such sources as frog droppings and sulfur. Some early scientists like Louis Pasteur had by the beginning of the twentieth century postulated the link between microbes and disease, knowing then that the key to treating many illnesses would be eventually finding a mechanism to treat them medicinally and not just by preventing infection by pasteurization.
The true power of the antibiotic weapon was harnessed when that mechanism and an antimicrobial substance was discovered. British scientist Alexander Fleming in 1928 discovered nearly by accident that a waste product of mold had a powerful bacteria-killing property. He named the mold that fell into his bacteria culture Penicillium Notatum (or penicillin). He gave a juice made with the mold to infected mice, which were able to overcome their illnesses with few side effects (in other words, no healthy cells seemed to be harmed, and harming microbes without harming the body's cells had been the main problem in many precursory treatments of infections just like it is today in the fight against cancer cells that we can kill but not much faster than anything kills human tissue).
USE OF ANTIBIOTICS IN MODERN MEDICINE
Fleming's breakthrough was incredible, but the real change to medical practice came when it translated into a form useful to doctors a few decades later. In 1941 English scientists Howard Florey and Ernst Chain were able to use a form of penicillin that was successful in fighting bacterial infections in humans. By 1945, penicillin was widely used, hailed as a new wonder drug. Penicillin in particular operates through blocking the formation of the bacterium's cell wall, killing the organism. The drug is still used successfully in the treatment of many bacterial diseases, including strep throat, syphilis and pneumonia. Fleming, Florey, and Chain shared the 1945 Nobel Prize for medicine for their work on penicillin. Other antibiotic drugs including synthetic and more powerful varieties have been developed over the years that vary in their strength and their mechanism, but they have all built uon the initial watershed discovery.
THE THREAT OF RESISTANT MICROBIAL STRAINS
Unfortunately, though we are certainly much better off than we were a century ago due to the work of Fleming and others, the threat that microbial infections present to human health isn't over yet. When the first few medicines were introduced they were astoundingly potent to the infections they treated, wiping out syphilis, post-surgical strep and all manner of bugs in their path. But as infections are increasingly treated chemically, (occasionally with indivisual organisms surviving), and when these reproduce themselves, increasingly they display resistance to infection. Weaker antibiotics like penicillin are increasingly ineffective in treating the diseases they once did. There are now incidents of drug resistant conditions like tuberculosis and meningitis because of this development, which if they spread can renew the terrible public health conditions of the past.
JUDICIOUS ANTIBIOTIC USE
After several decades of this heavy antibiotics use, many of the first drugs on the market have become less effective. This is because rarely does a course of medication kill all of the specimens of the bacteria population that cause the infection. Often the survivors reproduce leading to increasingly drug-resistant strains of disease that antibiotics not be used unless absolutely necessary. Conditions that are viral (like the cold or the flu) or that are otherwise unrelated to bacterial infections should not be treated with antibiotics, and sadly a commonly quoted statistic is that about one in five of the antibiotics prescriptions that are written are for viral conditions like the flu or colds.
This often happens because many patients expect to receive SOMETHING from their physician, and particularly anxious parents with sick children don't like to feel like there is a potential treatment that they should refuse. They often feel that they should be given antibiotics even 'just in case.' But rather than bow to emotions and risk a potentially essential strategy of keeping the planet healthy, there are several principles of antibiotics use that physicians and patients should try always to adhere to.
1. When possible, the weakest possible antibiotic should be used to treat bacterial infections, leaving the powerful ones as a last resort to treat the kinds of dangerous infections that are becoming increasingly difficult to manage.
2. Viral conditions should never be treated with antibiotics, even prophylactic courses, until it becomes evident that there is a serious secondary bacterial infection.
3. As much as patients and doctors hate to hear this, for the sake of global human health it is often best to let more minor bacterial infections take their course, leaving medicinal treatments available for the ones that become serious or life threatening.
4. Physicians' offices and public health centers should heavily rely on strategies to reduce patient demand for ineffectual medications, such as posters and pamphlets educating their patients on the difference between infection types. When possible diagnostic technology should be improved so that ear infections, throat cultures, and other sources of infections are quickly and efficiently labeled so there is no uncertainty and hesitancy on the part of either physician or patient to hold off on antibiotics.
CONCLUSION
The harnessing of antimicrobial medications have revolutionized health care, removing from many minor conditions the continual source of risk and danger. No longer are minor injuries and illnesses routinely life threatening, nor minor surgeries unsurvivable. But in the face of these gains, it is important that we be cautious in the use of this new and important resource to preserve its life-preserving capabilities for ourselves and future generations. We should try hard to implement reasonable and judicious use of these powerful and valuable medicines so that we able to harness the power that they give us over our lives and health.