Antibiotics – adverse reactions cause 100k+ death

Antibiotics – adverse reactions cause 100k+ death

by Dr. Piyali Mukherjee exclusive for

Lets flashback 2.5 billion years, the precambrinic period of earth, land masses are shifting, the atmosphere is at the formation stage with only traces of oxygen. It is in this era that life first appeared on earth. Tiny creatures consisting of DNA strands enmeshed in a bit of chemical soup, sheathed by a membrane. These tiny creatures were the fore runners of the present day bacteria. In time these microbes differentiated to different forms. The basic rules of ‘survival of the fittest’ applied to these simple life forms. To ensure survival of its kind some of these microorganisms started secreting chemicals to kill other organisms in its immediate vicinity.

Indeed, by the time humans came on earth, bacteria had carved out its own niche, and inhabited almost every corner of the earth. Our early animal ancestors were host to them and even today each of us have billions of commensal bacteria living within us. These commensal bacteria have marked us out as there own territory and help to ensure that their territory; that is our bodies are not invaded by pathogenic bacteria. They form a vital part of our inherit resistance to diseases.

During the early years of civilization the bacteria reigned supreme, a small infected cut or fever could shift our finely tuned immune balance and prove fatal. In the beginning of the last century tuberculosis, pneumonias, meningitis, typhoid, whooping cough were all untreatable fatal diseases. Bacterial diseases like tuberculosis, meningitis, gastroenteritis and diphtheria were amongst the top ten leading causes of death in the United States.

For centuries people have been using natural substances from the living world to combat infection, the early Chinese, Indians and Egyptians all used various natural remedies to treat wounds, but the exact component that brought about the cure was not known. In the latter half of the 19th century scientists stumbled upon those very chemicals that micro- organisms use to combat other organisms in their vicinity.  In 1860’s Louis Pasteur showed that we may be able to fight germs with other microbes. Rudolf Emmerich and Oscar Low conducted their experiments in the 1890’s. They proved that the germs that would cause one disease may be the cure for another. In 1928 Alexandra Flemming isolated penicillin, a chemical secreted from common mold, which lyses and destroys bacteria. The “magic bullet” had been discovered. It lived up to its name ‘Anti – biotic’ (against life). The death knell for the bacteria had been sounded.

By the 1940’s and 1950’s  commercial viable options for large scale manufacturing of penicillin were in place, It coincided with the second world war, thousands of injured soldiers from the battle field fueled the demand for more and better antibiotics. Money and time were pumped into research and soon a crop of new and more potent antibiotics flooded the market. Streptomycin, terramycin, tetracycline, chloramphenicol, aminoglycosides, cephalosporins, erythromycins and many more. Originally an antibiotic was a substance derived from one living organism which inhibited the growth of another living organism.  However soon semi-synthetic derivatives of natural antibiotics and even totally synthetically derived antibiotics came into the market; often they proved to be more powerful than the original natural molecule. Today some 150 different varieties of antibiotics are available.

Since then people both doctors and patients alike have come to regard antibiotics as a cure all for every thing from a bout of sniffles to more serious ailments like tuberculosis and meningitis. Data shows that 235 million doses of antibiotics were consumed in the year 2000.   Humans were not the only ones to benefit from the antibiotic magic. Antibiotics are routinely mixed in the feed of healthy farm animals to ensure that they grow faster and remain disease free. A survey conducted in 1996 showed that in that year alone 37,058 kilograms of streptomycin were used for animals compared to 5,409 kilos by humans. These figures clearly demonstrate the rampant   usage of antibiotics in animal husbandry. Even in agriculture antibiotics are regularly used to prevent bacterial plant infection.

Antibiotics act in different ways; some of them break up the cell wall leading to cell lysis. Some antibiotics interfere with the synthesis of protein in the bacteria and still others damage the bacterial DNA. However, bacteria are one of the most versatile creatures alive; they soon devised ways to overcome the antibiotic assault. In 1943 just four years after the onset of mass production of antibiotics, bacteria resistant to antibiotics made an appearance. The first bacteria to demonstrate this property was Staphylococcus aureus resistant to penicillin.  In a bid to overcome resistant bacteria, newer antibiotics were used. As soon as resistant strains developed a new molecule would be discovered to tame them.

How do resistant bacteria develop? When an antibiotics is used on bacteria almost all of them succumb to the antibiotic assault. Only a few bacteria resistant to that antibiotic survive. These resistant bacteria then proliferate rapidly passing on their resistant genes to a whole new genre of bacteria. In takes only about twenty short minutes for a bacterium to reproduce. So in no time, new colonies of bacteria are formed, all of who are resistant to the antibiotic.  A person infected with this new strain of bacteria will no longer respond to that antibiotic therapy. A different antibiotic is then used to control the infection. The same process can reoccur with this new antibiotic to give rise to multi drug resistant bacteria (MDR Bacteria).

MDR bacteria are especially found in hospitals and nursing homes. These places are inhabited by sick and old people, with low resistance who have already been treated with multiple antibiotics and are particularly vulnerable. These germs are apparently innocuous in healthy humans, who are the carriers, but once transmitted to a patient with a low immunity it results in flagrant infection which can not be controlled by most antibiotics. Vancomycin was one of the few effective antimicrobial drugs available but in recent years a spate of Vancomycin resistant infection has swept across hospitals around the world making it the second leading cause of nosocomial infections.

The list of dangerously virulent drug-resistant microbes is growing all the time. There has been a resurgence of disease like tuberculosis, pneumonia, and meningitis. Bacteria which once had been successfully vanquished from the developed world were back. This time around the micro-organisms are smarter and can resistant the antibiotic cocktails used to suppress them earlier.

The indiscriminate use of antibiotics accelerates the process of bacterial resistance. It is very common for a patient to visit a doctor and insist on an antibiotic prescription for minor ailments of unknown etiology. Many a doctor gives in to the pressure and prescribes. In the United States alone each year more than 160 million prescriptions are written for antibiotics, of which an estimated 20% -50% of that use is unnecessary.

The antibiotics once ingested by humans or animals are only partially digested and absorbed. A good portion of the antibiotics are passed out unchanged into the sanitary system, where it pollutes the soil and water. Antibiotics, amongst other drugs have been measured in surface water, ground water and drinking water. Because of the drug residues that contaminate our food and water supply, most of us ingest trace amounts of antibiotics and other prescription drugs on a daily basis. These quantities are small, but this constant exposure is responsible for the increasing menace of drug resistance.

Antibiotic usage is associated with the risk of side effects, ranging from the minor to serious life threatening ones. The most common side-effect of antibiotic use is diarrhea. When an antibiotic is taken for a bacterial infection not only does it kill the disease causing bacteria but even the friendly bacteria present in the body are killed. This disturbance in the intestinal flora is the cause of antibiotic induced diarrhea. Once the friendly bacteria are removed from the intestine it becomes susceptible to an attack from Claustridium difficile, a pathogenic bacterium. The toxins produced by this bacterium results in diarrhea and colitis.

Besides diarrhea, use of some antibiotics like Chloramphenicol, can lead to severe blood diseases, use of streptomycin can cause ear and kidney damage, azithromycin use can induce acute interstitial nephritis. Although most cases of antibiotic induced acute interstitial nephritis are benign and self-limited, some patients may be at risk for permanent renal injury. Occasionally some people may be allergic to certain antibiotics, this is specially seen with the penicillin group of antibiotics, it can lead to symptoms like shortness of breath, hives, itching. A full fledged allergic reaction can prove to be fatal.

Antibiotics can also react with other drugs. For example erythromycin is known to cause some abnormalities in cardiac rhythm. However when concurrently prescribed with certain other drugs it can result in ‘Torsades de Pointes’, a potentially life-threatening arrhythmia. Erythromycin is usually metabolized by an enzyme Cytochrome P-450 3A (CYP3A). A recent study of medical records revealed that combining erythromycin with strong inhibitors of the liver enzyme CYP3A increased the risk of sudden death from cardiac causes probably by abnormally raising the blood levels of erythromycin.

Retrospective data show that an alarming increase in the incidence of autism has occurred since the late 1980’s this coincides with the introduction of clavulanate/amoxicillin a commonly used broad spectrum antibiotic, used for respiratory tract infection.

Each year in the United States, more than 160 million prescriptions are written for antibiotics and in much of the world, in the third world countries where pharmaceutical markets are not so well regulated, an antibiotic can be bought over the counter by people in a bid to self medicate, people unarmed with the knowledge of the dangers they are exposing them self to. The most common form of antibiotic misuse is when an antibiotic is taken to treat viral infections like fever and cold.  Another common practice is to take an antibiotic for a few days and discontinuing treatment once symptoms are controlled and the patient feels better. Incomplete antibiotic therapy abets antibiotic resistance.

At times taking an antibiotic can be a life saving proposition. However with the risks involved does every minor attack of fever warrant a course of antibiotic? One accepted medical theory is the “hygiene hypothesis”, which states early childhood exposure to infection helps in building the muscles of the immune system; such children are less prone to allergies and asthma in later life. In spite of the all the evidence and known risks involved blatant antibiotic misuse for minor illness continues. Recent data indicates that 75% of all outpatient prescription for antimicrobial medication has been used for five ailments namely: otitis media, sinusitis, bronchitis, pharyngitis or nonspecific upper respiratory tract infection.

Just as micro-organisms secrete chemical substances to protect themselves human too are equipped with a complex immune system.

A healthy immune system keeps infection at bay. Every time an antibiotic is used it further suppresses the immune system by killing the friendly bacteria in our body that boost our immunity. Using probiotics is one way of combating this effect. Probiotics contain live culture of bacteria that are normally present in our intestine. They help in digestion, produce vitamin K and make our bowel ecology inhospitable to pathogenic micro-organisms. This is a perfect example of harmonious symbiosis.

Breast milk has high immunoglobin content. Studies show that babies who are nursed suffer from fewer infections. Besides this there are several herbs and essential oils that posses immunomodulatory properties and can kill bacteria as well as viruses, to enlist a few

  1. Grapefruit seed extract has demonstrated antimicrobial activities
  2. Green tea has been used for centuries and to increase resistance
  3. Noni also called Indian mulberry is effective against bacterial and viral infections.
  4. The essential oils derived from the Australian Tea Tree extract have clearly demonstrated its antibacterial efficacy. In a clinical trial a topical application of it proved to be as powerful as benzoylperoxide in reducing acne, with fewer reported side effects.
  5. Neem is one of the most powerful blood-purifiers and detoxifiers in Ayurveda.
  6. Garlic, its immune enhancing properties has been documented by research.
  7. Turmeric is a powerful antiseptic used for wound healing.
  8. In recent times Ginseng has gained a reputation of being a stimulant, however in the Far East it has always been used to increase overall immunity.

The history of antibiotics is just half a century old, compared to the billions of years bacteria have survived on earth, overcoming many a challenge. In the early days of antibiotics total annihilation of bacteria seemed feasible, but in recent times the microbes are successfully fighting back. Modern medicine has placed a vital tool in our hands, antibiotics have saved many a life, indeed it has altered our whole our lifestyle. If we are not careful then all too soon we will find ourselves catapulted into the dark ages of the pre-antibiotic era, where uncertainty prevailed. A time when a simple wounds could turn nasty, minor surgical procedures carried the same casualty rates as complicated surgeries of today, a time when mothers had several children to ensure at that at least a few of their offspring survived the obstacle course of life.

The optimal way to equip ourselves against the threat of bacteria is to boost our natural immunity. It is here that alternative therapy offers a treasure trove of time tested natural resources that can enhance your immunity and restore you to health without the added baggage of risks involved.

? By Dr. Piyali Mukherjee 2006.

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