By: Dr. Tariq Jagnarine
Why responsible antibiotic use matters for the health of Georgian communities
Antibiotics: One of Medicine’s Greatest Discoveries
Antibiotics are medicines designed to kill bacteria or stop them from growing. Since the discovery of penicillin in 1928, antibiotics have transformed medicine and saved millions of lives worldwide (Fleming, 1929). They made it possible to treat diseases that once caused widespread death, including pneumonia, tuberculosis, and serious wound infections.
Modern medicine depends heavily on antibiotics. Many medical procedures, including surgeries, cancer treatment, and organ transplants, rely on antibiotics to prevent infections (World Health Organization, 2023).
However, the effectiveness of antibiotics is now under threat. Around the world, bacteria are becoming resistant to these medicines, meaning the drugs that once cured infections are no longer working (Figure 1).
Figure 1. Cartoon depicting bacteria and viruses fighting against antibiotics.
What Is Antimicrobial Resistance?
Antimicrobial resistance (AMR) occurs when bacteria evolve in ways that allow them to survive exposure to antibiotics. Instead of being killed by the drug, some bacteria adapt and develop mechanisms that protect them from its effects (Davies & Davies, 2010).
This resistance occurs through natural biological processes. When antibiotics are used, they kill the most vulnerable bacteria. However, a small number of bacteria may survive because they possess genetic traits that help them resist the drug. These surviving bacteria multiply and pass their resistance genes to other bacteria (Ventola, 2015).
Over time, the antibiotic becomes less effective because the resistant bacteria dominate.
How Misuse of Antibiotics Drives Resistance
The misuse of antibiotics accelerates this natural process (Figure 2). When antibiotics are used unnecessarily or incorrectly, bacteria are repeatedly exposed to the drugs, increasing the chance that resistant strains will develop.
Common examples of misuse include taking antibiotics for viral infections such as colds or flu, stopping treatment early, using leftover medication, or sharing antibiotics with others. Each of these behaviours increases the likelihood that bacteria will survive and adapt (O’Neill, 2016).
In cases where antibiotics are easily available without a prescription, resistance tends to develop more rapidly.
Figure 1. Infographic from World Health Organization depicting the cycle of antibiotic misuse and resistance.
Evidence of AMR Emerging in Communities
Antimicrobial resistance is not only a hospital problem. It is increasingly seen in community infections worldwide. Research shows that resistant bacteria can spread through everyday contact between people, contaminated food, animals, and the environment (Laxminarayan et al., 2013).
For example, resistant strains of Escherichia coli have been found in community-acquired urinary tract infections in many countries. These infections are becoming harder to treat because the bacteria no longer respond to commonly used antibiotics (Ventola, 2015).
Studies also show that antibiotic use in agriculture and animal production contributes to the spread of resistant bacteria that can affect humans (World Health Organization, 2023).
What Are “Superbugs”?
When bacteria become resistant to several types of antibiotics, they are often called superbugs. These organisms are particularly dangerous because treatment options become limited.
One well-known example is Methicillin-resistant Staphylococcus aureus (MRSA). This bacterium developed resistance to methicillin and several other antibiotics after decades of exposure in hospitals and communities. MRSA infections can cause severe skin infections, pneumonia, and bloodstream infections (Chambers & DeLeo, 2009).
Another example is Carbapenem-resistant Enterobacteriaceae (CRE), which are resistant to some of the strongest antibiotics available. Infections caused by CRE can be extremely difficult to treat and are associated with high mortality rates (CDC, 2019).
A third example is Multidrug-resistant tuberculosis (MDR-TB). This occurs when Mycobacterium tuberculosis becomes resistant to the two most powerful first-line TB drugs. MDR-TB has emerged largely due to incomplete treatment and misuse of antibiotics, making treatment longer, more complex, and more expensive (World Health Organization, 2023).
The Real-World Impact of Superbugs
The consequences of antimicrobial resistance are serious. The World Health Organization estimates that resistant infections already cause hundreds of thousands of deaths globally each year (WHO, 2023).
Without effective antibiotics, routine medical procedures become riskier. Surgeries, chemotherapy, and treatment of premature infants depend on antibiotics to prevent infection.
A global review estimated that antimicrobial resistance could cause up to 10 million deaths annually by 2050 if action is not taken (O’Neill, 2016).
Better Prescribing Practices in Healthcare
Healthcare professionals play a critical role in slowing the spread of resistance through responsible prescribing. Antibiotics should only be prescribed when there is clear evidence of bacterial infection.
Many healthcare systems now use antibiotic stewardship programs, which promote evidence-based prescribing and monitor antibiotic use. These programs help ensure patients receive the right drug, at the right dose, for the correct duration (Dellit et al., 2007).
Such programs have been shown to reduce unnecessary antibiotic use and improve patient outcomes.
Why Public Awareness Matters
Community awareness is equally important. Many people believe antibiotics are necessary whenever they feel sick, but most common illnesses, including colds and flu, are caused by viruses and do not require antibiotics.
Public health campaigns such as World Antimicrobial Awareness Week aim to educate communities about the responsible use of antibiotics and the dangers of resistance (WHO, 2023).
When people understand how antibiotic resistance develops, they are more likely to use medicines responsibly.
What Individuals Can Do
Everyone can contribute to protecting antibiotics. Antibiotics should only be taken when prescribed by a qualified healthcare professional, and the full course of treatment should always be completed.
People should never share antibiotics, use leftover medication, or request antibiotics for viral illnesses.
Good hygiene practices, such as handwashing, safe food preparation, and vaccination, also reduce infections and decrease the need for antibiotics.
Antibiotics are one of the most powerful tools in modern medicine. But their effectiveness is not guaranteed forever.
Misusing antibiotics today allows dangerous superbugs to develop tomorrow.
Using antibiotics responsibly protects not only individual patients but entire communities.
Respect antibiotics today so they can continue saving lives tomorrow.
References
- Fleming A. On the antibacterial action of cultures of Penicillium. Br J Exp Pathol. 1929;10:226-236.
- Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev. 2010;74(3):417-433.
- Ventola CL. The antibiotic resistance crisis. Pharm Ther. 2015;40(4):277-283.
- Laxminarayan R, Duse A, Wattal C, et al. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2013;13(12):1057-1098.
- Chambers HF, DeLeo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol. 2009;7(9):629-641.
- Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States. CDC; 2019.
- Dellit TH, Owens RC, McGowan JE, et al. Infectious Diseases Society of America guidelines for antimicrobial stewardship programs. Clin Infect Dis. 2007;44(2):159-177.
- World Health Organization. Antimicrobial Resistance Global Report and Surveillance. WHO; 2023.
- O’Neill J. Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. Review on Antimicrobial Resistance; 2016.
Dr. Tariq Jagnarine
Dr. Tariq Jagnarine is a Family Medicine physician with clinical interests in Endocrinology and Diabetes. Dr. Jagnarine is also a Public Health Policy Consultant with speciality interests in infectious disease, climate change, and mental health. Dr. Jagnarine is a Masters of Public Health student at Emory University, Rollins School of Public Health.