Since the early 1940s and the debut
of penicillin into the medical world, society has relied heavily on antibiotics
as a “cure-all” for every type of ailment. Antibiotics greatly altered the
public’s view of medicine and shunted away the shame often associated with
incurable infectious diseases of the time, such as gonorrhea and syphilis. The
culture around infection and the pain associated with it, underwent a massive
change during this period. Specifically, the relationship between the patient
and the physician. The production of penicillin and other strains of
antibiotics that came after caused an influx in patients seeking treatment for
their newly-curable illnesses. The physician was no longer seen as the trained professional
who cured you, but rather, the person who prescribed you medicine that would
cure you. Antibiotics are an incredible advancement in their ability to cure
fatal infections, however, recent years have seen an adverse effect stemming
from their widespread accessibility, namely, antibiotic resistance.
Antibiotics
generally interrupt cell wall or protein synthesis thus rendering bacteria
ineffective. This is all well and good, until natural mutation takes place in
bacterial cells. Natural selection favors bacterial cells with mutated DNA that
protects them from the attacks of antibiotics. With nonresistant chains of bacteria dying
off, more room and resources are available for resistant bacterial strains to
proliferate. An example of such a strain would be MRSA (Methicillin-resistant
Staphylococcus aureus), which underwent a genomic mutation
that allows the protein that antibiotics target in the cell to be regenerated,
and thus impenetrable. MRSA is
incredibly dangerous, with a casualty rate from 30-50%.
The issue
of antibiotic resistance is not one we should take lightly, nor is it an issue
we should dismiss as inevitable. In fact, we are greatly contributing to this
issue, and it circles back to the patient physician-relationship that was so
greatly altered when antibiotics were introduces in the 1940s. Our mindset
around illness changed, and the act of receiving an antibiotic prescription
became therapeutic in itself. In many developing countries, such as Indonesia,
Pakistan, Ghana, and Uzbekistan, 60% of consultations with a physician end in
an injection, often of antibiotics. Similarly, the CDC (Center for Disease Control
and Prevention) estimates that 1 in 3 antibiotic prescriptions
are unnecessary. The question must be asked, what can be done to stunt the multiplication
of resistant strains of bacteria? First, the mindset around antibiotic
resistance must be changed, and physicians should exhaust other forms of treatment
before prescribing antibiotics. To ignore this issue is to allow more people to
be effected by illnesses such as MRSA. We should not shy away from calling
physicians out on the careless nature of their prescribing. This issue
transcends medical convenience and becomes a serious matter of medical ethics.
Tone, A. (2007). Medicating modern America:
prescription drugs in history. New York: New York Univ. Press.
