Over-prescribed antibiotics are becoming less effective as bacteria build resistance. Anti-microbial resistance is a real concern, with predictions it will result in millions of deaths annually. Ever stronger antibiotics can cause debilitating side-effects and subsequent illnesses such as Thrush and Vasculitis.
Most people, when they suffer their first few episodes of cystitis, seek a medical cure in the form of antibiotics. Initially, antibiotics can be very effective, especially if you have never had cystitis before. However, with every additional infection, that particular antibiotic is likely to become less effective, as the bacteria gradually build up resistance. We have reached the point in 2017 when no one could fail to be aware of the concerns regarding antibiotic resistance. Jim O'Neill, who chaired the review panel looking at Drug-Resistant Infections from 2014 - 2016, warned that by 2050 antimicrobial resistance could result in 10 million deaths a year. He suggests that doctors resist prescribing antibiotics until they have carried out tests to prove the infection is bacterial.
We must stop treating antibiotics like sweets, which is what we are doing around the world today.
Doctors are very aware of these concerns and are unlikely to want to keep prescribing more powerful antibiotics without extensive lab testing. Because if E.Coli develops resistance, standard antibiotics like Trimethoprim may no longer work. When that happens, episodes of cystitis could last longer and have the potential to develop in to kidney infections. Thorough investigation of serious Urinary Tract Infection involves testing cultures of the bacteria found in the urine. Tests are performed against a variety of antibiotics, both in isolation and combination, to find the most effective narrow spectrum antibiotic.
However, testing is costly. And worse for the patient, it takes time. When someone is clearly ill, broad spectrum antibiotics may be deemed necessary immediately. Common sense dictates that if doctors wait to get laboratory results before prescribing, an infection could develop rapidly, so it is hard for both patients and their doctors.
Sadly, we talk to people every day who have acquired resistant strains of bacteria that are no longer responding well to antibiotic therapy. ESBLs, Extended Spectrum Beta Lactamas, are an example of this.
ESBL-producing bacteria have joined the growing number of antibiotic resistant pathogens that cause hospital-acquired infections. ESBL bacteria are different from other superbugs, because ESBL does not refer to one specific kind of bacteria. For instance, MRSA refers specifically to methicillin-resistant strains of Staphylococcus Aureus whereas ESBL's are enzymes made by bacteria such as Klebsiella and E. coli, both common culprits in Urinary Tract Infections. This enzyme, beta lactamase, is an antibiotic-resistance enabling enzyme that the bacteria produce to protect themselves from attack.
Usually, ESBL's are harmless and live in the body without causing infection. But when ESBL's get into a part of the body where they do not belong, like the blood or bladder we may experience serious problems.
Reported side effects of broad-spectrum antibiotics, and in particular Fluoroquinolone based antibiotics such as Ciprofloxacin, may be rare but are varied.
Thrush, a disease caused by a fungus, affects the genitals and oral cavity, and is characterised by white, pasty patches. Small amounts of the candida fungus normally reside in your mouth and on your skin without causing problems, because their numbers are controlled by other bacteria. Some types of antibiotics can disturb this balance by killing the bacteria that control the fungus, causing the fungus to multiply out of control. As a general rule, the stronger the antibiotic, the worse the episode of thrush. Eventually, the thrush can become as persistent and almost as painful as the cystitis, because the fungus builds up resistance to treatments you use against it.
Symptoms of Thrush can include:
Vasculitis, inflammation of the blood vessels, is one of the listed side effects of some broad spectrum antibiotics commonly used for the treatment of cystitis. It is caused by immune reaction that can disrupt DNA and RNA, and put white blood cells on the attack against your own body. Lupus-like effects are reported.
Symptoms of Vasculitis can include:
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H.M.I. Osborn, J.J. Gridley, "Recent advances in the construction of beta-D-mannose and beta-D-mannosamine linkages", J. Chem. Soc., Perkin Trans. 1, 2000, 1471-1491.
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CDC Special Report: "Emerging Mechanisms of Fluoroquinolone Resistance" David C. Hooper Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Fuchs S, Simon Z, Brezis M: "Fatal hepatic failure associated with ciprofloxacin" Lancet 242:738-739 (1994).
InsightsandOutcomes.com - Article 194 : Health Researchers, Physicians Express Concern About Rising Antibiotic Resistance.
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