For well over a decade now the media has reported on the problems of resistant microorganisms and that medical science can’t stop them.
They blamed the over-use of antibiotic therapy as the cause. However, if the reporters had looked a little bit deeper they would have found a contributing cause that was far more dangerous than the over-prescribing of antibiotic medications. They would have found a much more distressful epidemic among the medical profession.Growing problems among many health professionals that were and still are contributing to the problems of resistant microorganisms.
Unlike resistant microorganisms, this problem is much easier to remedy. But first we have to admit that there is a problem, and that the problem must be addressed. So what is the problem? Simple – most doctors, nurses, and pharmacists fail to properly explain how to take antibiotic medications.
It is so simple that it bears repeating. Many of us are guilty of not properly explaining to our patients how to take their medications. Take a moment and think about the last discharge medication teaching you completed. You probably told your patient about the medication: it’s purpose, side affects, and to take it as directed. It is the take as directed part that I take issue with. What exactly does, take as directed mean?
If my medication is to be taken twice a day, does that mean upon awakening and at bedtime? What if I wake up at 6 a.m. but don’t go to bed until 1am? If I take the medication as directed, then I would be taking the pills 19 hours apart. What happens to the other 5 hours in the day? Perhaps some medication will still be quite affective taking it this way but as you will see below, antibiotics need to be given at very specific intervals in order for the medication to work effectively.
Let’s take an example of a prescription that directs the patient to take the antibiotic three times a day. What would you tell your patient? Would you say to take it after meals? That would seem to make sense, since most of us eat three meals a day. The problem of course arises when you have a patient that doesn’t eat three meals a day, or has irregular gaps in-between meals. Antibiotics work best when they are spaced properly to provide a steady level of medicine. Otherwise those bacteria are provided with an opportunity to resist, during medication dips and peaks.
There are twenty-four hours in a day, and taking the prescription as close to every eight hours would make sure that there was enough medicine on board to kill the bacteria. You must maintain a steady amount of medicine if you want to kill all the bacteria. If you take the medicine at breakfast (say 8 a.m.), then again at 1 p.m. for lunch, and then, 7 p.m. for dinner, you are not providing an equal and steady amount of medicinal protection.
In fact, you are taking the medicine at five, six, and 13-hour intervals. You are providing many opportunities for the bacteria to take hold again, and what is worse, you are providing bacteria an opportunity to mutate and become resistant to the very medicine you are using to kill it.
I will never say that antibiotic therapy is wrong. On the contrary I believe there are times when antibiotics are life saving. A case in point occurs with chronic strep throat infections. The streptococcus bacteria that causes this infection will go dormant if not killed and the child will appear to be getting well. A few weeks or months later, susceptibility of the child will trigger another episode of strep throat. Again if it goes untreated, it will resolve on its own. Over time the bacteria will work its way into the blood stream and damage the filtration component of the kidney called the glomeruli. Chronic glomerulus is the number one cause of kidney failure in children and one way to prevent it would be to properly follow a course of antibiotic treatment for strep throat.
Overuse and abuse of antibiotic therapy is what has gotten us in the resistant bacterial cycle in the first place. To help preserve the benefits of antibiotic therapy for future generations, I suggest exploring alternatives to antibiotics when they are made available, such as the tannins in cranberries and D-mannose for urinary tract infections. But more importantly, when antibiotics are prescribed that, as directed, be explained to include: the right amount, the right time, the right route, and until all medication is finished.
Bacteria are not all bad and, they are quite important in a variety of functions. It is when that normal flora becomes imbalanced and opportunistic bacteria flourishes that an infection occurs.
Dr. Mundorff is a Board Certified Naturopath, and not a medical doctor. The information in this column is for educational purposes only and should not be used to self-diagnose and treat diseases. She is the author (Rener) of Medical Terminology: a Student Workbook, and Memories of My Sister: Dealing with Sudden Death. You can reach her via email at Bridges2hlth@aol.com.