Wednesday, January 10, 2007

The danger of not taking all of your prescribed antibiotics

The danger of not taking all of your prescribed antibiotics

By Dr. Tom Gross Marin Independent Journal (California)Copyright 2007 Marin Independent Journal, a MediaNews Group publicationAll Rights Reserved Editor's note: Dr. Tom Gross is the emergency medical services director for the Novato Fire Protection District. His column appears every Monday.

I answered a telephone call the other day from a neighbor, who told me that she had a sinus infection. She wanted to know if it was OK for her to take some antibiotics. I asked her, "What antibiotics?"

She said, "Oh, I don't know, just something I have left over from my last infection." She described to me her symptoms, which included a sore throat, nasal congestion and sneezing; in other words, a common cold and not a sinus infection. She told me that whenever she gets those symptoms, she takes some leftover antibiotics from her medicine cabinet for a few days, but just until she feels better. Even though her cold would have resolved on its own, she thinks that the antibiotics are curing her illness.

There has been some doomsday press recently about strains of bacteria that are resistant to antibiotics. It is not difficult to create your own strain of antibiotic resistant bacteria. You can do it yourself at home. In fact, most people do.

Here is an experiment that you can try. All you need is some dishes of culture medium, easily available from any biological supply house, some cotton swabs, and your own vial of leftover antibiotics from the last time that you did not take your medication as prescribed.

First, take the cotton swab, wipe it along the back of your throat and rub it on a culture medium. Put the culture dish in a warm, dark place, like at the bottom of a laundry hamper and wait.

After a few days, the culture medium will be teeming with little white mounds of bacteria that look like cookie dough and smell like a laundry hamper.

Take another swab and transfer some of the bacteria to a new culture dish. Grind up a few of your leftover antibiotics and sprinkle them in the dish, close the lid and put it back in the bottom of the laundry hamper.

After a few days, examine your experiment again. The areas in the dish nearest to the antibiotic powder will be relatively free of bacterial culture; that is, no cookie dough.

However, the bacteria that have grown will have survived despite the presence of antibiotics. You will have just created your own strain of antibiotic-resistant bacteria, and you may now consider yourself to be a world-class WMD bioweapons manufacturer. You can go one step further, by repeating the experiment with another antibiotic, and you can make a bacterial culture that has multidrug resistance.

This type of experiment is known as "in vitro"; that is, your experiment was carried out "in glass." You can also perform this experiment "in vivo"; that is, in a living organism. In vivo experiments carry more scientific validity than in vitro experiments because their results are shown to be valid in actual patients rather than merely in a glass jar.

People who take their antibiotics for less than the prescribed period of time are performing in vivo experiments on themselves.

By taking antibiotics for only a few days, they are killing off the bacteria that are most susceptible, and leaving the most resistant behind to survive. They have participated in a living experiment that has demonstrated the validity of Darwin's theory of natural selection.

By exposing bacteria to intermittent small doses of antibiotics, they have killed off the bacteria that are most susceptible and have selected for those that are antibiotic resistant.

Having grown in their throats an antibiotic resistant strain of bacteria, then their next sinus infection will be truly resistant to antibiotics. These resistant bacteria can also spread to other people.

You may read in the paper about deadly strains of antibiotic resistant bacteria, such as MRSA (methicillin resistant staph aureus) or VRE (vancomycin resistant enterococcus). You may read about strains of tuberculosis bacillus that are resistant to all five antibiotics used to treat this disease.

This is no joke. This threat is real. The next time that you read about strains of antibiotic resistant bacteria, ask yourself if maybe you have been a part of this great experiment. Do you have antibiotics at home in your medicine cabinet left over from the last time that you did not take them as prescribed?

Please don't ask for stronger antibiotics. They have not been invented yet.