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Introduction: Antibiotics. Their discovery as powerful drugs that could cure life-threatening infections was viewed as a miracle. And, in fact, it was. In 1943, penicillin, the first antibiotic, was used widely to treat the infections and wounds of soldiers during WWII.

Antibiotics continue to be lifesavers, curing everything from tuberculosis and pneumonia to staph infections and strep throat. But in order for antibiotics to retain their ability to vanquish infections, they must be used correctly. The problem is that they are often misused, causing antibiotic-resistant germs. As a result, some antibiotics are no longer effective in curing illnesses for which they were typically prescribed.

Some experts say that unless we stop the problem of antibiotic resistance, we could end up in the Dark Ages of medicine, when a simple cut could turn into a deadly staph infection. The question is: When and for how long should we take antibiotics? And are there other ways to prevent these essential medications from losing their punch? I'm Laurie Udesky.

Udesky: Dr. Stuart Levy is an expert on antibiotic resistance and author of the groundbreaking book The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers. He says that one of the key reasons that antibiotics lose their strength is that people use them for illnesses such as cold and flu, which are usually caused by viruses. Instead, they should be taken only when your doctor thinks you have a bacterial infection.

Levy: If we use an antibiotic for a viral illness, we can't expect it to work because it doesn't have any antiviral activity. Instead, what we do is build up resistance in the environment, which then could come back at a later time to cause an illness that's difficult to treat.

Udesky: In other words, when we take an antibiotic it kills a lot of bacteria, but some may survive the antibiotic onslaught. Those resistant bacteria multiply over time, making it less likely that the same antibiotic will work as it should in the future. Penicillin is one example, says Levy, of a once-powerful antibiotic that's lost its strength.

Levy: One of the most common bacteria faced by a community is pneumococcus. This is a bacterium that we've faced through centuries. It causes ear infections and pneumonias and blood-borne infections, which can cause death. It's really these kinds of infections that brought the [term] "miracle" to "miracle drugs." These bacteria are now resistant to penicillin and to two or three other antibiotics that we would first use. We have drugs to treat with, but [people] will suffer longer, they'll be more out of school time and out of work time, there are more costs to society and people. In certain instances, if it's an elderly person -- if the right antibiotic isn't chosen -- that person could die.

Udesky: Antibiotic resistance also makes its way back to us through the food chain, says Levy. Antibiotics are used to prevent infection and also to promote growth in the animals we eat.

Levy: But what emerges from that treatment of the animal is, of course, the consequence: lots of bacterial resistance to that antibiotic, which can be transferred to people on the meat and even on the produce, because much of the manure that is excreted by the animals on antibiotics gets spread onto fields. The antibiotic is still in the feces and active. So it continues to select out the resistant strains and kill the susceptible ones.

Udesky: As a result we need to act defensively with food, Levy warns. Meats and produce should be thoroughly washed on the outside and prepared on different kitchen surfaces. That's to ensure that bacteria from raw meat don't end up in your salad. And all meat should be cooked to well done.

The best solution to antibiotic resistance, says Levy, is to avoid infection by washing our hands with soap and water before meals, after going to the bathroom, and when we've been around others who are ill. And if you do get ill, don't insist on an antibiotic unless your doctor is convinced you have a bacterial infection.

Udesky: For Consumer Health Interactive Radio in San Francisco, I'm Laurie Udesky.

First published September 14, 2004
Last updated May 6, 2008
Copyright © 2004 Consumer Health Interactive