What Everyone Needs to Know®
Mary E. Wilson
Table of Contents
ORIGIN AND FUNCTION
What are antibiotics? What is the difference between an antibiotic and antimicrobial?
What do they do?
How do they work?
Why do we have so many different ones?
Do they work against viruses?
How were they discovered?
Where do they come from?
How are they made?
Are new ones created in the laboratory or discovered in nature?
Are the same antibiotics used all over the world?
USE IN HUMANS
How are antibiotics administered besides by mouth and injection?
Do pills work as well as injections?
Where does the antibiotic go in the body? Does it reach all organs and tissues? What is its fate? Does any part of the antibiotic leave the body in urine or feces?
How long does it take to work?
What determines the right dose of an antibiotic?
Can one overdose on an antibiotic?
Does an antibiotic have any effect other than against the bacteria being treated?
How long does the effect of an antibiotic last?
Why are some antibiotics given as a single dose and others prescribed for weeks or longer?
Why are some infections, such as tuberculosis, always treated with multiple different antibiotics taken simultaneously?
Does one always have to take the entire course of prescribed antibiotics?
Can one take leftover antibiotics for a new infection? Or give it to a family member or friend?
What should one do with leftover antibiotics?
Is it dangerous to take expired antibiotics?
How common are allergic reactions? What are the signs and symptoms of an allergic reaction? How much antibiotic does it take to cause an allergic reaction? Does exposure to the sun make one more likely to have a reaction to an antibiotic?
What is the difference between an allergic reaction and an adverse reaction?
What can make an antibiotic stop working?
When are antibiotics used to prevent infections (in contrast to treating an established infection)?
How common is the practice of prescribing of antibiotics for prevention in health care today?
Why shouldn't a person take an antibiotic if there even a small chance that it may help treat an infection?
What do antibiotics do to an individual's microbiome? [collateral damage]
OTHER USES OF ANTIBIOTICS
What are the uses of antibiotics other than to treat infections in humans?
What proportion of antibiotics produced in recent years had a non-human use?
Are the antibiotics used in food animals (including fish) the same ones used in humans?
Why are the same antibiotics used in people also used in animals?
Are the antibiotics used on plants the same ones used for human infections?
Why are healthy animals given antibiotics in their feed or water?
Are antibiotics used in food animals in other countries?
Is any antibiotic still present in the meat or other organs when sold for human consumption?
Does feeding animals antibiotics in large production facilities (such as mass production of chickens, pig, cattle) have impact on the local environment?
What is antibiotic resistance?
How does one test for it?
Where does it come from?
How does it spread? From one type of bacteria to another? From one region to another?
Does it ever disappear?
Which bacteria have developed antibiotic resistance?
Is it found in all countries?
Is it influenced by the amount of antibiotic used in a region or country?
What can be done to slow or stop it?
Do animals carry antibiotic-resistant bacteria?
Do antibiotic-resistant bacteria in animals reach humans? What are the routes of spread from animals to humans?
CONSEQUENCES OF RESISTANCE
Are infections caused by antibiotic-resistant bacteria less severe? More severe?
Are outcomes worse for antibiotic-resistant infections?
What would be the consequences if antibiotics stopped working? What do people mean by the “post-antibiotic era”?
Do we have antibiotics to use when bacteria become resistant to first-line drugs?
Are these other antibiotics as safe and effective as the first-line drugs? Are they available and affordable?
Can antibiotics still be used for prevention when bacteria become resistant?
What medical procedures today rely on the availability of highly effective preventive antibiotics?
Are people dying today because of antibiotic resistant infections?
Why are antibiotics sometimes called “societal drugs”? How does my taking an antibiotic affect my neighbors and the community?
ALTERNATIVES TO ANTIBIOTICS
Are there ways we can reduce risks of infections so that we do not need antibiotics?
[vaccines; improved sanitation and clean water; better infection control in hospitals, etc.]
Are there approaches to treating infections that do not involve antibiotics?
[immune modulation; anti-toxins; antibodies; surgery, phage therapy, etc.]
RESEARCH AND INDUSTRY
Why aren't pharmaceutical companies developing more new antibiotics? Why don't we have more antibiotics in the pipeline?
Whose responsibility is it to develop new antibiotics? Who pays for their development?
How much does it cost to develop a new antibiotic? How long does it take?
How common is inappropriate prescribing of antibiotics?
What can individuals do to reduce the inappropriate use of antibiotics?
What is the role of better diagnostics in reducing use of antibiotics?
What approaches have been effective in increasing the appropriate use of antibiotics and decreasing inappropriate prescribing by clinicians?
What can hospitals do to encourage appropriate use of antibiotics and reduce spread of resistance?
What can the CDC, FDA, and other agencies do to promote appropriate use of antimicrobials?
Can national policies affect antibiotic use?
Why are some antibiotics approved in other countries not available in the U.S.?
Can you trust antibiotics obtained outside the U.S.? Why are antibiotics sold without a prescription in many countries?
How serious is antibiotic misuse in other countries?
What is the role of international agencies in reducing overuse of antibiotics?