What is the superbug problem?
A ‘superbug’ is a dramatic sounding word that refers to the types of bacterial infections that are very hard to treat and prevent from spreading because the common medicines to treat them are no longer effective because those bacteria have become resistant to the medicines (Miller, 2015). The name is dramatic for a good reason because this is a huge and scary problem in today’s world. Every year, about two million people get sick from a superbug and about 23,000 people die in the U.S. alone which means the number is much bigger worldwide (Miller, 2015). Any species of bacteria can turn into a superbug (Miller, 2015). Superbugs are bacteria that are highly resistant to antibiotics and so the main issue is antibiotic resistance which needs to be dealt with to lower the effects of superbugs (Harvard University, 2018). Bacteria are smart organisms that adapt, mutate, and get new genes in ways that help them outsmart the antibiotics that once used to kill them very effectively (Harvard University, 2018). Once the bacteria go through this transformation into a superbug then there are few or maybe no medications that can cure the infection from these bacteria (Harvard University, 2018). An example of an antibiotic resistant bacteria is Staphylococcus aureus (MRSA) which is now almost always resistant to benzyl penicillin which was what was used to treat MRSA before which means now there is a need to figure out a new treatment that works just as well for this infection (State of Victoria, 2018). The scary thing about old treatments not working on dangerous infections like MRSA is that how many new treatments can there be found before nothing works at all? Another big issue created by superbugs is that important medical care such as organ transplants or C-section surgeries are becoming more dangerous since certain antibiotics are becoming less effective to prevent and treat infections during those medical operations (WHO, 2018). All this really means that there is more chance of more illnesses, complications during surgery, and even death. Antibiotic resistance leads to higher medical costs because of things like different treatment plans need to be given, complications can happen, and people need to stay in hospitals longer (WHO, 2018). Now that we have a basic understanding of what the issue with superbugs is, we need to go deeper into the problem to see how it spreads.
How do superbugs spread?
Resistance to antibiotics is a side effect of the overuse and abuse of antibiotics (Manyi-Loh, Mamphwell, Meyer, & Okoh, 2018). Misusing antibiotics, which means taking them when they are not needed or not finishing the entire course that was prescribed, is the single leading factor in the superbug problem because exposure to the antibiotics gives the bacteria the resources and time to figure out how to adapt and become resistant (Miller, 2015). Not finishing the entire course of antibiotics lets some of the bacteria remain alive and able to deal with the antibiotic next time. The main worry is that eventually there won’t be any antibiotics left or created to treat the resistant bacteria (Miller, 2015). The more antibiotics that a person has taken, the higher the risk is for a superbug take over in their bodies in the future and the same is for the more times a person is in the hospital (Miller, 2015). This is why it is important to try and deal with illnesses naturally or with over the counter medications until the person knows for sure there is a bacterial infection problem and then use antibiotics as a final step and to also not go into the hospital for every little problem. For example, it is important to not be too scared when you have a new child and keep taking them to the hospital for every little thing or allowing too many prescriptions of antibiotics when it is not for sure a bacterial issue.
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Most people who get an infection caused by a superbug get it in a hospital and are usually people who have many medical problems which means they have been in the healthcare system a lot and have needed a lot of antibiotics in the past (Harvard University, 2018). One area where antibiotic resistant bacteria is spread is in hospitals where workers are not cleaning their hands and equipment properly which is why it is important for these workers to be trained properly and there should be good monitoring and systems to make sure things are properly cleaned and sanitized (State of Victoria, 2018). For example, it should be ensured that healthcare workers wash their hands before and after touching patients and that they use important equipment that prevents contact such as gloves (State of Victoria, 2018).
Antibiotic resistant bacteria can also be passed from person to person within a community (State of Victoria, 2018). Some ways to prevent this type of spreading is to make sure everyone knows that they should wash their hands before and after touching food and going to the toilet (State of Victoria, 2018). Also, people should cover their nose and mouth when they cough and they should stay at home or keep their kids at home when they are sick (State of Victoria, 2018). One interesting thing people should do is to not use too many products that have antibiotics or antibacterial chemicals in them because then they are killing good bacteria and giving the resistant ones more opportunity to grow (State of Victoria, 2018).
Patients are also another big cause for antibiotic resistance since they take the incorrect doses and also keep leftover antibiotics to use later or on other family members (Goldman, 2018). In a study done on 500 parents in the U.S., it was found that 73% of parents who kept leftover antibiotics gave them to someone else in the family such as the sibling of who it was prescribed to (Goldman, 2018). One reason people do this dangerous act is because these drugs can be expensive if they do not have insurance and so they hope they can stretch out the one-time expense for a long time (Goldman, 2018). This shows that maybe pharmaceutical companies need to stop making these drugs so expensive or the government needs to cover more specialized medicines like antibiotics. One issue with this practice is that maybe the child who was prescribed the liquid antibiotic will get less than they were supposed to which creates the chance for superbugs or it might not be the correct dosage for the child who was not given the prescription and so it will not work fully leading to potential superbug infection (Goldman, 2018).
Irresponsible antibiotic use in developing countries is scary for global health because in developing countries there are issues such as the use of antibiotics that have been banned in other countries and the use of antibiotics in an unsafe manner since they are easily available over the counter (Manyi-Loh et al., 2018). Since there is so much travel between countries in today’s world, the connection to humans across the lands is closer and that is why it is dangerous that resistant bacteria is becoming more available in any part of the world because it could easily come to our part of the world.
The overuse of antibiotics in animals which are bred for food for things such as disease prevention for the animals or to make the animals bigger is a big way for the creation of antibiotic resistance that then gets into humans after being eaten (Manyi-Loh et al., 2018). The use of nonessential antibiotics in animal food for making them bigger is very unregulated in the underdeveloped countries which is dangerous for how resistant bacteria is spread (Manyi-Loh et al., 2018).
Finally, the environment is also a huge part of why resistant bacteria spreads between people and causes illnesses to keep getting worse (Bengtsson-Palme, Kristiansson, & Larsson, 2018). Some examples of where disease causing organisms can interact with many types of bacterial species with resistant strains and then come into contact with humans are in sewage treatment plants, from livestock, water bodies, and the food supply chain (Bengtsson-Palme et al., 2018). The reason those examples of environments can be so dangerous to spreading resistant bacteria is because the connection to humans after the resistant bacteria has come into contact with pathogens from the environments happens in a short time (Bengtsson-Palme et al., 2018). For example, sewage treatment plants usually release their waste products, which has been shown to contain resistance genes, into water that is used to water large farmland or water where people swim recreationally (Bengtsson-Palme et al., 2018).
With the understanding of some of the ways that superbugs are spread, we can start to see some of the ways that we can potentially lower the spread.
What are some solutions to the superbug problem?
Antibiotic resistance can be prevented by lowering unnecessary prescribing and overprescribing of antibiotics, the correct use of prescribed antibiotics, and good hygiene and infection control (State of Victoria, 2018). People need to stop demanding antibiotics for any illnesses they have because they want or need to feel better right away because antibiotics do not work on viral illnesses which are commonly what are making people sick (State of Victoria, 2018). Healthcare workers need to be better at not prescribing antibiotics to those illnesses that do not require them or where other treatment options might work as well. It was estimated that in 2016, one in three antibiotic prescriptions in the U.S. were unnecessary (Agrawal, 2018). Also, healthcare workers need to make sure people understand that it is very important to finish all the antibiotics that are prescribed even if they feel better because otherwise the resistance is creating because of the bacteria that weren’t killed (State of Victoria, 2018). It has been shown in Australian hospitals that antibiotic restriction and education of prescribers and patients about how to use antibiotics has improved overall overuse of antibiotics in the hospitals (Manyi-Loh et al., 2018). Also patients should take control of their health and safety and ask healthcare workers if they have been properly sanitizing and if the hospital is good at following the rules and regulations. Ask the person prescribing the antibiotics if it is truly necessary and see if there are other types of treatment plans that can be used.
Some things people can do to prevent the spread of antibiotic resistance is to never share or use leftover antibiotics (WHO, 2018). Also people should maintain proper hygiene and food safety.
In the agricultural sector, some ways to prevent the spread of antibiotic resistance include not using antibiotics for making the animals grow or to prevent diseases in healthy animals (WHO, 2018). Antibiotics should only be given to animals who need it because they are sick (WHO, 2018).
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The government and large organizations and community groups can do a lot to raise awareness about the problem and what people should do and they can set regulations and rules for the public and businesses to follow to reduce the use of unnecessary antibiotics. The World Health Organization has many plans in place to spread the word about preventing the spread of superbugs throughout the world. One thing they do is promote World Antibiotic Awareness Week which is held every November since 2015 where the WHO spends a lot of time and money doing activities and other advertisements to explain to people how to properly use and deal with antibiotics (WHO, 2018). This is such an important way to spread the word on how to not spread superbugs. Other important things are being done as well throughout the world to reduce the unnecessary use of antibiotics such as the European Union banning the use of antibiotics as growth making in animals in 2006 (Agrawal, 2018). Also these governmental and large organizations should try to ensure that developing countries try to make sure that antibiotics are not given without a prescription and have more regulations in place for the use of antibiotics in animals to be used only when they are sick.
The most obvious solution is to create more antibiotics to use on the superbugs.
What is the future for superbugs?
The development of new antibacterial medicines is not as easy as before because the most effective and safe ones have already been developed and sometimes newer ones have higher costs or are more toxic which can lead to kidney failure (McAdam et al., 2012). The development of new antibiotics has slowed down a lot in recent times because pharmaceutical companies are spending most of their time and money on dealing with other issues like cancer (Agrawal, 2018). The last new class of commercial antibiotics was developed in the 1980s (Agrawal, 2018). Antibacterial resistance could kill ten million lives per year by 2050 if everyday infections and illnesses become untreatable while at the same time pharmaceutical companies do not develop new antibiotics quickly enough (Agrawal, 2018). Even if new antibiotics come, bacteria can develop resistance to the drugs within a year (Sifferlin, 2017). Even though it seems hopeless that any solution can come in the near future, there is actually some hope.
Phage therapy is something scientists are getting very excited about as a solution to the superbug problem (Sifferlin, 2017). Phage therapy uses bacteriophages, which are viruses that destroy bacteria, to potentially target resistant bacteria which will allow medicines to work on whatever remains (Sifferlin, 2017). Each strain of the phages attacks only a specific kind of bacteria they evolved to kill (Sifferlin, 2017). This is good because now good bacteria will not also be killed but it is bad because there are so many types of bacteria out there and so it will take a long time to figure out how to target so many types and it is so complicated and needs lots of money to figure out (Sifferlin, 2017). However, in some cases, it can be developed quickly and can tweak it as needed quickly too (Sifferlin, 2017). Also, bacteriophages can be found everywhere on Earth (Sifferlin, 2017). So, it seems like there is a lot more good than bad in phage therapy as a solution which is exciting and hopeful for the world.
In conclusion, the starting point in the battle against superbugs is to make people aware of the huge problems such as complications during and after surgery because superbug infections are not able to be treated. This awareness will then hopefully make people act more hygienically, take better care when using antibiotics, and keep doctors who overprescribe antibiotics regulated by asking if antibiotics are necessary. Also, the awareness will hopefully also cause people to make their voices heard by asking governments to put in more regulations into antibiotic use in our food and environment and to demand that more money is given to scientists to find other solutions to this problem. Bacteria are smart organisms but humans have overcome so many healthcare issues since the beginning of time that I believe humans will be able to be smarter than the bacteria and overtake superbugs.
- Agrawal, R. (2018, June 6). Superbugs Are Going to Eat Us Alive. Retrieved from https://foreignpolicy.com/2018/06/06/superbugs-are-going-to-eat-us-alive/
- Bengtsson-Palme, J., Kristiansson, E., & Larsson, D.G.J. (2018), Environmental factors influencing the development and spread of antibiotic resistance. FEMS Microbiological Review, 42(1). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29069382
- Goldman, B. (2018, November 5). ‘Alarming’ number of families share leftover antibiotics, study suggests. Retrieved from https://www.cbc.ca/radio/whitecoat/alarming-number-of-families-share-leftover-antibiotics-study-suggests-1.4892322
- Harvard University (2018). Stay safe from superbugs: Understanding superbugs can help you avoid them. Retrieved from https://www.health.harvard.edu/diseases-and-conditions/stay-safe-from-superbugs
- Manyi-Loh, C., Mamphwell,S., Meyer, E., & Okoh, A. (2018), Antibiotic Use in Agriculture and Its Condequential Resistance in Environmental Sources: Potential Public Health Implications. Molecules, 23(4). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29601469
- McAdam, A.J., Hooper, D.C., DeMaria, A., Limbago, B.M., O’Brien, T.F., & McCaughey, B. (2012). Antibiotic Resistance: How Serious Is the Problem, and What Can be Done? Clinical Chemistry, 58(8). Retrieved from http://clinchem.aaccjnls.org/content/58/8/1182
- Miller, K. (2018). Superbugs: What They Are and How You Get Them. Retrieved from https://www.webmd.com/a-to-z-guides/news/20150417/superbugs-what-they-are#1
- Sifferlin A. (2017, December 18). Superbugs Are Nearly Impossible to Fight. This Last-Resort Medical Treatment Offers Hope. Retrieved from http://time.com/5068513/superbugs-are-nearly-impossible-to-fight/
- State of Victoria (2018). Antibiotic resistant bacteria. Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/antibiotic-resistant-bacteria
- WHO (2018, February 5). Antibiotic resistance. Retrieved from http://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance