A temperature of 105 degrees Fahrenheit was recorded. Breathing too quickly. Lips and nail beds have a bluish cast to them. It sounds like you might have pneumonia. But don't worry; there's an antibiotic for everything. Penicillin is a well-known hero in the medical community. As a result, germs like those that cause bacterial pneumonia have less of a reason to fear penicillin and other antibiotics.

There is still a lack of public awareness about the dangers of antibiotic-resistant microorganisms. We can always try a different antibiotic if the first one doesn't work, right? Yes, in theory. Antibiotics are gradually being defined as less effective against an increasing number of resilient bacteria as time goes on, however. Within the next two or three years, a brand new antibiotic that was extremely effective may require a new antibiotic to replace it if it proves unproductive. To replace the old antibiotic, we must embark on a lengthy and expensive search for a new compound. As a final resort, it is not possible to simply switch to a different antibiotic. In his Nobel talk, Alexander Fleming, the Nobel laureate and accidental discoverer of penicillin, warned of the antibiotic's misuse:

However, I'd want to issue a cautionary tale. There is no need to be concerned about overdosing on penicillin and risking poisoning the patient. Underdosing, on the other hand, could be harmful. Penicillin-resistant microorganisms may easily be created in the lab by exposing them to quantities that are too low to kill them, and the same thing has happened in the body on occasion...

To put it another way, there is a possibility that the naive guy may easily underdose himself and thereby make his microorganisms more resistant to the treatment. (92-93)

Fleming described a hypothetical case of a man who didn't take enough penicillin to kill all of the pneumonia-causing germs in his system in that speech. Even if his wife is later diagnosed with pneumonia, the bacteria has evolved resistant to penicillin as a result. His wife died as a result of the penicillin treatment failing. Fleming holds someone responsible for her death. His "...negligent penicillin use" had "...altered the microbe's nature" (93). Whether antibiotics are used properly or not is solely up to us. Doctors advise us to finish the specified course of antibiotics in order to avoid any nasty bacteria remaining in our system that could develop resistance. For some reason, a word of advice isn't enough.

Just how clueless our culture is when it comes to antibiotic use can be shown in this case study from the University of Missouri-Virtual Columbia's Health Care Team. A female patient approached a doctor's clinic in search of help for her cough and fever. She insisted on having an antibiotic prescribed for her cough. The most likely source of her symptoms was a virus rather than bacteria, because antibiotics can only treat bacteria. He agreed to write her an antibiotic, but asked her to return if she didn't feel better after taking it for a week. The next day, she returned complaining of a "drug-induced rash associated to the antibiotic." That's why they gave her another one. In the end, she was given three different antibiotics, and this one didn't help either. It took the woman two weeks before she was sent to the hospital, where an enterocolitis diagnosis was made. The healthy bacteria in the bowel are sufficient to keep the intestine in balance, so the bacteria that cause this usually have no effect on the carrier. Antibiotics, which kill both good and bad bacteria, allowed the evil germs to flourish unchecked in this woman. In the end, the patient died of enterocolitis as a direct result of her refusal to take an antibiotic that would have helped her with her flu symptoms in the first place (Hedrick 3).

In 68 percent of acute respiratory tract visits, antibiotics were recommended – and of those, 80 percent of them were unnecessary, according to CDC recommendations (Scott et al.). Only patients who don't understand that antibiotics won't cure their viral illness and that they're also contributing to the rise of antibiotic-resistant bacteria, which Fleming warned against right away when antibiotics were first discovered, are likely to get unnecessary prescriptions from their doctors. However, it's not just patients who are to blame for the rise of antibiotic-resistant microbes in the world. Doctors, too, are involved.

During the early days of antibiotic development, doctors appeared to be so ecstatic with their newfound power to destroy bacteria that they failed to notice a troubling pattern. Both Dr. Elinor Levy, a microbiologist at Boston University/Boston Medical Center and an expert in the field of immunology and writing about science, and Mark Fischetti, an editor for Scientific America and a well-known science writer, note that bacteria developed resistance to penicillin in just three years after it was first sold commercially in 1943. It took just one year after the introduction of the antibiotic methicillin in 1960 for reports of resistance to emerge, according to Levy and Fischetti (177). Within a few years, many other antibiotics were becoming less efficient against germs. Doctors and microbiologists, on the other hand, were less concerned. Rather, they frequently dismissed any evidence that the number of resistant germs was increasing. To save time and money, they decided that if the first antibiotic didn't work, they could simply switch to another. Doctors began to observe that their overprescribed therapies were beginning to deteriorate as the years passed, bringing with them the potency of antibiotics. Bacterial resistance to antibiotics was not noticed worldwide until 1997, according to Levy and Fischetti, when Keiichi Hiramatsu of Juntendo University in Tokyo's department of bacteriology published a paper in Journal of Antimicrobial Chemotherapy describing his and another colleague's discovery that staph infections could indeed become resistant to the antibiotic Vancomycin (178-182). After more than half a century of rapidly developing bacteria, the medical community began to realize that we were lagging behind in the battle against bacteria.

One area where we're falling short is in our hospitals. Many examples of doctors and nurses failing to wash or sanitize their hands regularly enough to prevent the spread of antibiotic-resistant germs abound. However, that doesn't mean that our fight against microbes is doomed.

If we don't use medicines properly, we'll face a new wave of antibiotic-resistant germs, warned Alexander Fleming in 1945. Many are listening to his warnings now, some seventy years later. As a result of our botched use of antibiotics, we must now prepare. Antibiotic classes should be expanded, bacterial infections should be treated with greater caution, and the development of novel medicines should be reserved for extreme cases. We may be able to get back into the fight against microbes if we act swiftly enough.

Works Cited

Fleming, Alexander. “Penicillin.” Norwegian Nobel Committee. Stockholm, Sweden .11 December 1945. Nobel Lecture.

Hedrick, Eddie. “Misuse of Antibiotics.” University of Missouri-Columbia. Virtual Health Care Team, 2012. Web. 5 Nov. 2013.

Levy, Elinor, and Mark Fischetti. The New Killer Diseases: How the Alarming Evolution of Mutant Germs Threaten Us All. New York: Crown Publishers, 2003. Print.

Scott, J.G., et al. “Antibiotic Use in Acute Respiratory Infections and the Ways Patients Pressure Physicians for a Prescription.” USA.gov. Centers for Disease Control, 2001. Web. 6 November 2013.