Antibiotic Resistance: Go Big Or Go Home
After the development of antibiotics, experts in infectious medicine who’d seen the fatalities in their field drop by more than 90% trumpeted an end to their entire specialty; and many medical schools closed the infectious disease departments entirely.
Today, we’ve come a good part of the way around a full circle. A few microbes are now resistant to every available antibiotic. Deaths from resistant microbes increasing every year with no end in sight. And those infectious disease departments? They’ve reopened, and are full of worried people.
And that’s when the full modern medicine chest is available. Although many preppers stock antibiotics, most are limited to a few varieties that are produced for veterinary use and so are available without prescription.
Antibiotics commonly stocked by preppers are older drugs, freely available, and often used on livestock. That adds up to a high risk of resistant microbes. The potential for more strains to develop such resistance is also high. In short, there’s a very real risk of the prepper’s stock of antibiotics not being effective when it’s most needed.
How does antibiotic resistance arise?
There are two main ways bacteria get resistant to antibiotics. One is that a random mutation arises in one member of a population of bacteria that happens to make that bacterium less likely to die when exposed to the drug. The person takes the antibiotic and most of the bacteria in the population die quickly so the person feels much better. However, this one resistant bacterium survives and continues to divide. Soon the population of bacteria is enough to cause sickness again; and now the entire population is resistant to the drug.
In any infection, a small number of bacteria are likely to randomly have a mutation that allows them to be resistant to drug treatment. Taking antibiotics — particularly in partial doses or short courses, just removes the competition to let these bacteria thrive.
The other way is related, and is more about helping resistance spread from one species of bacterium to another. One species of microbe gets resistant by the means described above, but no one notices because the resistant strain is not one that causes disease. (Many kinds of bacteria live in and on humans without making them sick at all.) Then the person picks up a nastier, disease causing species of microbe. Because some bacteria are ‘promiscuous’ in that they’ll trade genes with other species, the disease-causing species picks up the resistance gene from the harmless species.
Antibiotic resistance in a nutshell: Go Big or Go Home
Go Home: The less we rely on antibiotics, the less likely resistant strains of bacteria will develop.
Every time we take antibiotics, we are selecting bacteria that happen to have resistance genes and making them more successful. Sooner or later, resistance will develop. The prepper message I take from this (Not being a physician, I’m not going to tell you what to do) is: Don’t take antibiotics unless you need them. Many infections are viral; antibiotics won’t help anyway. Others will improve if you give your immune system a fair chance at them.
Many prescriptions are given as prophylactics “just in case” you would’ve gotten some infection related to that surgery or secondary to that viral infection. Public health and infectious disease specialists are trying hard to get other physicians to cut down on those prescriptions, as the resistance they encourage is being judged more harmful than the number of infections they may have prevented.
The more antibiotics we use, the more resistance develops. That’s true for the world in general, and within each person in particular.
Alternatives
There are alternatives to antibiotics for many uses. That’s great news, for two reasons. One, it cuts down on antibiotic use and the related risk of training resistance. Two, it gives us Something useful to do when we do get a bacterium for which we have no useful antibiotic. So, what are the options?
Bacteria do not get resistant to good hygiene. Not getting a load of infective bacteria into you in the first place is a great way to not have them make you sick. Properly irrigating and debriding wounds reduces microbe loads in a way they can’t evolve around as well.
Bacteria also don’t get resistant to basic attacks such as dehydration and oxidation, as no one gene could protect against all the havoc these attacks cause. That means the microbes are unlikely to get resistant to good hand-washing, alcohol gels, iodine-based skin disinfectants, wipe-downs of food handling areas with bleach solutions, and similar simple but very useful defenses against infection.
There’s no developing resistance against this.
Go Big: When you do need antibiotics, don’t use them as half-measures
Not going big is especially tempting from a prepper point of view. One’s hoard of prepper antibiotics is likely to be limited, and perhaps irreplaceable at least in the short term during an emergency. It will be tempting to take the drugs when the problem is glaring, but see if you can get by with less than a full course. That strategy, though, invites resistance. At least originally, most of the randomly occurring mutations provide microbes resistance to the drug, not immunity. Taking a full course is likely to kill ’em all, even the somewhat resistant ones. Half courses just reward them for being resistant and encourage them to develop more of it.
If someone takes a partial course of antibiotics, they kill off a lot of the original population of microbes. They feel better, but the remaining microbes all carry resistance genes. When these survivors breed back up, the drug is far less effective. Most preppers can’t afford to let any of their few antibiotic choices become ineffective. If you’re going to take antibiotics, now or in an emergency, doctors strongly recommend taking enough to do the job right.
Half measures can be worse than useless with antibiotics.