Five ways to fight antibiotic resistance

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It can start off as a minor scrape on the knee after a fall, or perhaps a queasiness in your stomach that you blame on the sushi you had for lunch. Soon you go to the doctor, because what started as something quite small has become a sweating fever and vomiting. Next trip is to the emergency room. You think that everything will be fine once they put you on antibiotics, but after a couple of days there’s no improvement and you've developed pneumonia and kidney failure.

That’s how the story goes for hundreds of thousands of Canadians a year who have contracted an antibiotic-resistant bacteria, which can leave patients hospitalized for weeks and can even be fatal. According to the Canadian Antimicrobial Resistance Alliance, 220,000 to 250,000 Canadians annually develop an infection while in a hospital, resulting in 8,000 to 12,000 deaths.

Since the mid-1990s, sales of antimicrobial products — which kill or inhibit the growth of microorganisms like bacteria — have boomed. It started with a few dozen products, growing up to more than 700 today, amounting into a billion-dollar industry, according to the National Resources Defense Council. But some studies suggest that these products may be causing more harm than good. For this year's World Health Day — on April 7, 2011 — the World Health Organization (WHO) is shining a light on the dangers of antimicrobial resistance, which threatens to undo some of the progress we've made in fighting disease and infection.

Over the last couple of decades, certain strains of bacteria have evolved to become resistant to widely-used antibiotics like penicillin and methicillin. Part of this resistance is due to our overuse of antibiotics: as medication, in household products and in livestock feed.

The most common of these superbugs are C. Difficile, MRSA, VRE and NDM-1. Data from the Canadian Nosocomial Infection Surveillance Program revealed that VRE has been documented in all 10 provinces. MRSA has increased ten-fold in the last decade with the highest rates in Ontario — 13,458 patients were colonized or infected with it in 2006. In 2005, a six-month study reported 1430 cases of C. Difficile. Though NDM-1 is less common (eight people in Canada were infected with NDM-1 as of November 2010), scientists have found strains that are resistant to all types of antibiotics.

Popular antibacterial products are not necessarily a good way to fight these bacteria strains. According to Consumer Reports, antibacterial wipes tested were unable to kill all bacteria. In fact, if you’re using the same wipe on multiple surfaces, you can transfer germs from surface to surface and spread bacteria throughout your home. The Canadian Medical Association wants the federal government to ban antibacterial household products for fear that they lead to the spread of antibiotic-resistant bacteria — or superbugs.

The World Health Day topic for 2011 is Antimicrobial resistance: No action today, no cure tomorrow. As WHO organizers and health experts meet to discuss how to combat this global issue, here are five tips for preventing infectious disease:

1. Practice good hygiene: Wash your hands frequently, and with regular soap, which has been shown to work better than antibacterial soap. Triclosan, the most common antibacterial ingredient, needs to be left on your hands for two to three minutes for the agent to work — most people wash soap off their hands in less time than that. If you’re using sanitizers, make sure they are alcohol-based. A range of 60- to 70-percent alcohol is effective in reducing bacteria on the hands.

2. Do not share personal items: Personal care items such as razors, clothing, combs, manicure items and towels can transmit organisms. With clothing and towels, make sure to wash thoroughly before reusing.

3. Be informed about antibiotics prescribed to you: Are they absolutely necessary? For instance, antibiotics are sometimes mistakenly prescribed for conditions like a viral chest cold. Antibiotics should only be prescribed for bacterial infections, certain fungal infections, and some kinds of parasites. If you are taking antibiotics, make sure you finish the whole course. Even though your symptoms may have disappeared, the germs may still exist in your body in small numbers. They could infect you again or develop a resistance to the antibiotic and breed, creating a strain of antibiotic-resistant bacteria.

4. Avoid using products containing antibiotic ingredients: In the book Slow Death by Rubber Duck, co-author Rick Smith used himself as a test guinea pig, testing everyday household products with antibacterial ingredients. After two days of shaving with Gillette gel, washing dishes with Dawn Ultra, brushing his teeth with Colgate Total, and using other products with controversial ingredients, his level of toxicity (according to an urine sample) rose alarmingly. Whenever possible, read product labels and go for brands that are known for making products with all natural ingredients — or even better, make your own products. 

5. Treat products with antibacterial ingredients as hazardous waste: Whether it’s medication or household products, dispose of them into the hazardous waste depots in your municipality. Studies have shown that when these products get into the waste system and water treatment plants, the ingredients do not degrade. According to researchers from the University of Michigan, Toronto tap water was found to contain drug-resistant bacteria. Though tap water is still considered safe to drink, prevention is key: dispose products with toxic chemicals into the appropriate waste depots.