It is now well known to everyone that one of the most significant health crises of recent years is the progressive global spread of infections caused by bacteria that have become resistant to antibiotics. This phenomenon stems from the fact that most antibiotics are derived from substances produced by bacteria themselves: they are used in the competition between different bacterial species to ensure that one prevails over the other, acting as a sort of weapon against rival bacteria. Since bacteria are among the most primordial forms of life and have been present on our planet for over three billion years, the various species have developed mechanisms to defend themselves against their enemies’ weapons by learning to become resistant to them very quickly.
Humankind then learnt to use these substances as medicines to combat infections: penicillin, the first antibiotic discovered by humankind, is in fact derived from a microscopic fungus (Penicillium notatum) and was introduced as a medicine in 1941. It was a major discovery for medicine, but shortly afterwards the first instances of resistance – albeit isolated ones – were also observed.
Over the years, the range of available antibiotics has expanded, and their use – initially restricted to cases of clear-cut bacterial infections – has become so widespread that it has turned into a ‘habit’ that is not always consistent with or appropriate to the clinical condition.
It is always worth remembering, in fact, that antibiotics are only effective against bacterial infections and not against infections in general. In particular, antibiotics are of no use whatsoever against viruses and the infections they cause – for example, all seasonal respiratory conditions such as colds, flu and parainfluenza, all of which are caused by viruses and not by bacteria – and may even be contraindicated.
This excessive medical use of antibiotics, combined with their equally indiscriminate use in the livestock and agricultural sectors, has led to the development and spread of numerous species of bacteria that are resistant to these treatments; this is particularly the case in settings where high levels of antibiotic use coincide with the presence of individuals in a more compromised state of health, namely healthcare settings.
This phenomenon, therefore, has been going on for a long time but is now reaching a stage of increasing severity, to the extent that the entire health service is engaged in a wide-ranging campaign to tackle it. I believe, however, that it is particularly important for all of us – that is, users of the health service – to be aware that the unnecessary use of antibiotics does more harm than good.
The fight against antibiotic resistance therefore also depends on patients adopting the right attitude towards their treating doctors, whose diagnostic and prescribing autonomy must be respected so that they can always act ‘in good faith and to the best of their knowledge’, a key factor in ensuring the maximum effectiveness of any medical treatment.
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