November 18, 2018

By JOSHUA VAN OSTRAND

A lecture dedicated to talking about what could mean a very scary future, the superbug, was held at the University of Waterloo’s School of Pharmacy on Nov. 12. It’s not a 50-metre-tall cockroach or a spider that spits fire, it’s something much smaller and much more likely to cause us harm.

Superbugs are evolving strains of bacteria that are capable of resisting antibiotics, our strongest weapon against their infections. If superbugs become the norm, the forms of medicine we know and love will have to adapt and they may not be able to keep up.

“I think superbugs are very dangerous,” said Brett Barrett, infectious disease specialist at Grand River Hospital and one of the speakers.

“It’s a bit like global warming. I think that it’s a problem that we underestimate at our peril. There are a million things that we do to keep people healthy and keep them alive that if antimicrobial resistance gets out of control, we will not be able to continue.”

According to Dr. Kelly Grindrod, assistant professor of pharmacy at the University of Waterloo, the development of superbugs is a natural part of evolution but it’s created an arms race pitted between medical science and harmful bacteria. Doctors and scientists are fighting tooth and nail to keep ahead but they have to compete harder each year because people are giving
the bacteria the tools to evolve faster.

It’s easy to forget to take antibiotics that are prescribed. It’s easy to stop taking antibiotics when people start to feel better rather than finishing the prescription. It’s easy to take antibiotics when you are sick with a cold or other virus. It’s easy to do these things but they’re exactly what makes the fight against bacteria harder and they need to stop according to Grindrod.

“Do we have (superbugs) in Waterloo? Absolutely, and some of them are quite nasty,” said Barrett. “We don’t have them probably as much as some of the teaching hospitals do. We absolutely don’t have them as much as India or Asia. (However,) I don’t think that we should feel like we’re in a protective bubble.”

Treating these resistant strains is a challenge for medical staff. The first and most effective antibiotic that doctors choose to treat a bacteria with is often the first that the bacteria becomes resistant to. This leaves doctors with a difficult challenge in treating the infections.

“For most of the bugs we’re talking about, we do have drugs that still work, excluding infections like extensively-resistant tuberculosis. The big problem is that compared to drugs that will work against the non-resistant bacteria, the other drugs won’t work as well. We use them because they’re all that will work but they still don’t work as well as the original ones. The other thing about them is they have a lot more side effects and are much more likely to be harmful and toxic to you. There are a few of those bugs where we have so few options we have to do crazy things like combination therapies that are just unheard of or we have to pull out drugs that we retired in the 1960s because they were so toxic. We’re giving you an antibiotic where the difference between it killing you and killing the bug is really small because we have nothing else that will treat your infection.”

It’s not all grim news though. Both Barrett and Grindrod have hopeful outlooks and offer very simple advice to make sure that we stay ahead of the bacteria.

“As a professor, if a student emails me and says I’m not going to be in class tomorrow because I’m really sick and I don’t want to make other people around me sick, I’m like ‘stay home!’” said Grindrod. “I absolutely support that. Don’t get an antibiotic if you have a virus, wash your hands and get your vaccines.”

Barrett said, “Try and be conscious of the fact that sometimes we think we need an antibiotic when we walk in the door (of the doctor’s office) … with a preconceived notion that you need antibiotics then the doctor has a good chance of giving them to you whether you actually need them or not. That was the biggest eye-opener for me preparing this talk. It never occurred to me that my preconceived notion is going to affect their prescribing.”

One of the things that both speakers covered with passion was how important it is to remember to take antibiotics following the prescription to the letter. Always take antibiotics on time and it’s important to make sure that the whole prescription is taken whether people feel better or not.

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