Antibiotics and the Effects of Antimicrobial Resistance
Antimicrobial resistance—when bacteria develop a way to render antibiotics ineffective—has become a growing concern in the world of medicine over the last several decades. Pediatric infectious disease doctor Shannon Ross, M.D., explains the effects it can have and what parents need to know.
Featured Speaker:
Shannon Ross, MD, MSPH
Shannon Ross, M.D., M.S.P.H., is a professor of pediatrics and microbiology in the Division of Pediatric Infectious Diseases at the University of Alabama at Birmingham (UAB). Ross earned her medical degree from the University of Alabama School of Medicine. She completed her pediatric residency and pediatric infectious diseases fellowship at UAB. During her fellowship training, Ross also earned an MSPH in clinical research at the University of Alabama School of Public Health. She is the medical director of the Children’s of Alabama Antimicrobial Stewardship Program. Transcription:
Antibiotics and the Effects of Antimicrobial Resistance
Conan Gasque: Welcome to Inside Pediatrics, a Podcast brought to you by Children's Hospital of Alabama in Birmingham. I'm Conan Gasque. Our topic today is antimicrobial resistance. It's a big concern in the world of medicine these days, but we'll tell you what parents need to know about it and how it may affect their kids. I'm joined by Shannon Ross, a pediatric infectious disease doctor here at Children's of Alabama. Dr. Ross, thanks so much for your time today.
Dr. Shannon Ross: Thanks for having me.
Conan Gasque: So let's start by talking about antibiotics and what they are. I think most people have heard of them and have probably taken them at some point, but what exactly do they do?
Dr. Shannon Ross: So antibiotics are medicines that specifically treat bacterial infections. So they do not treat other types of infections. So they don't treat viruses or they don't treat other organisms, but they're specific for bacteria.
Conan Gasque: Pretty commonly prescribed, I guess?
Dr. Shannon Ross: Very commonly prescribed because children often do get some bacterial infections, right? So yes, they're a common medicine that's given to children.
Conan Gasque: So when we hear the phrase antimicrobial resistance, what does that mean?
Dr. Shannon Ross: So that means bacteria have developed a way, a mechanism by which makes the antibiotic not effective. It's not able to kill or stop the bacteria from growing. So this can due to a number of different mechanisms, you know, by the bacteria, but essentially the antibiotic does not work for the bacteria.
Conan Gasque: Sounds like a pretty big concern.
Dr. Shannon Ross: It is. It's a very big concern and a growing concern over the past several decades. It's becoming a larger problem.
Conan Gasque: What are some of the results of that? I mean, how, how dangerous is antimicrobial resistance?
Dr. Shannon Ross: So, I think what's important to understand is antibiotics are very essential to our health, anytime we need to get surgery or if a patient has cancer and needs to get chemotherapy, antibiotics are very important to all of what we do in healthcare. But as we have more and more resistance, antibiotics, you know, often don't work for those things that we need. But even for simple infections that we see, urinary tract infections, ear infections, pneumonias, bacteria have become increasingly resistant. One of the big problems is we only have a small. Sort of selection of antibiotics to use. And so as they become resistant, we have less and less options to treat infections when we actually really need them.
Conan Gasque: So are there any signs that a parent might need to watch out for, like let's say if their child is on an antibiotic that maybe the antibiotic is not effective?
Dr. Shannon Ross: Well, typically if you know a patient truly has a bacterial infection is on the appropriate antibiotic, the patient should get better over time. So for instance, if the patient has a bladder infection and is running fever and having urinary symptoms, over time, if the antibiotic is working it, the symptoms should get better. So when they don't, for instance, if the fever's not going away, if the bladder symptoms are continuing, that's sometimes alerts us that the antibiotic may not be effective. There could potentially be antibiotic resistance at play.
Conan Gasque: Who is at the biggest risk or, or is there a group that's at the biggest risk for complications related to antimicrobial resistance?
Dr. Shannon Ross: So typically children who are exposed to a lot of antibiotics tend to be those that are at risk for having an antibiotic resistant bacteria. So these are children who may have underlying complex medical conditions that require that they receive a lot of antibiotics. One concern, however, is that more and more we are seeing healthy children come in with infections due to antibiotic resistance. And this is because there's just a growing antibiotic resistance crisis out there. So some healthy children are coming in, for instance, with very resistant bacteria causing bladder infections. So even though certainly there are certain children at risk, it's becoming more and more of a problem for everybody.
Conan Gasque: Any specific advice that, that parents need to know about this, and how it might affect their child?
Dr. Shannon Ross: Sure. I think parents can play a big role in helping to sort of slow down this process of this antimicrobial resistance process. First off, I think the important thing is we only want to give antibiotics if they're necessary because when we give unnecessary antibiotic, Inappropriate use of antibiotics, that's what drives this resistance. So parents really only need to get the antibiotics for their child when they're necessary. So the doctor, the child's pediatrician should determine when an antibiotic is necessary.
So I always tell parents if your doctor didn't give an antibiotic, there's probably not a reason and there's no need to ask for it. Certainly you can ask questions from your pediatrician, but we don't wanna give them unnecessarily for colds and things of that nature. So don't necessarily ask your doctor when they haven't prescribed it. However, if your doctor has prescribed an antibiotic, it's very important to take it as prescribed. So you wanna take it for the length of time it's prescribed.
You know, don't stop the course shorter than it should be. The other issue is never, never take anybody else's antibiotics. Don't take that antibiotic sitting on a shelf. That was someone else in the family. That is one thing that really can drive antibiotic resistance because it may not work against the issue that you're having. So the antibiotics really only need to come from a physician who's seen the patient.
Conan Gasque: So just so people understand it, you know, antibiotics, they serve a specific purpose, but they don't fight everything across the board. Correct?
Dr. Shannon Ross: Correct. So in children, most of the time when children get sick, It's caused by a virus. So certainly this time of year in the winter, we see lots of viruses, we see cold viruses, we see flu. Right now we're seeing a lot of RSV. These are viruses that antibiotics do not work against, and I think that's important to realize that antibiotics serve that certain purpose. So again, unless you have a specific bacterial infection, antibiotics are not gonna work against your common cold or your common flu.
Conan Gasque: Do you feel like just general good health practices, good hygiene practices, Prevent some of the effects of antimicrobial resistance just by people washing their hands and doing things like that?
Dr. Shannon Ross: Absolutely. So we all know that doing those health hygiene things prevent infections in general. So we wash our hands, we cover our mouth when we knee and cough with our elbow. All those things are important to get any types of infections. But again, if we're not getting these infections and we're not exposed to antibiotics, that does help slow down the spread of resistance and the development of resistance.
Conan Gasque: So certainly antimicrobial resistance is a big concern in the medical world, but there are things parents can do to protect their children. Once again, Dr. Shannon Ross with advice for parents on antimicrobial resistance. Dr. Ross, thanks for your time.
Dr. Shannon Ross: Thank you for having me.
Conan Gasque: Thanks for listening to Inside Pediatrics. You can find more podcasts like this one at children'sal.org/insidepediatrics.
Antibiotics and the Effects of Antimicrobial Resistance
Conan Gasque: Welcome to Inside Pediatrics, a Podcast brought to you by Children's Hospital of Alabama in Birmingham. I'm Conan Gasque. Our topic today is antimicrobial resistance. It's a big concern in the world of medicine these days, but we'll tell you what parents need to know about it and how it may affect their kids. I'm joined by Shannon Ross, a pediatric infectious disease doctor here at Children's of Alabama. Dr. Ross, thanks so much for your time today.
Dr. Shannon Ross: Thanks for having me.
Conan Gasque: So let's start by talking about antibiotics and what they are. I think most people have heard of them and have probably taken them at some point, but what exactly do they do?
Dr. Shannon Ross: So antibiotics are medicines that specifically treat bacterial infections. So they do not treat other types of infections. So they don't treat viruses or they don't treat other organisms, but they're specific for bacteria.
Conan Gasque: Pretty commonly prescribed, I guess?
Dr. Shannon Ross: Very commonly prescribed because children often do get some bacterial infections, right? So yes, they're a common medicine that's given to children.
Conan Gasque: So when we hear the phrase antimicrobial resistance, what does that mean?
Dr. Shannon Ross: So that means bacteria have developed a way, a mechanism by which makes the antibiotic not effective. It's not able to kill or stop the bacteria from growing. So this can due to a number of different mechanisms, you know, by the bacteria, but essentially the antibiotic does not work for the bacteria.
Conan Gasque: Sounds like a pretty big concern.
Dr. Shannon Ross: It is. It's a very big concern and a growing concern over the past several decades. It's becoming a larger problem.
Conan Gasque: What are some of the results of that? I mean, how, how dangerous is antimicrobial resistance?
Dr. Shannon Ross: So, I think what's important to understand is antibiotics are very essential to our health, anytime we need to get surgery or if a patient has cancer and needs to get chemotherapy, antibiotics are very important to all of what we do in healthcare. But as we have more and more resistance, antibiotics, you know, often don't work for those things that we need. But even for simple infections that we see, urinary tract infections, ear infections, pneumonias, bacteria have become increasingly resistant. One of the big problems is we only have a small. Sort of selection of antibiotics to use. And so as they become resistant, we have less and less options to treat infections when we actually really need them.
Conan Gasque: So are there any signs that a parent might need to watch out for, like let's say if their child is on an antibiotic that maybe the antibiotic is not effective?
Dr. Shannon Ross: Well, typically if you know a patient truly has a bacterial infection is on the appropriate antibiotic, the patient should get better over time. So for instance, if the patient has a bladder infection and is running fever and having urinary symptoms, over time, if the antibiotic is working it, the symptoms should get better. So when they don't, for instance, if the fever's not going away, if the bladder symptoms are continuing, that's sometimes alerts us that the antibiotic may not be effective. There could potentially be antibiotic resistance at play.
Conan Gasque: Who is at the biggest risk or, or is there a group that's at the biggest risk for complications related to antimicrobial resistance?
Dr. Shannon Ross: So typically children who are exposed to a lot of antibiotics tend to be those that are at risk for having an antibiotic resistant bacteria. So these are children who may have underlying complex medical conditions that require that they receive a lot of antibiotics. One concern, however, is that more and more we are seeing healthy children come in with infections due to antibiotic resistance. And this is because there's just a growing antibiotic resistance crisis out there. So some healthy children are coming in, for instance, with very resistant bacteria causing bladder infections. So even though certainly there are certain children at risk, it's becoming more and more of a problem for everybody.
Conan Gasque: Any specific advice that, that parents need to know about this, and how it might affect their child?
Dr. Shannon Ross: Sure. I think parents can play a big role in helping to sort of slow down this process of this antimicrobial resistance process. First off, I think the important thing is we only want to give antibiotics if they're necessary because when we give unnecessary antibiotic, Inappropriate use of antibiotics, that's what drives this resistance. So parents really only need to get the antibiotics for their child when they're necessary. So the doctor, the child's pediatrician should determine when an antibiotic is necessary.
So I always tell parents if your doctor didn't give an antibiotic, there's probably not a reason and there's no need to ask for it. Certainly you can ask questions from your pediatrician, but we don't wanna give them unnecessarily for colds and things of that nature. So don't necessarily ask your doctor when they haven't prescribed it. However, if your doctor has prescribed an antibiotic, it's very important to take it as prescribed. So you wanna take it for the length of time it's prescribed.
You know, don't stop the course shorter than it should be. The other issue is never, never take anybody else's antibiotics. Don't take that antibiotic sitting on a shelf. That was someone else in the family. That is one thing that really can drive antibiotic resistance because it may not work against the issue that you're having. So the antibiotics really only need to come from a physician who's seen the patient.
Conan Gasque: So just so people understand it, you know, antibiotics, they serve a specific purpose, but they don't fight everything across the board. Correct?
Dr. Shannon Ross: Correct. So in children, most of the time when children get sick, It's caused by a virus. So certainly this time of year in the winter, we see lots of viruses, we see cold viruses, we see flu. Right now we're seeing a lot of RSV. These are viruses that antibiotics do not work against, and I think that's important to realize that antibiotics serve that certain purpose. So again, unless you have a specific bacterial infection, antibiotics are not gonna work against your common cold or your common flu.
Conan Gasque: Do you feel like just general good health practices, good hygiene practices, Prevent some of the effects of antimicrobial resistance just by people washing their hands and doing things like that?
Dr. Shannon Ross: Absolutely. So we all know that doing those health hygiene things prevent infections in general. So we wash our hands, we cover our mouth when we knee and cough with our elbow. All those things are important to get any types of infections. But again, if we're not getting these infections and we're not exposed to antibiotics, that does help slow down the spread of resistance and the development of resistance.
Conan Gasque: So certainly antimicrobial resistance is a big concern in the medical world, but there are things parents can do to protect their children. Once again, Dr. Shannon Ross with advice for parents on antimicrobial resistance. Dr. Ross, thanks for your time.
Dr. Shannon Ross: Thank you for having me.
Conan Gasque: Thanks for listening to Inside Pediatrics. You can find more podcasts like this one at children'sal.org/insidepediatrics.