Why are antibiotics becoming less and less effective?
Antibiotics are becoming less effective because bacteria naturally possess protective mechanisms and eighty years of intensive use has greatly accelerated their spread. Use antibiotics only when truly necessary, and always complete the full course to limit the selection of resistant bacteria.
Resistant bacteria are not a recent problem. Antibiotics have existed for hundreds of millions of years as natural substances produced by micro-organisms, and in that time bacteria have already developed protective mechanisms. Human use over the past eighty years has enormously accelerated the spread of that resistance, but the foundation was already there.
How does that acceleration process work? Every time an antibiotic is used, the bacterium that happens to be better able to withstand it survives. That bacterium multiplies, and resistance increases. Researchers call this selective pressure. Overuse, misuse and overly liberal use in both humans and animals amplify that pressure. The result: resistant 'superbugs' are now commonplace in many countries.
Bacteria have four ways of outsmarting antibiotics. They can alter the target site so that the drug no longer fits. They actively pump the antibiotic out through pump mechanisms in the cell wall. They produce enzymes that break down the antibiotic, such as the enzyme that neutralises penicillin. And they make their outer layer less permeable. On top of that, they can sometimes form a slime layer inside which antibiotics have an even harder time getting through.
Particularly problematic is the fact that bacteria can pass resistance genes directly to one another, including to other species. This happens quickly and does not stop at national borders. Resistance genes are now turning up in aircraft wastewater, the faeces of migratory birds and ocean areas, so the spread occurs through all kinds of environmental routes. The WHO has designated six groups of bacteria as top priorities, including MRSA and Klebsiella pneumoniae, because infections caused by them are becoming increasingly difficult to treat.
Antibiotics also have a side effect that hits closer to home: they disrupt the body's own gut flora. Beneficial bacteria disappear along with the harmful ones. This can lead to diarrhoea, and with repeated use to persistent infections with a bacterium called Clostridioides difficile. There are also indications that early exposure in young children is associated with gastrointestinal and immune problems, although the causality for this is less certain.
All claims are based on reviews (no randomised trials or meta-analyses). The mechanisms of resistance are well described and widely supported; the role of environmental spread (migratory birds, wastewater) is associative and less well quantified. The side effects in children have not yet been causally confirmed.
What are the symptoms of an underactive thyroid?
An underactive thyroid produces vague complaints such as fatigue, weight gain and cold intolerance, but the diagnosis can only be made through a blood test. If you have recognised several complaints for a while, discuss them with your general practitioner.
What actually helps with chronic lower back pain?
Strength and stabilisation exercises have the strongest evidence base for chronic lower back pain. If those do not help enough, pain relievers that also reduce inflammation are the first step. Opioids and surgery can almost always be avoided.
Does milk really help against heartburn?
Milk has a brief suppressive effect on stomach acid. For persistent symptoms, common antacid medicines work considerably better.
How harmful are microplastics in your body to your health?
Microplastics demonstrably accumulate in your organs and are associated with signs of inflammation and reduced sperm quality. How harmful that actually is, we do not yet know.
Is eating a lot of protein bad for your kidneys?
For healthy people, kidney damage from eating a lot of protein has not been demonstrated. If you already have kidney disease, the amount and type of protein matter: discuss this with your doctor or dietitian.
Do your eyes age faster than the rest of your body?
The lens of the eye ages noticeably early and quickly, but whether your eyes as a whole age faster than the rest of your body has not been demonstrated. The retina actually reveals a great deal about your overall health, so the two track more closely together than you might think.