What is antibiotic resistance and how air pollution increases it; steps to prevent it

A recent study published in The Lancet Planetary Health Journal has concluded that rising air pollution is potentially linked with a higher risk of antibiotic resistance and the increase in air pollution levels could be coinciding with greater increase in antibiotic resistance in recent years. Antibiotic resistance has become a cause of concern in the past many years, and it can happen due to many reasons like taking over-the-counter antibiotics, not taking antibiotics for stipulated time, antibiotic resistant bacteria making its way through industrial waste among other things. One can be exposed to antibiotic resistant bacteria through water, soil or air or contact with animals.

What is antibiotic resistance

Many people are finding it difficult to recover from diseases like pneumonia, tuberculosis, gonorrhoea, and salmonellosis due to antibiotic resistance. Antibiotic resistance can happen due to misuse of antibiotics apart from other reasons. It is rapidly rising across the globe and needs to be dealt with urgently.

"Antibiotic resistance has become a real menace in the past decade or so which led to the emergence of super bugs that means bacteria which is not responding to any antibiotic. It happens because of our own mistakes. Most of the time it happens by taking antibiotics which are not sufficient in dosage or not taking antibiotics for the stipulated time. For example, if the patient has been advised to take antibiotics for 5 days but patient takes it only for 3-4 days once they start feeling better or taking just one tablet. Taking antibiotic when one is just having viral fever and then popping in any antibiotic pill from the chemist or something that is available in our houses," says Dr Bela Sharma, Additional Director of Internal Medicine at Fortis Memorial Research Institute, Gurugram.

How we make the bacteria stronger by misusing antibiotics

Dr Bela says it's like getting vaccine for disease and making ourselves immune to that particular disease.

"Most of us have this tendency to save money by not consulting a doctor rather going to nearby chemist and asking him for medicine for fever, loose motion etc. The chemist who is not a trained physician may give something from his own knowledge which will further strengthen the bacteria but will not be any useful to the person who is ingesting it. The antibiotic that has been given may not even be appropriate but will further make the bacteria resistant and stronger. Bacteria generally divide and multiply very quickly so the progeny of this bacteria is going to be resistant to that particular antibiotic also," says Dr Bela.

"We take live attenuated vaccines of the same bug. For example a number of diseases where we get vaccinated by taking a weakened virus or bacteria which is injected into our system so that our system gets familiar with that bacteria and kills it and becomes stronger so that when the same bacteria or virus attacks us our system is already recognizing it as an enemy and will be able to destroy it. Similarly the antibiotic we keep ingesting, the bacteria residing inside and around us, start ingesting that antibiotic in sub chemical doses or lower doses and they start getting immune to it so that when we actually have that disease and starts taking that antibiotic in proper dose the bacteria is already being exposed to it in sub chemical doses and has become resistant to it. Gradually one shifts onto higher or stronger antibiotic and the bacteria has already been exposed to it even taking a stronger antibiotic of the similar nature will not going to make much difference," she adds.

Antibiotic resistant bacteria are all around us in our environment, food, air and water and they may enter our system through breathing, ingestion or water and can cause infection like pneumonia, bronchitis, asthmatic issues, Hepatitis A, gastroenteritis, typhoid or other stomach related issues. Most of these bacteria have already been made resistant due to their exposure to antibiotics.

Pollution and antibiotic resistant bacteria connection

"Another issue that comes over here is that once the pollutant comes from the hospital or healthcare industry, in hospitals they have been exposed to other antibiotics also which may be very high ended antibiotics and if this waste gets mixed into the sewage. Industrial waste sometimes is also carrying antibiotics. Waste from the dairy farms is also carrying antibiotics because these animals are fed with antibiotics for their growth or to prevent infection. Sometimes indiscriminate use of antibiotics is done. These bacteria become antibiotic resistant, and they find their way into our system through air, water or food pollution and can cause infections which may become antibiotic resistant," says Dr Bela.

How to prevent the emergence of antibiotic resistant bacteria?

Popping antibiotics indiscriminately does not offer any solution and one must not ask their neighbours or chemist for over-the-counter medicine.

"Antibiotic is not an answer to all kinds of problems. If one has mild fever, it is better to take medicine for fever, if there is cold or cough then medicine for cold and cough not antibiotic because most of the time it may not need antibiotic but if it does not get better in 24 or 48 hours consult a doctor. Don’t take antibiotics unnecessarily. Please take antibiotics in prescribed dose and in specified number of days. Don’t save them up to distribute among your neighbours. Antibiotics should not be shared and should not be saved they need to be taken in proper dosage. Don’t take advice from anyone in order to take antibiotics just consult a doctor," advises Dr Bela.

Controlling pollution

In order to prevent air pollution, please check your vehicles regularly, do carpooling, don’t burn leaves and garbage. I’ve seen these piles of garbage in Gurgaon and whenever it rains all these garbage piles start floating on the roads which give rise to more of water pollutants. This water will find some place in the drinking water. When this pile of garbage is dry, it attracts all kinds of flies or cockroaches which find the way to our house causing more pollution. Fumes that rise from the piles where all kind of material is rotting all the time. So proper authority needs to look into this in Gurgaon and needs to be disposed off properly. Grow more trees, more vegetation, stop cutting down trees to make space for concrete jungles. We need more green, not grey, says Dr Bela.