Protect your family from antibiotic resistance: germs are becoming less susceptible to antibiotic treatment. Here's how you can fight back.

Last year when Meredith started getting symptoms of a sinus infection, this 44-year-old teacher and busy mother of three opted to call her doctor's office and describe the symptoms to the nurse instead of going in for an evaluation. After speaking with the doctor, the nurse called in a prescription for antibiotics to the local pharmacy. A few months later when Marilyn was preparing for a family's vacation, she again called the nurse and asked for several refills of the antibiotic "in case she became ill."

Meredith did become ill and stayed on the antibiotics for four weeks, yet her dry cough and discolored mucus seemed to worsen. She also had a low-grade fever and body aches, and was extremely fatigued upon little exertion. Her pulse was fast, and she had lost weight. Meredith's husband convinced her to see her doctor, who diagnosed her with pneumonia and immediately admitted her to the hospital. Meredith was in the hospital on IV antibiotics (two different ones) for more than three weeks before the pneumonia was resolved.

Today, while Meredith no longer harbors the bacterial infection, she is very susceptible to a relapse. Her immune system is still weak, forcing her to take a leave from teaching--all because of antibiotic misuse and bacteria that was resistant to treatment.

While it may seem puzzling that antibiotics could actually increase your risk of a life-threatening illness, as it did with Meredith, the problem of antibiotic resistance is becoming increasingly commonplace and threatens the lives of millions around the world. Consider that in 1941, 40,000 units of penicillin a day would cure a patient with pneumonia in just four days. Today that person may receive 24 million units of penicillin a day and still die. And even with the strongest antibiotics available, infectious diseases are a leading cause of death worldwide and the third leading overall cause of death in the United States.

The Alarming Resistance Process

It's easy to become confused about antibacterial resistance. And while many people believe that the body becomes resistant to the specific antibiotic, this is not true. It is the germs that become resistant to the drug, making it difficult--if not impossible--to treat the illness and end the bacterial infection. This type of resistance can occur in any type of germ, and exactly how germs become resistant is an incredible process.

According to the Centers for Disease Control, antibiotic resistance happens when microbes develop ways to survive the use of medicines meant to kill or weaken them. If a microbe is resistant to many drugs, treating the infections it causes can become difficult or even impossible. For instance, strains of resistant staph infections, which have become prevalent in hospitals, are now appearing in nonhospital settings, and several strains of this bacteria are becoming resistant to vancornycin, one of the most powerful antibiotics in our modern medical arsenal. Added to this is the fact that routine illnesses such as strep throat, cystitis, sinusitis, bronchitis, and ear infections are becoming much more persistent and difficult to treat.

Germs become resistant to antibiotic medications for different reasons. Sometimes this happens when you take antibiotics too frequently or take them for other illnesses for which they are not indicated. Then when you get a resistant infection, you can pass that same infection on to another person. In this manner, an illness that is resistant to antibiotic treatment can spread from person to person until you have an epidemic that can lead to serious illness, disability, or even deaths. Although resistant germs are prevalent everywhere, they have a higher incidence in places where people have close contact--hospital rooms for the chronically ill, nursing homes, crowded day-care centers, compact military quarters, and even on the streets among the homeless.

Making Peace With Germs

While germs are all over the place--in your body, on your body, and on everything around you--most assist in shielding you from infection as they restrain the duplication of pathogenic bacteria, those antagonistic microorganisms that make you ill and tear down your body's tissues. When you do get a bacterial infection, there's no doubt that antibiotics are miracle drugs. But where do you draw the line? While antibiotics can treat bacterial infections, many times they are used inappropriately simply because a patient demands the medication. Sometimes a doctor may "guess" which type of antibiotic to give without culturing the germ to find out the exact drug that can kill it. And when you consider that more than 12 million antibiotic prescriptions given to adults in the United States in 1992 were for upper respiratory tract infections and bronchitis--on which these drugs have little or no effect--you have to be alarmed!

Antibiotic Awareness

As with any threat to your health or well-being, knowledge is part of the solution when it comes to antibiotic resistance. There are also self-help strategies you can take to protect yourself and your family:

1. First, talk openly and knowledgeably with your doctor about antibiotic resistance, and do not demand antibiotics if you are ill. Your doctor will try to determine if you have a bacterial infection or a virus and should prescribe antibiotics only if necessary.

2. When your doctor prescribes antibiotics, use them exactly as prescribed. Finish all of the prescription, as instructed, even if you are improved in a few days. Do not save leftover pills "just in case" you or a family member might get sick later on.

3. Discard any remaining pills in a way so that others (particularly children) cannot get access to them. And do not give your antibiotics to anyone else. Likewise, do not take someone else's medication.

Disease Prevention

Along with knowing when to take--or not to take--antibiotics, it's vital to build your body's natural defense against infection. When our immune system falters, we battle the resulting lifestyle ailments, such as frequent viral infections, sore throats, colds, skin problems, and allergies, as well as bacterial infections. Yet if you can focus on changing lifestyle habits, including using self-care to treat an illness early on, your prevention measures may help to keep you well so you can avoid antibiotics altogether. Try the following stay-well strategies:

Get immunized. Because epidemics of influenza are responsible for an average of approximately 20,000 deaths per year in the United States, ask your doctor about an annual flu vaccination. While the flu is a viral infection (meaning antibiotics cannot cure it), you can get a secondary infection, such as pneumonia, or it can worsen chronic health problems, such as heart or lung disease. While the flu shot is no guarantee against the flu, it can help to lessen the symptoms if you do get it. Also, ask your doctor about the pneumovac (pneumococcal vaccine) to see if this may reduce your chances of getting pneumonia. Make sure you and your family are all current on the recommended immunizations.

Know if you are at higher risk for infection. While a cold virus may leave most of us feeling bad for a week, we usually get well without treatment. Yet there are some people who are at higher risk of infection and should talk to the doctor at the start of any illness.

Also, if you care for a high-risk person, such as an elderly parent or newborn baby, or work with people who are at high-risk for infection, take greater precautions to stay well, including getting the influenza shot each year.

Keep your house disinfected. Many preventable germs are harboring in your kitchen sink, your bathroom (particularly on the toilet seat and faucet handles), door knobs, the computer keyboard, and the family telephone. While you don't want to become obsessed with cleaning, make sure that you disinfect your kitchen and bathrooms frequently. A disinfectant is a chemical used to destroy germs, and a homemade solution of household bleach and water is one of the most effective disinfectants. The recommended strength is one tablespoon of bleach in one quart of water, or mix one-fourth cup of bleach in 1 gallon of water. (After applying, let it air-dry or use disposable paper towels to wipe.)

As well as using this solution on the kitchen sink, countertops, refrigerator, and floor, use it in your bathroom and in the baby's nursery to wipe down changing tables, and wipe the telephone receiver, doorknobs, and your child's toys. Especially when someone in the family is ill, keeping your home disinfected is a good way to avoid spreading the germs to other members.

Eat plenty of fresh fruits and vegetables. Eating a well-balanced diet of fresh fruits and vegetables high in antioxidants and phytochemicals can help to maintain immune function. An antioxidant is a super nutrient that helps to repair cell damage and is vital to the body's resistance to infection. Phytochemicals are biologically active substances that give plants their color, flavor, odor, and protection against plant disease. Some phytochemicals work as potent antioxidants. Be sure to also have sufficient protein and caloric intake. (An average adult needs 45 to 55 grams of protein each day.)

Eat a varied diet. A variety of vitamins and minerals work together so you can be disease-flee. For instance, vitamin E may be aggressive against viral infections and respiratory illness, while zinc fights against agents such as fungi, parasites, and viruses. Although the individual properties and functions of each nutrient are important, it is the sum of their combined effort that helps to protect and strengthen the immune system.

Stay well hydrated. Staying well hydrated with plenty of water intake throughout the day is important to detoxify the body, helping to eliminate any impurities.

Get healing sleep. Make sure you get eight hours of sleep each night. Getting enough deep sleep will allow your body tissues to rejuvenate and boost immune function. When you feel a cold coming or are feeling rundown, plan periodic rest times throughout the day to give your body a chance to regain strength.

Get plenty of exercise. During exercise, your white blood cells start to increase in number. After your workout, the number or the aggressiveness of certain immune cells such as natural killer (NK) cells increases by as much as 50 to 300 percent. When you work out consistently at a moderate pace (not high intensity), your immune system becomes a powerful weapon against viral and bacterial infections.

Chill! Avoid stressful situations, as stress wreaks havoc with hormones and may lower your immune defenses. Learn how to work periods of "time-out" or relaxation in to your daily routine to ease tension and give your body time to recover.

Wash your hands frequently. While germs can be transferred through the air, ingestion, or bodily fluids, one of the biggest transportation centers for germs is your hands. However, frequent hand washing can prevent the spread of some diseases, especially if a family member has a cold or flu virus. Be sure to wash thoroughly with soap and warm water--for at least 20 seconds each time--and teach your children to do the same.

An interesting program called Operation Stop Cough was implemented at a recruit training command center in Illinois. As part of this program, recruits were instructed to wash their hands at least five times a day. After two years, the hand-washing team reported 45 percent fewer cases of respiratory ailments compared with the weekly rates of illness among recruits during the year before Operation Stop Cough started. Consider implementing a similar program in your home!

Practice prevention. You can prevent serious illnesses with regular medical checkups. Early detection and treatment work best and help you to avoid more serious health problems later on, when medication is not as effective.

Among those who should use extra caution to avoid getting sick are:

* people over age 65;

* residents of nursing homes or long-term-care facilities;

* adults and children with chronic disorders of the pulmonary or cardiovascular systems, including asthma;

* adults and children who have chronic metabolic diseases (including diabetes mellitus), renal dysfunction, or other compromised immune function problems;

* pregnant women; and

* premature infants and newborns.

Debra Fulghum Bruce writes on health issues from Atlanta, Georgia.