00:01
Hi, and welcome to our video, an
Introduction to Antibiotics.
00:05
Okay. When it comes down to antibiotics,
it's us against them. And by
"them," I mean bacteria.
00:13
So that's what we're going to talk about, how
do we win the war against infection?
Now, antibiotics are medications that
are used to treat bacterial infections.
00:24
Yeah. Let me say that again.
00:26
Antibiotics are medications used
to treat bacterial infections.
00:32
Viruses cannot be treated with antibiotics.
00:36
Now, every time we go to the doctor,
people usually want to leave
with some type of medication,
but it's really important
that only bacterial infections
are treated with antibiotics,
not viruses. Now, here's why.
00:49
You're going to see this ginormous
chart come up to review,
and I've listed the common reasons
people go to the doctor.
00:56
But I want you to see which one are viruses
and you'll notice in that far column,
does an antibiotic needed? It's colored
red and the word is "No."
So a cold or a runny nose, no.
Antibiotic is inappropriate.
01:10
A bronchitis, no. The flu, no.
01:14
A sore throat, except strep throat, no.
01:17
And fluid in the middle ear,
like otitis media,
the answer is still no.
01:22
Now let's talk about why that is
such a big deal, but first,
I want to show you lots of examples of
bacterial infections that we do treat
with antibiotics. In fact,
I've listed so many of them for
you, it's going to take
2 slides for you to see them.
01:38
I'm not expecting you to race through all
these names, but spend a minute, pause,
and see which one of these you've heard.
01:45
Put a small checkmark or circle the
bugs that you're familiar with.
01:52
Ready for the second slide?
Okay. Now let's talk about
antibiotic resistance.
02:04
That's why it is so important
that we only treat bacterial infections
with antibiotics because
if we misuse or overuse antibiotics,
these bacteria are pretty smart.
02:16
They can develop the ability to defeat
the drugs we designed to kill them,
and we've seen it happen
over and over again.
02:24
So, the number 1 reason we want
to appropriately use antibiotics,
only treat infections
that should be treated with antibiotics --
they have to be bacterial --
is because if we misuse that, if we treat
viruses with antibiotics, if we
overuse antibiotics,
these antibiotics are going
to develop a resistance.
02:45
So that means we're going to
start giving the drugs
and the bugs know how to defeat that.
02:50
So let's walk through that. So how
does antibiotic resistance happen?
Well, the term "antibiotic resistance" means
you've got an infection that becomes
very, very difficult to treat.
03:01
When you're in your clinical rotations,
2 that you are likely to see
are VRE and MRSA.
03:09
Now, VRE stands for Vancomycin
Resistant Enterococcus.
03:14
Yeah, that is a mouthful, isn't it?
So vancomycin is the drug.
03:20
Resistant Enterococcus means
we used to be able to treat
the bug, Enterococcus, with vancomycin,
but now it's become resistant.
03:30
Methicillin-resistant Staphylococcus
Aureus, or we also call that MRSA,
that means that that is the
bug, staphylococcus,
that is now resistant to methicillin.
03:40
So MRSA and VRE are 2 really strong bugs
that have become resistant to the
drugs that used to treat them.
03:50
Well, let's talk about kind of
how does that happen?
Now, they've made a really
cool drawing for you.
03:55
I love what they did with this drawing
because it will really help you understand.
03:58
First of all, look at the colors
of the circles.
04:01
There's green and it kind of
progresses to a red color.
04:04
That means that the bugs themselves are
getting increasingly resistant to drugs.
04:09
So see how that happens? You start
with just kind of all variety,
and they give you an antibiotic--
You come in with an infection,
you receive an antibiotic, and
then the antibiotic
kills the non-resistant bacteria.
04:22
So we're moving from the gentleman
in 1 to number 2.
04:25
Well, now that we've killed the
non-resistant bacteria,
the resistant bacteria like having a party
because now they start to multiply.
04:35
Then that person spreads and
infect -- a new person
spreads that resistant bug to the
next person, and now it's got --
the antibiotics fail to kill
the resistant bacteria.
04:47
So, using those steps, 1, 2, 3, 4, and 5,
that shows you how you go
from having an infection,
using an antibiotic, and how it can sometimes
turn into antibiotic resistance.
05:01
Okay. Now I don't want to trip you out,
but microorganisms, really, are everywhere.
05:06
I remember when I was in college, we used
to share toothbrushes and drinks.
05:11
1 microbiology course cured
me of those practices.
05:14
I don't drink after other people
and I definitely don't share
a toothbrush anymore
because microorganisms are everywhere.
05:22
I try not to think about it when I'm pumping
gas or using an ATM machine,
because I know that those are
really crazy places for bugs.
05:30
And especially, try not to think
about it when I'm at the gym
because I know what happens there,
but that's a healthy habit, anyway.
05:37
But let's look at the microorganisms
that are everywhere because
bacteria, like we said, are everywhere:
in the air, in the ground, in the water,
and they're inside our body
and definitely on our skin.
05:49
Now, not all bacteria are
bad, but they multiply
very rapidly under favorable conditions.
05:55
So remember, our body temperature
is about 98.6 Fahrenheit.
05:59
That's pretty warm, and bacteria do very
well at that temperature. They thrive.
06:05
Now, bacteria can be either really good,
or really bad, or kind of innocuous.
They're not a big deal at all,
so they can either help us
or really hurt us,
or just kind of not bother us at all. We've
got them all the way across the spectrum.
06:21
So, as we're entering into this
discussion about antibiotics
and how we treat infection,
keep in mind, it's impossible to
avoid bacteria completely.
06:30
They are everywhere. Some of
them are fantastic for us.
06:34
Some of them are fantastically harmful
to us, but they are everywhere.
06:38
So, what do we do? I mean, how --
Let's first talk about the good stuff.
06:42
Let's talk about how they can be
beneficial to the body.
06:45
Well, E. coli, these are in the gut
and they help with digestion.
06:49
So, E. coli in the GI tract,
that's really good. We want it in the gut.
06:54
That helps us synthesize vitamin K.
06:57
They can also prevent harmful
bacteria from taking hold
because when I have bacteria that
are good for me, like E. coli,
they're taking up some real estate, they're
taking up some space and the nutrients that
the harmful bacteria need.
07:10
See, that was the problem. Sometimes,
when we kill the resistant bacteria,
that's how the other resistant
bacteria kick in.
07:17
So, how do the good bacteria help us?
They take up resources and space to prevent
those resistant organisms from taking over.
07:26
Now, how can I defend myself
against infection?
Well, we're gonna talk about
the physical barriers first.
07:33
Okay, so if my skin stays intact,
that's a really good thing.
07:37
That's one of the great benefits of skin.
07:40
As long as it's not broken, it helps
keep out a lot of nasty bugs.
07:44
I also have that cilia, right, in
my respiratory mucosa.
07:48
They catch things and they can dump
them down into your stomach.
07:50
That's a really good deal,
because the gastric acid in my stomach
will usually kill those bacteria.
07:58
So the first 2 host defenses
we're talking about
are physical barriers, like
my skin and the cilia,
and the physiological defenses, like
the gastric acid in my stomach.
08:09
Now I've got a killer immune
response. If I'm a healthy,
functioning immune system,
they do some really
awesome stuff because the antibodies
recognize that bacteria and
they mark it for destruction.
08:22
Then the white blood cells get involved --
They come racing in, they're phagocytic --
that's a cool sounding word, right?
Macrophages and the neutrophils,
because the antibodies mark the
bacteria, they make it a target,
and the white blood cells know to
rush in and to take care of them.