Overcoming Antibiotic Resistance

MANY MEDICATIONS HAVE unwanted side effects, although most subside once a patient completes the prescribed dosage. Unfortunately, this is not always the case when it comes to antibiotics. Once considered a “super drug,” antibiotics have been prescribed successfully for decades to treat all manner of bacterial infections. But for patients with chronic conditions requiring multiple, ongoing courses of antibiotics, a dangerous and lingering side effect can be resistance to those antibiotics, along with a host of opportunistic infections.

Antibiotic resistance occurs when antibiotics no longer work against disease-causing bacteria. These infections are difficult to treat and can mean longer-lasting illnesses, more doctor visits or extended hospital stays, and the need for more expensive and toxic medications. Some resistant infections can even cause death. Or in Rhode Island resident Betty Gordon’s case, symptoms can manifest as a series of life-hampering infections that simply never go away.

The Disease that Caused the Resistance

Betty suffers from primary immunodeficiency disease (PIDD), although this chronic illness went undiagnosed for decades. Sick off and on since age 4, Betty endured numerous bouts of sinusitis and pneumonia and had been on antibiotics for most of her adult life.

She finally was diagnosed with PIDD at the age of 57. “After a failed sinus surgery, I was correctly diagnosed with PIDD by my ENT, but I still had to argue with other doctors who simply did not believe I had an immune disease,” recalls Betty. “They said I didn’t seem sick enough, although I certainly felt sick enough.”

In the small community where Betty lives, she found it difficult to get the specialized healthcare she needed. Her quest eventually led her to see an immunologist in Boston who, since 2004, has taken her through a series of antibiotics trying to find the right fit. Her current regimen, which she started in 2011, seems to be working so far, says Betty. To manage her PIDD symptoms, Betty performs weekly subcutaneous infusions of immune globulin. For a while, says Betty, she felt pretty good, but gradually the years she’d spent on antibiotics treating the symptoms rather than the root of her illness began to take their toll.

On an Antibiotic Roller Coaster

“For the past three years, it seems I’ll be on an antibiotic that I’ve taken effectively forever and suddenly I can’t take anymore,” explains Betty “Macrobid was the first antibiotic that began giving me problems. While taking it I felt extremely tired and anxious. Next, my doctor prescribed Augmentin, and I reacted with horrible diarrhea, so we switched to Biaxin … and the list goes on.”

Like many people her age, Betty’s first introduction to antibiotics was penicillin, a drug she handled well until she developed a small rash during a course of treatment and was (incorrectly) diagnosed with a penicillin allergy. Feeling very much like a guinea pig, Betty says she has tried more antibiotics than she can name, and the recurring sinus and yeast infections are a constant reminder of the toll this regimen has taken on her body’s equilibrium.

According to the Centers for Disease Control and Prevention (CDC), antibiotic resistance is defined as the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply, causing more harm.

For Betty, who has seen dozens of doctors in her quest to feel better, a major frustration has not only been the trial-and-error approach to treatment, but what she views as a lack of collaboration within the healthcare system as a whole. “If I could make one suggestion to doctors, it’s that I wish that they would take the time to pick up the phone and check with other specialists on their patient’s healthcare team,” says Betty. “I know that can be time-consuming for a patient like me; I have a primary care doctor, an immunologist, an allergist and a hematologist. But if even a few of them had gotten together to develop a treatment plan, I might not be as sick as I am today.”

Taking Matters into Her Own Hands

For some antibiotic-resistant patients, lifestyle changes can help. Betty keeps a humidifier in her room, for example, to help treat the recurring sinus headaches. She also takes acidophilus supplements to ease the digestive distress she battles constantly. As far as diet, Betty avoids milk products and sticks to a very simple daily menu of protein, fruits and vegetables to try to ward off potential infections.

“As a PIDD patient, you want to avoid a hospital stay at all costs,” she explains. “No matter what I do, I have to plan my life carefully, because you just never know when you are going to be sick again. I live with some type of infection every day — it just never gets better.”