At least 2 million people a year get a serious infection from bacteria that is resistant to one or more antibiotics. Each year, at least 23,000 people die as a direct result of antibiotic-resistant infections. The extra cost of treating antibiotic-resistant infections is more than $70 billion annually.

Antibiotic resistance occurs when germs no longer respond to the drugs designed to kill them. It is one of the deadliest public health threats facing the United States, according to the Centers for Disease Control and Prevention (CDC). The more antibiotics are used, the less likely they will be effective in the future. Antibiotic resistance threatens every person and could reduce our access to modern medical advances: cardiac bypass, dialysis, joint replacement, transplants, cancer therapy and treatment for many chronic diseases.

The best way to protect yourself against this growing health threat is to learn the facts. Take this TRUE/FALSE quiz to improve your awareness about overusing antibiotics.

1. Simply using antibiotics creates resistance.

True___      False___

When you take an antibiotic or even use antibacterial soap or hand cleaners, bacteria are killed. But resistant germs may be left to grow, multiply and cause more illness. Since antibiotics were first introduced in the 1940s, bacteria have shown a relentless ability to become resistant to every antibiotic. Some bacteria can change every 40 minutes. This one is true. Arkansas has one of the highest antibiotic-prescribing rates in the country. In 2010, there were 996-1,237 antibiotic prescriptions per 1,000 people of all ages in Arkansas. That’s twice the rate of prescriptions in California, Colorado, Oregon or Vermont.

 2. Antibiotics are powerless against virus infections.

True___      False___

True. Antibiotics cannot kill a virus, only bacteria. Don’t ask your doctor to prescribe an antibiotic for the common cold, flu, bronchitis, and most coughs and sore throats. These are caused by viruses. Besides not helping you get better, taking antibiotics when you have a bacteria-caused infection leads to weaker antibiotics, more diseases that are resistant to antibiotics and fewer effective antibiotics. You’ll be more likely to develop a resistant infection in the future. In addition to bacteria, many fungi, viruses and parasites can no longer be stopped by antibiotics.

3. If one antibiotic doesn’t work there’s another one that will kill the infection.

True___      False___

We can no longer count on this to be true. There may not be one that is effective. When first- and second-line antibiotics are limited by resistance or are unavailable, your doctor must use third- or fourth-line antibiotics. They are more toxic, less effective and frequently more expensive. Several key antibiotics are already useless for specific infections such as pneumonia or staph. According to Lauri Hicks, medical director of the CDC, “We should be thinking of antibiotics not as a magic bullet, but as a precious resource that we should only use when absolutely necessary.” Patients with resistant infections are much more likely to die. If they survive, they have significantly longer hospital stays, delayed recovery and are more likely to have long-term disability. Treatment costs double for infections that are resistant to antibiotics.

4. Antibiotics are the only medicines that have no bad side effects.

 True___      False___

Antibiotics are responsible for 20 percent of emergency department (ED) visits for adverse drug events; they are the most common cause of ED visits for adverse drug events in children. Antibiotics can cause side effects including allergic reactions and a potentially deadly diarrhea that causes 14,000 deaths a year. They can interfere with other drugs you’re taking for another condition. This one is definitely false.

5. If you’re prescribed an antibiotic, there’s a 50-50 chance it won’t help you.

True___  False___

At least half of all antibiotics prescribed are not needed and/or not effective as prescribed. This question is true. Overprescribing, prescribing antibiotics when they cannot help and prescribing the wrong antibiotic are three main causes of antibiotic-resistance. Always ask your health care provider if there is a way to confirm if your infection is caused by bacteria, like a strep test. If appropriate, laboratory tests can help confirm if bacteria are causing your infection. Even though antibiotics are powerless to fight viruses, many patients ask for an antibiotic prescription when they visit their doctor, believing the false notion that an antibiotic “can’t hurt.”

6. Antibiotic resistance is present in our foods, our pets and in the environment.

True___   False___

Food-producing animals are routinely given antibiotics to promote growth and prevent illness, even when they’re not sick. This is a prime contributor to antibiotic resistance in humans. The U.S. Food and Drug Administration says there are more antibiotics sold in the United States for food-producing animals than for humans. This contributes to the emergence of antibiotic-resistant bacteria in food-producing animals. People can develop antibiotic-resistant infections by eating the meat or poultry from animals that carry resistant bacteria. There are several other direct routes through which people can get resistant bacteria from healthy animals or the environment. These include: improper handing or eating under-cooked or contaminated meat, poultry, fish or shellfish; contact with infected farm workers or meat processors or anyone they come in contact with; drinking contaminated water; contact with air that is vented from concentrated animal housing or released during animal transport. This one is true.

7. The drug industry is concentrating on developing new antibiotics to use on resistant bacteria.

True___   False___

Not true. The number of new antibiotics developed and available has steadily decreased in the past 30 years. Only eight antibiotics have been approved since 2000. Each of them is already experiencing some degree of resistance. There’s very little chance of making a profit on a new antibiotic. It is extremely expensive and takes many years to develop and get a new drug approved for use. The failure rate for antibiotics, from discovery to drug approval, is 97 percent. Because hospitals tightly control new antibiotics so they can prevent the emergence of newly resistant strains of bacteria, new antibiotics are less profitable than other types of drugs. The industry cannot charge more for the new drugs to compensate for slow adoption because they are competing against older and less expensive generic antibiotics.

8. Antibiotic resistance cannot be stopped.

True___   False___

Resistance can be slowed, but it’s true that resistance cannot be stopped. Resistance occurs as part of the natural process in which bacteria evolve. However, stopping even some of the unnecessary or ineffective prescribing and use of antibiotics will help slow bacteria’s evolutionary process and the spread of resistant bacteria.

9. The best way to fight antibiotic resistance is to prevent infections from happening in the first place.

True___   False___

Very true! Prevention reduces the likelihood that antibiotics will be needed and that resistance will develop and spread. Other ways to prevent infections include:

  • Washing hands frequently.
  • Keeping up with your immunizations, including an annual flu shot, children’s immunizations, tetanus boosters every 10 years, and, if you are older, a shingles shot and two pneumonia shots.
  • Practicing safe food handling and preparation. Use hot water and soap to keep your kitchen counters, cabinets, utensils and cutting boards clean before, during and after food preparation. Avoid antibacterial cleaners.
  • Taking antibiotics exactly as directed. Do not skip doses and take all the pills even if you start feeling better. Stopping too soon will let bacteria survive and re-infect. Never take antibiotics prescribed for someone else. The wrong antibiotic can delay correct treatment and give more time for bacteria to multiply.
  • Asking for a laboratory culture so your doctor can accurately prescribe what will help, not harm you. If prescribed an antibiotic, be sure your doctor reassesses the effectiveness of it after 48-72 hours. If it’s not working it needs to be stopped and another antibiotic prescribed. Don’t ask for an antibiotic for a viral infection such as a cold, flu, most coughs and bronchitis and many ear infections and sore throats. It won’t help and will likely harm you in the future.
  • Being patient with a viral infection and giving yourself time to rest and heal. Force fluids, use a vaporizer and an over-the-counter product for pain or congestion. Stay home so you don’t infect others.
  • Practicing safe sex through correct and consistent condom use and mutual monogamy. Sexually transmitted diseases (STDs) have become much more widespread and harder to cure with antibiotics. The last two antibiotics that are used to treat the most common type of STD – gonorrhea – started showing signs of resistance in 2016, according to the CDC.
  • Asking your veterinarian to limit antibiotic use in your pets.
  • Asking your grocer for and buying antibiotic-free meat, poultry and fish.

How did you do? If you got 7 – 9 answers correct, you’re an Antibiotic Steward. Congratulations! If you got 6 or less answers correct, your health is at risk concerning your use of antibiotics.