Change Your World Week Winter 2022 (Archived)

Because you could be contributing to the mutation of bacteria! Not finishing a course of your antibiotics can lead to the bacteria becoming "immune" or "resistant" to that type of antibiotic in the future, making it more difficult to treat. When you don't finish your course of antibiotics, the microbes that are "left over" from your infection, were able to tolerate the medication you were on, leaving them, to pass on their resistant gene! Now, you may develop a more severe infection that won't be able to be treated with regular oral antibiotics, you could wind up in the hospital needing higher and stronger doses of antibiotics through an I.V. 

But, this isn't just about your medicine cabinet! Another source of blame can be put onto our sewage plants and filtration companies. The same can happen similarly, as not finishing your antibiotics, if you were to flush any unused antibiotics down your toilet!  Even with our treatment plants today, there are still traces of medications found in our drinking water. The bulk of filtration companies do not treat water for antibiotics or other medications. This can cause what we call "gene transfer". In simplest term, this means that when two pathogens that are similar are around each other they can share their genes or instructions on being resistant to an antibiotic, continuing the spread of antibiotic resistant microbes!

Data also shows that not only do we need to worry about proper drug disposal in our homes, but in the hospitals as well! Horizontal gene transfer has a more significant chance of happening in the hospital due to heavy exposure to medications that are disposed of improperly and by contaminated hands of staff on the floors at the hospital, contaminated medical or surgical equipment or other surfaces around the hospital with a high "touch volume". This gives microbes a free ride anywhere! Prolonging the treatment of these diseases also increases the risk of something called vertical gene transfer. Meaning that the "parent" cell can pass down it's resistant genes to its "offspring", further contributing to the ever growing list of antibiotic resistant microbes!

First, unless instructed by your physician, you should ALWAYS finish your course of antibiotics, even if you feel better. Next, proper disposal is another line of defense! If you experience side effects from your antibiotics and your physician instructs you to discontinue them, you can generally return any unfinished medications and antibiotics to any pharmacy, like CVS or Walgreen, that have drug disposal "Kiosks". NEVER flush them down the toilet!

Next, thanks to the Drug Enforcement Agency(DEA), who was granted authority to create regulations and propose new options for proper medication disposal, regulations were made to include a medication take-back program, medication mail-back programs, and collection receptacle for medication disposal.

Which leads to the emphasis needed to be given by the doctor prescribing these medications and the pharmacist who are distributing them, on how and when to dispose of these medications

The battle is never ending when it comes to microbial evolution, so if we can make these small changes now and help decrease their drug resistance, we will help slow this evolution and make great strides towards more effective medications.

Visit the Drug Enforcement Administration’s (DEA) website (www.deatakeback.com) or call (800) 882-9539 for more information and to find an authorized collection facility in your community. The site also provides valuable information about DEA’s National Take-Back Initiative.                                                                                                                                                                                                                         

The plan to getting started is simple. Proper education by the right sources is key! Creating pamphlets or brochures to be handed out by the pharmacist or prescribing physician, is a significant start. Giving out proper instructions with all prescribed or refilled medications from pharmacies is a non-hassle way of spreading the word about the right way of getting rid of unused and expired pharmaceuticals. They can include resources like websites, drop off locations or instructions on the mail-back program. They could also be a source for people to read up on the current issues and consequences of improper drug disposal. Although this is just a start, this action plan seems to be the most doable in our current global pandemic situation.

 Chatterjee, R., Singh, D., Tripathi, S., Chauhan, A., Aggarwal, M. L., & Varma, A. (2021). Isolation and characterization of multiple drug resistant human enteric pathogens from Sewage Water of Delhi. Nature Environment and Pollution Technology, 20(2), 569–578. https://doi.org/10.46488/nept.2021.v20i02.013

George, D. F., Gbedema, S. Y., Agyare, C., Adu, F., Boamah, V. E., Tawiah, A. A., & Saana, S. B. (2012). Antibiotic resistance patterns of escherichia coli isolates from hospitals in Kumasi, Ghana. ISRN Microbiology, 2012, 1–5. https://doi.org/10.5402/2012/658470

Insani, W. N., Qonita, N. A., Jannah, S. S., Nuraliyah, N. M., Supadmi, W., Gatera, V. A., Alfian, S. D., & Abdulah, R. (2020). Improper disposal practice of unused and expired pharmaceutical products in Indonesian households. Heliyon, 6(7). https://doi.org/10.1016/j.heliyon.2020.e04551

Kinrys, G., Gold, A. K., Worthington, J. J., & Nierenberg, A. A. (2018). Medication disposal practices: Increasing patient and clinician education on safe methods. Journal of International Medical Research, 46(3), 927–939. https://doi.org/10.1177/0300060517738681