Welcome to Ask a Doctor! Every week we’ll be asking our CarePoint Health doctors some questions that we’d all like to know the answers to. This week we have John Rimmer DO. He’s one of our doctors in Hoboken with a focus on Emergency and Internal Medicine. He currently works in the E.R. at our Hoboken location.
Q: What is an antibiotic?
A: An antibiotic is a medicine designed to treat bacterial infections. From Penicillin, discovered in the early 1900's, to advanced synthetic medicines used today to fight specific bacteria, an antibiotic's ability to help cure infections is responsible for much of the increased life expectancy of mankind over the last 75 years. They can be administered orally, topically, or sometimes required intravenously, and there are many types. As medicine advances, antibiotics are becoming ever more cutting-edge, but there are always new challenges, and antibiotic resistance is an important one.
Q: What kind of conditions should be treated with antibiotics?
A: With few exceptions, only known and suspected bacterial infections should be treated with antibiotics. There are several types of "germs" which can make people sick, but bacteria are often the most serious culprits. They are ubiquitous, incredibly tiny and opportunistic micro-organisms that cause infections ranging from simple conditions, such as an ear infection, to more serious, potentially life-threatening illnesses, such as pneumonia or meningitis. Antibiotics, when combined with the body's own immune system, work in tandem to heal these infections. It is important to note that viruses, which are another type of "germ", are different than bacteria, and are not cured with, nor require, traditional antibiotics. Differentiating between a viral and bacterial infection is often an important, although tricky, step in proper treatment.
Q: How do bacteria become resistant to antibiotics?
A: Bacteria, like any living organism, evolve and adapt to their environment. They “learn” how to survive longer, developing sophisticated defense mechanisms against antibiotics. Some have even developed microscopic “bullet-proof jackets” to prevent the antibiotic from penetrating, and killing, the bacteria. Others have evolved tiny pumps they use inside their cell walls to push the antibiotic out, thereby rendering the antibiotic ineffective. Overall, the more the bacteria are exposed to a particular antibiotic, the more they learn and adapt, thus causing greater resistance to the medicine.
Q: Why should I be concerned about antibiotic resistance?
A: Growing antibiotic resistance is one of the preeminent public-health concerns of the 21st Century. Simple conditions such as urinary tract and common skin infections are becoming more difficult to treat with the most-commonly prescribed antibiotics. More serious, life threatening infections, such as pneumonia, are requiring longer, more complicated hospital stays. New antibiotics are being researched and tested, but often not fast enough. Bacteria are becoming stronger and we need everyone’s help to help combat this trend.
Q: What can be done to slow the spread of antibiotic resistance?
A: Resistance will likely never be completely reversed, but it can be slowed with a combination of improved strategies by patients, healthcare providers and hospitals. Patients can prevent getting infections with improved hand washing hygiene, getting up to date vaccines, keeping medical conditions such as diabetes under control and avoiding smoking. Patients should finish all of their prescribed antibiotics regardless if they feel better, avoid saving pills for their next illness or for family members with similar symptoms, and trust doctors when they are told they don’t need antibiotics for their current illness. Also, be sure to follow-up on all results from your hospital or doctor visit. If your stay was brief, some tests, specifically bacterial cultures, won’t be complete for several days after your discharge. These tests often hold important clues as to antibiotic resistance, sometimes even requiring a change in antibiotic course to tailor your regimen for a specific bacterial strain. Doctors and hospitals need to prescribe antibiotics appropriately, know the resistance trends in their area, encourage appropriate infection control practices in their hospital or office, and evolve along with the bacteria to maintain stewardship of antibiotic programs.
Q: Where can I find more information?
A: The Centers for Disease Control (www.cdc.gov/drugresistance) has a wealth of information on infections and antibiotic resistance. Your family doctor and Emergency Physicians are trained to spot potentially resistant or dangerous infections from the community. In addition, most hospitals, including those in the CarePoint System, have physician experts specially trained in Infectious Disease to help combat the most serious infections.
Dr. John Rimmer is a board certified Emergency Physician and Internist. He completed his undergraduate education at The Pennsylvania State University and obtained his medical degree at the New York College of Osteopathic Medicine, where he was awarded a prestigious clerkship at the NASA/Kennedy Space Center Biomedical and Flight Surgery Office. He completed his internship at St. Vincent's Midtown Hospital in Manhattan, and then transitioned to St. Barnabas Hospital in the Bronx for a simultaneous residency program in Emergency Medicine and Internal Medicine. During his training he was commissioned as an Officer in the United States Naval Reserves and collaborated on award-winning research involving acute ophthalmologic emergencies. He is a currently a full time Emergency Physician at Hoboken University Medical Center, part of CarePoint Health.