Fly Well: A Tale of Two Flemings

Antibiotics are either naturally occurring or synthesized medications that destroy certain disease-causing organisms, with names that would grace any 007 movie—sulphonamides, aminoglycosides, cephalosporins, and, of course, penicillins. Pharmaceutical companies have endeavored to develop new ones to knock off bugs that are trying to knock us off, but ideas are drying up.

Antibiotics only kill bacteria—specific drugs for specific bugs—with zero activity against viruses or fungi. Deploying antibiotics to kill a bug that is not susceptible may kill “good bacteria” in your gut, allowing maleficent microbes to wreak havoc. This can lead to pseudomembranous colitis, a potentially fatal condition demanding urgent treatment.

It’s a nasty enough condition if it arose because the causative antibiotic was required, but imagine discovering that the drug causing the colitis should not have been administered at all—for instance, for a sore throat. Yes, that can be caused by streptococcus and is often easily treated with Alexander Fleming’s wonderful revelation, but a sore throat is frequently a viral illness for which antibiotics are useless. Or worse than useless. So, instead of demanding antibiotics from your doctor, or gulping down something left over in your home medicine cabinet (never a good idea), ask your physician if he or she can do a simple office strep test first and, if negative, treat yourself with chicken soup and bed rest.

The other problem is that when bacteria are exposed to small, nonfatal doses of antibiotics, they evolve and become resistant, passing that capacity to their offspring, and then another drug heads for the scrap heap. This is happening faster than new medications can be discovered.

A sore throat is frequently a viral illness for which antibiotics are useless—or worse than useless. More than 80 percent of all antibiotics are used in farm animals, a matter of concern and contention. While some are utilized to treat animal disease, 90 percent are dispensed to support and encourage growth for intensive food production. The small amounts passing into humans, some believe, contribute to the growing problem of resistance.

More than half of all antibiotic prescriptions are inappropriate and, as such, doctors and veterinarians need to be part of the solution. The Global Chief Medical Officers Network has agreed to publicize this issue before it becomes a cataclysm. But we are few; we need others to lead the charge. And that is where you come in. Pilots—leaders by nature—can help themselves and society at large by becoming informed.

As in the sore throat example, determine if antibiotics are medically necessary, and then consider that while the FAA may allow you to fly while taking antibiotics such as zithromycin, the underlying condition may make flying inadvisable. For instance, if you have a sinus infection, you should not be flying. If you have a chest infection, you should not be flying. Get the picture? Additionally, antibiotics can cause delayed side effects, most commonly nausea, vomiting, and diarrhea—not things you want to deal with while in the left seat. If taking an allowable antibiotic, and the underlying condition is not a barrier to flight, wait at least
24 hours from the first dose before flight.

Antibiotics may be one of several medications you’re taking, so ensure that every drug you are taking is allowable and appropriate for the cockpit.

Additionally, socializing while infected puts co-workers at risk, which is inconsiderate and could put further strain on antibiotic use.

Be involved in health care decisions affecting you; if an antibiotic is not absolutely necessary, avoid it. Support the production of antibiotic-free foods and read the labels; at the very least, this practice can’t hurt.

Do all you can do win your own blue plaque and ensure that there is never one to tell us where antibiotics finally died.

Email [email protected]