Antibiotic Resistance Explained: The Dangerous Habits Making Medicines Stop Working

Why are some infections becoming harder to treat?

Antibiotic resistance is growing around the world—and everyday habits like self-prescribing antibiotics, reusing old medicine, and sharing antibiotics with family members are part of the problem.

In this episode of Healthy Beginnings, Dr. Edgar Kalimba explains what antibiotic resistance actually means, how it develops, and why the misuse of antibiotics is becoming a major threat to child health.

Many people believe antibiotics can cure almost everything—but using them incorrectly can make bacteria stronger and medicines less effective over time.

In this episode we discuss:

•  What antibiotic resistance is and how it happens 
•  Why antibiotics do not work for viral illnesses like colds and flu 
•  The dangers of self-prescribing and sharing antibiotics 
•  Why unfinished antibiotic courses matter 
•  How misuse today can affect treatment in the future 
•  What parents should know before giving antibiotics to children 

This episode is designed to help parents make safer decisions and understand why antibiotics should be used carefully and responsibly.

Healthy Beginnings offers clear and evidence-based conversations about children’s health, family wellbeing, and the systems that shape our lives. 

New episodes every Monday 

Have a question? Email: healthybeginningspodcast@gmail.com

Produced by LF Media

Transcript

SPEAKER_01 0:00

Hello and welcome back. Uh, this week I'm pleased to uh be back to our conversations at Healthy Beginnings. Um I'm very glad for the feedback that we keep getting. People have reached out and really are listening to these conversations, and I hope that together we'll continue to tackle topics and discussions that are relevant to you as you raise your children to be healthy and do well. So today I would like to delve a little bit deeper, uh, a second part of our discussion on antibiotics. This topic is common and important enough that I thought uh one conversation was not sufficient, and that's why today I would like to recap a few things and build on, and hopefully, also tackle some other angles of this discussion that we didn't get to speak about last week. So we will look uh briefly again at the antimicrobials and what happens inside your child's body when they overuse or when they abuse antibiotics. Um, and some practical questions. Can you reuse antibiotics that you've probably used a few days, a couple of weeks earlier? I would like to also mention something about breastfeeding while taking antibiotics, because I feel like this is important. And then the last part of our conversation today will be around um what I would call a medical conversation because there's very common terms and misnomers, misconceptions around infections. Um, everybody says they had a blood infection. What does this really mean? And what type of tests do we do in the hospital to confirm or rule out these infections? So just to recap, um the word antibiotics actually does not cover all infections. Some people have this understanding that you know antibiotics treat all types of infections, but this is actually not correct. I mentioned in our last conversation that there are different types of antimicrobials, which would include antibiotics that treat bacteria, antivirals that treat viruses. So, for example, HIV is a virus, and it's treated with antivirus, not antibiotics. And then there's a class of other microbes or organisms called fungo or fungus, and um these can also be very serious depending on the context, and these are treated with antifungals. And then we have a fourth group of parasites. So parasites are different from bacteria, they're different from viruses, and they're different from fungal infections. And parasites, a common example is malaria, another common example is worms, intestinal worms, and these are treated with antiparasitic medication. So when a child or your baby has a viral illness like a cold, a flu, a regular cough, antibiotics will not help because this is a viral, it's a virus, it's not a bacteria. And I wanted to sort of briefly recap this because I feel like it matters to get this uh clearly and be better informed. And this is exactly why a correct diagnosis matters, because when the diagnosis is not correct, then you might end up having to treat with the wrong medication or having to use antibiotics when they're not required. So, antibiotics as a class of drugs has uh different subclasses. So all antibiotics are not the same. There's different classes. I won't go into it because uh this is not medical school, but just broadly, we have, for example, penicillins, we have cephalosporins, we have macrolides, we have different classes of antibiotics. And in fact, um this kind of goes with the different types of bacteria because bacteria that are treated by with antibiotics also have many different classes. So you you you have to know what you're trying to treat specifically, and that is why when we prescribe antibiotics, we choose a specific antibiotic to treat a specific illness, not just any antibiotic for any infection. And I'll try to explain it a bit more. I think, um, for example, in children, respiratory infections are very common, whether it's a throat infection, a tonsillitis, an ear infection, or even the lower respiratory tract of uh the lower respiratory tract, which is your bronchi and your lungs, also need a specific uh type of antibiotic when it gets infected. So when you have a pneumonia or a bacterial bronchitis, those usually respond to a specific group of antibiotics, not any antibiotic. There's obviously other types of bacterial infections. So, for example, intestinal bacterial infections, bacteriocolitis, or things like uh dysentery, Shigella, all these common uh intestinal bacterial infections, they also need a particular class of antibiotic or a particular type of antibiotic. There's other bacterial infections, for example, that affect the urinary tract system. So if you have a urinary tract infection, if your baby has what we call a UTI, urinary tract infection, um, they also might require a specific type of antibiotic. So it's not a one-size-fit-all. There is a lot of detail that goes into it. Also to note is that infections can also be age-dependent. So, for example, newborns tend to have uh certain very common infections, sometimes transmitted from the mother. If a mother had a urinary tract infection, especially in the third trimester of pregnancy, sometimes the baby can get infected with that bacteria. There are also other bacteria that uh, for example, a mother might carry and the baby catches it. But the mother is not sick because they are an adult, they have a fully matured immune system, but the newborn catches it. And then there's other examples of what we call uh opportunistic infections. Um, nowadays HIV has reduced in terms of prevalence, especially in Rwanda, but it's still there. And some listeners might remember that when somebody has HIV, uh, it affects their immune system and makes it easy for them to catch other infections, especially bacterial infections and fungal infections. So different types of infections. Um we used to have in the past when there was more HIV patients, people getting a specific type of pneumonia, a fungo pneumonia, a fungomeningitis, and so on and so forth. Or things like tuberculosis. When somebody has HIV, they are prone to get tuberculosis a bit a bit more, they are more prone, they are more vulnerable. So infections as they are are very broad, and this is really to say that it's important to be diagnosed, get a proper diagnosis, get your child tested if they have very high fever or they have something that points towards an infection, so that you can tell is it bacteria and what needs to be given should be appropriate. So I also mentioned in our previous conversation about abusing and misusing antibiotics. And of course, we know that this is quite common. Um, one, people buying antibiotics without a prescription, from what I just explained, that is very inappropriate. Two, stopping treatment early, earlier than the prescribed number of days, because sometimes you start an antibiotic after two days or three days, your baby or your child is doing very well, the fever is gone, they are up and about, and you just stop. And yet, you were supposed to give it for five days or for seven days. So it's important to follow the instructions. I've also seen some parents that actually share antibiotics between family members. So you give um you have a prescription for one child, and then the other child maybe gets sick as well, and you decide, okay, I'm going to share this antibiotic between them. It's not appropriate because you don't know if it's exactly the same infection and if they actually need the same antibiotic, and what dose is actually appropriate. Because again, this is age-dependent, and this is also depends on the weight of your child, or using leftover medication, or using antibiotics for viral illnesses. So there's many ways that people abuse or misuse antibiotics, and this has a price, which is really my next part of the conversation of what happens when we use misuse antibiotics. Now, I previously mentioned something about resistance. Resistance means that an antibiotic that used to competently treat and kill a certain bacteria does not have that capacity anymore. So the antibiotic loses potency, loses the power, because the bacteria has adapted to that antibiotic. So when we use or abuse or misuse antibiotics, with some of the examples that I already gave, over time medicine stops working. And this is a big global phenomenon with really fatal consequences because these drugs are very powerful, they're very useful, but should be used appropriately. Now, I've also mentioned previously something about the good bacteria that we have in our bodies, particularly in our gut, in our intestines, something I referred to as the microbiome. So even when you take antibiotics appropriately, there's always a chance that they will affect your good bacteria composition. And that has an impact on digestion, on immunity, and of course, protection from harmful germs. So I'll give an example in a child who is below one year during the first year of life, if they take one or two courses of antibiotics, this can wipe out a large part of the good bacteria in the intestine. And this really causes some disruptions. And that's why, for example, uh, you might have noticed if your child was prescribed to take an antibiotic, that they had like diarrhea that was really profuse or persisted for a couple of days, or had a reduced appetite, or had some other signs that were clearly from the antibiotic that they took. So there is a price on the immune system. Um, and that's why it's always really strongly recommended that whenever there is a need, a clinical diagnosed need to take an antibiotic, it should be handled appropriately so that you make sure that you do not reduce the potency of the antibiotic, you do not reduce the natural defenses of the immune system of your child, and you do not increase susceptibility to other infections. And typically, when we say that antibiotics can wipe out the good bacteria in our gut, on our skin, on different parts of our body, that on the other side means that we get exposed to things like fungal infections because your immunity is reduced and uh the good bacteria has been partially wiped out, and then the other opportunistic infections like fungus get an opportunity to grow. I'm sure some people have experienced this in the past. So, for example, you give your baby an antibiotic, and while they are taking it or after they have taken it, they develop oral thrash, you know, that white patch inside the mouth, which is fungus. Uh, and this typically can be from actually taking antibiotics. So there is really a price to this. And uh, I hope that with this conversation these two conversations last week and this week, that this will be much more clearer. Now, one practical question is around breastfeeding. Um, I've been asked over and over, can I still breastfeed while I'm taking antibiotics for something? So it's common, it happens. Sometimes a mother needs to take antibiotics for a particular problem. This is fine, it happens all the time. And the good news is that most antibiotics are safe during breastfeeding. So this is not a big concern. However, there's always small amounts that can pass into the breast milk. And again, depending how old your baby is, it might affect them in one way or the other. You might see, for example, a change in bowel movements. They might get a rash on the skin, they might develop orothrash because they are actually being exposed to an antimicrobial from the mother. And of course, in rare cases, this may contribute to resistance patterns that I already mentioned. So mothers should only use antibiotics when necessary and when they are prescribed, even during breastfeeding. And this should be monitored, uh, especially in younger babies and uh infants that are still breastfeeding. And then it's always a common question. So last month my child was diagnosed with a throat infection, they seem to have it again. Can I just go by or use the same antibiotic? This antibiotic worked before, can I use it again? The answer is no. Do not do it without medical advice because the current illness may be different, bacteria may have changed, and resistance might have developed. So each illness should be assessed independently. So before I talk about uh, before I respond to questions from our listeners, I would like to touch briefly about a common topic called blood infection. I hear it all the time. People saying I had a fever, I went to the clinic, had a blood test, and I have a blood infection. Now, a blood infection is actually a particular phenomenon, a particular scenario. That means that you have bacteria in your bloodstream. So, technically speaking, a blood infection, which we refer to as sepsis or septicemia in medical terms, means that bacteria has entered your bloodstream and is spreading throughout your body. Now, a proper blood infection is very serious and life and can be life-threatening. However, the way this term is used is often inappropriate. So if you have, let's say, a urinary tract infection, or you have a throat infection, uh, you have a fever, you have a sore throat, you're struggling to swallow, maybe you have you're developing a tonsillitis. When we take your blood and we check what we call inflammatory markers or nonspecific markers of infection. So things like your white blood cell or specific types of white blood cell count, or something we call a C-reactive protein, CRP. If you look at your blood results, that is very common. It's done almost all the time. And in some centers, especially in hospitals, we might do what we call a procalcitonine, which is a much more sensitive marker of bacterial infection. Not all kinds of infections, but bacterial infection. So when these things are high or they show that somewhere in the body there is an ongoing bacterial infection, people often refer to this as a blood infection. And these two things are different. Most of the time, when there's truly a blood infection, you, your child, yourself, you might end up in hospital requiring intravenous antibiotic treatment because it's that serious. So most of the scenarios where you have a bacterial infection that you need to just take an oral antibiotic, really what is being referred to is that the markers of infection in the blood have gone up to a level where it shows that somewhere in your body there is an ongoing bacterial infection. So it's pretty nanspecific, but just gives a guide to the doctor on top of the clinical exam, having examined you, to put those two together and then decide what antibiotic treatment is needed. Sometimes when it's required in the hospital setup, we actually do what we call cultures. We culture your blood, or we culture your urine, or even other body fluids. And when we do a blood culture, urine culture, body fluid culture, we take these samples and we expose them to a medium that helps the bacteria to grow. And that helps us to identify the specific bacteria and also decide and test which antibiotic is appropriate to treat it. So these are a little bit more uh advanced in the hospital setup, uh, but these are tests that we do routinely, and they're important because they give guidance to the treatment. So I think with this conversation today, things are a little bit clearer as a buildup and follow-up from last week. And I look forward to hearing from you, getting more questions, and to continuing these conversations.

SPEAKER_00 21:02

Second question from Joanne 28 from Kampala. My son eats a lot but stays very slim. Meanwhile, other kids gain weight quickly. Could there be a health issue, or are some children naturally built different?

SPEAKER_01 21:17

Very interesting question. So we always say that for somebody's physical build, whether it's their weight, their height, uh, there's two components. First component is genetic. Because whether we are exposed to the same amount of food and the same type of food, we don't grow the same because we have a genetic imprint that we take from our parents and from our ancestors, from our line, family line, that determines how our body grows. So, nutrition is only a part, it's only a component. And that's why. Uh, your child might be eating healthy, eating enough. They might even be eating more than the bigger guy, the bigger child, but they stay small or smaller. So that's not a problem. It's not because they're lacking anything. It could be partly because of their genetics. You know, sometimes I always joke with parents, um, parents who have a modest build, uh, meaning a mother and father who are relatively small in every aspect, and they complain that they have a small child. I'm like, okay, look how big and tall you are, and you want to have a big baby, but this is your baby. So clearly, genetics plays a big role on top of nutrition. So I don't think uh it's because they're not eating enough. It could be partly because of their natural build and their uh genetic imprint.

SPEAKER_00 23:00

First question from Daniel35 from Kigali. Our son behaves very differently depending on who he's with. With me, he's calm, and with his mother, he becomes more demanding and emotional. Is that normal, toddler behavior or a sign of something deeper?

SPEAKER_01 23:15

This is very normal. I think sometimes as parents, we don't realize how smart our children are. Our children are smart, they know us, they know how to deal with us, and it's pretty normal for a child to behave slightly differently depending on which parent they are dealing with. Um most of it has to do with our temperaments, it has to do with how we respond, it has to do with how we relate with this child. So um even in our African context, our cultural context, despite things changing, it's not uncommon for children spending a little bit more time with their mothers than their dads. And typically they're going to probably manipulate their moms a bit more because they hang around them so frequently, they know how to trigger them emotionally, and that could answer why you know they're a little bit emotional and tantrums about uh around their one of the parents more than the other. Um, the other thing that maybe should be noted is that children really adapt and they learn how you respond. So if one parent usually gives in and responds and rewards tantrums, you're gonna have more of those. If you are very clear-minded and you can really separate these things and, like, okay, put your foot on the ground, I'm like, okay, you're not going to have this because of this, and you stick to that and even have very clear boundaries and consequences with love, children adapt. And that could also be why they behave in a certain way around one parent and behave differently around a different parent because they know what to expect. So that's very, very normal and it's not a problem at all.

SPEAKER_00 25:27

Last question from Brian37 from Kigali. I work hard to provide for my family, but sometimes I feel like my efforts are only noticed when something goes wrong. I know my partner is also overwhelmed, but how do couples avoid resentment building silently?

SPEAKER_01 25:43

Communication really boils down to communication. Um, life is not black and white, and you know, um, as a couple, as spouses, there's always differences in opinions, understanding how we deal with situations and just life in general. And often I think we take things for granted, and there's buildup, there's buildup of uh miscommunication, build up of uh bad emotions, and the only thing that really helps is to communicate openly and appropriately, you know, to speak about your emotions, uh, speak about how you feel and really break it down and don't let it build up in you. I know that sometimes in our African context, uh communication is not our strong point. Sometimes people just choose to um hold things back and really not express how they've been feeling about specific things, about specific words that are being used, and that can be dangerous. So I think it really, really boils down to communication in a manner that works for you both. Thank you for listening to Healthy Beginnings. If you have any questions you'd like answered in the next episode, you can submit them to our email, healthybeginningspodcast at gmail.com. You can also follow us on all social media platforms. You can find us on YouTube as well as the audio platforms of your choice. See you next week.

SPEAKER_00 27:32

This podcast is for general informational and educational purposes only. Do not make health decisions without consulting your doctor. This podcast is brought to you by LF Media, home of Great African podcasts.