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
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.