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Are all germs created equal? - (3/17/2020)

By Dr. Ron Gasbarro 

Bill was in the pharmacy, waiting for the pharmacist to fill a few prescriptions. “Hey, doc,” Bill called out to the pharmacist, “If I think I am getting this coronavirus, can I take the antibiotic my doctor gave me last year when I had bronchitis? Those pills will kill any germ I have, right?” The pharmacist explained to Bill that whether his old antibiotic will kill “any germs” depends on the definition of what a germ is. The word “germ” is an informal term for “pathogen.” A pathogen is any “bug” that promotes disease. That is why we also refer to pathogens as “infectious microorganisms,” which are really nothing but germs. But wait! There are different kinds of germs. Bacteria, viruses, fungi, and even certain worms and insect larvae can cause disease.

This point is where viruses come in. Especially now when a viral pandemic has enveloped Earth. Common antibiotics cannot kill viruses. They only work against bacteria. Why? Bacteria are radically different from viruses, both in structure and in function. First, an antibiotic can destroy a bacterium by disrupting the integrity of its cell wall. However, a virus does not have a cell wall and is not even a cell because it has no internal cell structure. Therefore, the antibiotic would have no cell wall to attack. 

Second, antibiotics are designed to interrupt the way a bacterium replicates or copies itself. However, note that bacteria and viruses reproduce in fundamentally different ways. A one-celled bacterium replicates by dividing into two identical cells. This process is called binary fission, in which a bacterium cell grows in size, duplicates its own DNA, that is, its genetic information, and then splits into two identical cells.   

Unlike bacteria, viruses reproduce only when inside a living cell. A virus is much smaller and less complex than a bacterium. Viruses multiply by infiltrating their host’s cells and hoodwink them into manufacturing copies of their DNA. Soon after, the host cell is filled to capacity with the virus and the cell ruptures, and releases viruses throughout the host. Viral infections are more difficult to eradicate because the viral material is already injected into the cell, where a typical antibiotic cannot enter.   

Diseases caused by bacteria include tuberculosis, bubonic plague, whooping cough, syphilis, gonorrhea, cholera, and many types of pneumonia. Viruses cause the common cold (rhinovirus), influenza, polio, measles, AIDS, chickenpox, and smallpox. Most of these diseases – both bacterial and viral – have either vaccines or drugs that will either stop, treat, or prevent them.

"It wasn’t always this way," the pharmacist explained to Bill. History books are replete with instances of pandemics that literally wiped out a portion of the planet’s population. AIDS was considered 100% fatal when it first emerged in the 1980s. Now, we have medications – the antiretrovirals – to turn it into a chronic condition. The Black Death, which peaked from 1347 to 1341, was one of the most destructive pandemics in human history, culminating in the deaths of almost 200 million people in Europe. Although we now know the bacterium that causes it, we also have medications to treat it. Our level of sanitation and hygiene has also significantly helped. “Whether humanity can survive this current coronavirus pandemic is unclear,” the pharmacist said. “However, what we know now about events that happened back then may pull us through this challenging time.” And, as he told Bill, “Not all germs are created equal.” Thus, Bill’s antibiotic from last year will do nothing to prevent coronavirus. “Better off washing your hands!” 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com.

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