Tag Archives: bacteria

Antibiotic confusion in the Wall Street Journal

If you follow me on Twitter, you’ll know I have a thing against antibiotics. I love to take them when I have a bacterial infection, but I think it’s a terrible synonym for ‘antibacterial’, an older word that doesn’t mislead people into thinking the drug can work against viruses and other microorganisms. The problem with “antibiotic” is that people (as in “folks” who are not scientists, doctors, and science journalists) typically assume that they can treat non-bacterial infections, and this encourages people to demand antibiotics for anything that ails them. Part of this confusion is from the word itself (it sounds like it should work against all types of microorganisms). In addition to it sounding like it should be broad drug that can kill all things living, many dictionaries actually suggest exactly that, and that’s actually what the word used to mean. Unfortunately (and this seems to be the bigger problem), scientists, doctors, and science journalists don’t think “antibiotic” is at all confusing to lay people.

So last week I begged Ben Zimmer (Wall Street Journal) on Twitter to explore the origin of the word “antibiotic”, with the hope that people (folks and otherwise) would listen to him. Here’s his column: A Cure for ‘Antibiotic’ Confusion? It’s short and sweet, so just read it, but here’s my favorite sentence:

In current usage, “antibiotic” is roughly synonymous with “antibacterial,” though technically speaking antibiotics can act on microbes other than bacteria. [italics mine]

Two comments about the column.

First, I wish the article had explored just how common the confusion is. It’s not just that some people are confused. I think most people are confused. Again, I’m talking about “folks”, not the overeducated people who might be reading this nerdy blog post. But to be honest, some of the overeducated people I’ve talked to don’t understand antibiotic specificity, either. Because terrible word.

Second, Zimmer asked two people whether “antibacterial” could ever float as a substitute for “antibiotic”. They answered that it couldn’t because (essentially) the disinfectant lobby would object. That’s an odd reason because just as antibacterial wipes kill bacteriaantibacterial drugs kill bacteria. That’s because they both contain antibacterials, though the sources might differ. Zero conflict. Similarly, disinfectants and pills can contain antivirals. Or antifungals. And if there really was a conflict, I think the original use of antibacterial should trump the wipe lobby. Regardless, some scientists and physicians are already using “antibacterial” as synonym for antibiotic, so it’s not like there isn’t a precedent; it’s just too rare that they are doing so.

The issue is more that it’s hard for older people to avoid a word they have been happily using for their entire life. Good examples are “life preserver” (now “personal floatation device”) and suntan lotion (now “sunscreen” or “sunblock”), words that will probably only fully die when we do. But if properly motivated, people can make switches much faster. Two good examples are demonstrated by the employees of BackRub.com and Beaver College, now Google and Arcadia University, respectively. So I think a bunch of PhDs and MDs can summon the mental power to say “antibacterial” when speaking with impressionable patients or when designing outreach graphics. But they’ll only do so if some higher power (CDC, WHO) makes it clear that doing so might reduce overprescription of antibiotics. Even if using “antibacterial” would only reduce overprescription by 5%, the change would be worth doing.

I’m not suggesting that we stop using the word, “antibiotic”. The word is totally fine for conferences, publications, and situations where the context is clear or when there is plenty of time to clarify that they are antibacterials. The word is also invaluable when socializing with people from the powerful wipes lobby.

Thanks, Ben Zimmer!

Here are my previous posts on the topic, if you’re interested. If you conduct “science literacy” polls, you should read them. The reason is that asking something like, “Will antibiotics treat colds?” is a terrible question. You should be asking, “Do antibacterials kill viruses”. That will assess the science literacy more directly. Sticking with the old question just demonstrates that pollsters are unfamiliar with what “antibiotic” actually means.

You keep using the word antibiotic

Happy “Get Confused about Antibiotics Week”

The CDC designated this week as “Get Smart About Antibiotics Week.” I know, pretty exciting.

Although I’m all on board with awareness, and its goal (reducing resistance evolution in bacteria), I think the people at the CDC are actively ignoring an insanely easy way to educate the public: simply stop using the word “antibiotic,” and instead say “antibacterial”. E.g., people at the CDC should open up all their Word documents and web pages and do a global search/replace. Would take a week to fix the formatting changes caused by the extra characters. The cost of doing this would probably be much less than what they spend getting all those cartoons for their posters on antibiotics.

The reason I suggest this is that most people assume antibiotics work against viruses. And who can blame them? It’s what the word use to mean. Below is a sample definition from 1910:

Definition of antibioticand here’s what a Google search displays:

Definition of antibioticOf course, the CDC loves the word “antibiotics.” And thus it would take an Executive Order to get them to do what I suggest. But if you agree with me and eventually become President, could you please consider sending them that memo?? You’d make me happy, and save a lot of lives.

More details at “Curbing the misuse of antibiotics.”

Dangerous bathroom design

Flu season is coming, so here are some photographs to highlight one of my pet peeves, bathroom design that promotes disease transmission.  I post with the hope that somebody with true influence over architects will someday link to this post.  My pet peeve: bathroom doors hinged in a way that require people to touch the handle or knob to exit. I’m sure there are fire code reasons why architects specify for this, but it’s strange (remote risk of fire vs real and daily risk of disease).  I designed a graphic to highlight the issue:

In other words, when you touch the handle, you will most likely pick up viruses and bacteria left by the people who didn’t wash their hands (and those people might be really sick).  Really: research has shown that door handles have more bacteria than (gasp) toilet seats.  But even if architects are required by law to hinge doors to pull in, I think all bathrooms should be equipped with signage like the above, with perhaps additional verbiage about using a paper towel or shirt to open the door to educate people who don’t normally think about such things (you should do this if you don’t already; photo).

Compounding the above problem is the fad of equipping bathrooms with only electric hand dryers (“Saves the environment!”).  Because cheap hand dryers take about 3 minutes to dry your hands, many people opt to just exit the bathroom without washing their hands.  Or at least guys opt out…I don’t hang out in women’s restrooms that often.  This means that the handle or knob is going to get a lot more use from hands that are coated in microbial nasties. (Somebody needs to compare bacterial counts on handles in paper-free and paper-provided bathrooms…let me know what you find.) Here’s a graphic I designed for the machines:

 

So: my plea to people in power is for doors to be hinged so that mere pushing (e.g., with shoulder) allows exiting.  And for paper towels to be provided.  Or, if that is too costly, then for installation of signage that truly informs bathroom users about bad bathroom design and what they can do about it.  If you work in a hospital and have both MRSA and immune-suppressed patients, you definitely need signage like this. It’s cheaper than installing a door handle sanitizer, I’d wager.

If you like the idea of signage but are worried about selling it at your institution, here is a article to send to your colleagues and staff. Signage makes a difference, but edgy signage makes more of a difference.

If the Bathroom Signage Committee at your workplace is packed with people averse to anything novel, don’t worry, you can do it yourself!  Just download the door signage and hand dryer signage files (PDFs), then print onto 4 x 6″ paper.  I recommend 3M’s removable adhesive labels (#6200), which are essentially Post-Its you feed into your inkjet or laser writer. I love these sheets for stealth stickering projects when I don’t want to permanently annoy people. Then, of course, you need to sneak the stickers into the bathrooms at your workplace.  If you place them carefully and all at once, people will assume somebody in charge mandated the change and they will have a better chance of staying up.  Good luck, and have fun.

NOTE: the signage above was installed at Swarthmore College.  They lasted about a week before they take down by order from above.  Now they are back to zero signage, and are promoting disease transmission. Hey, I tried!

Please share with your friends, folks.