Are we entering a post-antibiotic age?
The crown jewel of modern medicine is under threat.
Growing up it seemed like I’d score an antibiotic prescription every time I went to the doctor. Yes! More Penicillin!
Ok, that’s not really how it happened.
But I did get prescribed antibiotics a lot, especially after I got my tooth knocked out by a baseball.
Whatever sickness I had, I’d take the pills for a few days, get better and inevitably forget about the prescription and stop with the bottle still mostly full.
And according to any expert on antibiotics, this is where the world went wrong. (Yes, it’s all my fault).
This widespread behavior, combined with feeding antibiotics by the shovel load to livestock to get a few extra pennies for each pound of animal, has some serious consequences.
Because of reckless antibiotic use, humanity may have “squandered the crown jewel of modern medicine,” according to Ramanan Laxminarayan, one of the world’s leading experts on antibiotic resistance.
Before the discovery of Penicillin, if a person got scratched and that scratch became infected, it was pretty much “well, sorry,” and death would follow.
Or if a person contracted any number of bacterial infections such as tuberculosis, pneumonia, some diarrhea, the flu, C. difficile, strep throat, gonorrhea, sepsis or anything else--same thing, death was probable.
But then Penicillin changed all that and saved the lives of millions of people.
And then people got a little too careless with Penicillin, and my childhood was repeated on a scale of millions.
Over time, nature did as nature does: in the face of so much overexposure and so many incomplete dosages, bacteria evolved and many bacterial resistant strains came into existence.
Now the world is facing the rise of superbugs, bugs that are basically indestructible, that modern medicine has no chance of treating.
The past 30 years have failed to yield a single new type of antibiotics. Antibiotics are hard to develop and many drug companies see no monetary benefit in exploring for a new type of drug.
But that may change.
In the US, 2 million people get antibiotic resistant infections each year and 25,000 die. In Europe, 400,000 get infected and 25,000 die.
In India, where the problem is arguably the worst, 80,000 newborns died in 2013 because of antibiotic resistant infections such as pneumonia and sepsis.
This country has it particularly bad because of the problem of open defecation, contaminated water, lack of health monitoring, overcrowded health facilities and evasion of basic hygiene.
The superbugs forming in India are quickly spreading to other countries. If this trend continues, then humanity may find itself back in the 1930s.
By 2050, it is forecasted that superbugs could kill 10 million people per year if they are not reined in.
So how can they be reined in?
Most importantly, countries have to start getting serious about antibiotics. Hospitals, doctors and patients all have to get serious. Antibiotic resistance would not be an issue if basic protocols were followed. If proper hygiene were followed in hospitals, then bacteria would be much less likely to infect patients. Further, information on the use and outcomes of antibiotics has to be collected more effectively so that a global database on superbugs can be monitored. As WHO notes in its latest report, it is “ critical to obtain a broad picture of the international scope of the problem.” In many countries, better community sanitation systems have to be built, because many infections are carried by contaminated water and open sewage.
Finally, If doctors sparingly prescribed antibiotics and actively monitored their use, then the likelihood of someone becoming an incubator for superbugs would drop.
The pressure of money often gets people to act. When countries want to keep climate change in check, they impose carbon taxes and other measures that put the costs of pollution on the polluters.
Similarly, if antibiotics were more expensive, if doctors were penalized for overprescription or if taxes were levied at every step of their distribution, then there would probably be less prescriptions. Doctors and patients would be more hesitant to get a prescription.
However, prescriptions still need to be accessible to the world’s poor who cannot afford price spikes. These just have to be appropriately dispensed.
Development of new drugs
The drug industry backed away from developing antibiotics in favor of higher profit margins a long time ago. That has mostly left underfunded public researchers to delve into the field. The new urgency of major infections will likely spur pharma giants back into the arena, but for now universities are making some breakthroughs.
Antibiotics are cultivated by studying bacteria, often by using the very antibiotics that bacteria use to defend themselves. But more than 99% of bacteria can’t be formed in typical lab settings. That means that scientists have only really explored around or less than 1% of possible antibiotics.
One natural compound called Teixobactin attacks bacterial infections in an entirely novel way, by blocking the creation of fatty cells that infections need to build walls and proliferate. Scientists believe these fatty cells are unlikely to evolve and develop resistances. This compound is still a few years away from human trials, but it is an exciting example of the ingenuity of scientists and nature.
When and if this drug makes it to the market, the issue will be getting people to use it the right way: sparingly and diligently. There really is no alternative. Antibiotics can be effective for centuries if they are just used the right way.
Antibiotic resistance is regrettable. I don’t think many doctors and patients realize the grave harm they can cause by prescribing and using antibiotics recklessly.
Just like with climate change, it's hard to see and grasp the big picture consequences of individual actions.
But on a massive scale these consequences multiply and can alter the path of the world and humanity.
If smart practices and policies are put in place, all of this dystopian stuff can be shelved. Humanity doesn't have to fear a new Black Plague.
A good start is becoming informed on the state of antibiotic resistance and supporting research for the development of new antibiotics.
Go to TAKE ACTION NOW to spread awareness of this vital issue and the importance of all facets of health.
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