The End of Antibiotics?
‘A Post-Antibiotic Apocalypse’ Is On the Horizon
The era of antibiotics is ‘coming to a close,’ says the August 12th Guardian.
With the once ‘miracle medicines’ now ‘beaten into ineffectiveness by the bacteria they were designed to knock out,’ we could be entering a ‘post-antibiotic apocalypse’ in which pneumonia could again become the ‘mass-killer’ it once was, especially among the old and frail; in which gonorrhea becomes extremely hard to treat; in which tuberculosis is simply ‘incurable.’ Need a transplant for a kidney or other organ? You’d best forget it, says the Guardian, as organ recipients’ immune systems will be unable to fight off infections without antibiotics. And surgery for a burst appendix will again become ‘dangerous.’
And the worst of it is, this ‘post-antibiotic apocalypse’ could have been avoided. While bacteria have become increasingly resistant to the antibiotics out there, drug companies have not been undertaking the difficult research to develop new ones. Unlikes medicines for conditions like heart disease, people typically take antibiotics for a week; drug companies, therefore, stand to profit much less from them. Too, ‘because resistance means the drugs become useless after a while,’ the money is simply not in antibiotics.
New Study on the Spread of Multi-Drug Resistant Bacteria
Last September, [Professor Tim] Walsh published details of a gene he had discovered, called NDM 1, which passes easily between types of bacteria called enterobacteriaceae such as E. coli and Klebsiella pneumoniae and makes them resistant to almost all of the powerful, last-line group of antibiotics called carbapenems. Yesterday’s paper revealed that NDM 1 is widespread in India and has arrived here as a result of global travel and medical tourism for, among other things, transplants, pregnancy care and cosmetic surgery.
“In many ways, this is it,” Walsh tells [Guardian reporter Sarah Boseley]. “This is potentially the end. There are no antibiotics in the pipeline that have activity against NDM 1-producing enterobacteriaceae. We have a bleak window of maybe 10 years, where we are going to have to use the antibiotics we have very wisely, but also grapple with the reality that we have nothing to treat these infections with.”
It could be said that, like vaccines, antibiotics have become the victims of their own success. Just as—thanks to vaccines—many of us no longer get measles or other infectious diseases (whooping cough, for one), so have we ceased to see pneumonia as fatal, much less tuberculosis.
The Guardian mentions the MRSA scare of ten years ago when patients in hospitals were ‘picking up Staphylococcus aureus infections that were resistant to the hitherto powerful antibiotic methicillin.’ Hospital hygiene was vastly stepped up and pharmaceutical companies have put more resources into developing new antibiotics to fight against MRSA and also C. diff (Clostridium difficile). But these are ultimately just stop-gap measures because
Bacteria are great survivors. The biggest threat now, experts believe, is from multi-drug-resistant Gram-negative bacteria, such as NDM 1-producing enterobacteriaceae and an enzyme called KPC which has spread in the US (and in Israel and Greece) which also gives bacteria resistance to the carbapenems, the most powerful group of antibiotics we (once) had.
In other words, without the development soon of new antibiotics, ‘superbug[s]‘ like MRSA could again spread and cause ‘front-page panic.’
Who Hasn’t Taken Amoxicillin?
As a parent, it used to be a routine thing for me to show up yet again at the pharmacy to get prescriptions filled (and refilled) for antibiotics when my son Charlie had ear infections (when he was a toddler) and other illnesses. As he’s minimally verbal and really can’t tell us when he has a physical pain, where it is, or any of that, whenever Charlie’ss had an infection, his pediatrician has tended to give him an antibiotic ‘just to be sure’ that whatever Charlie has gets done away with.
I’ll never forget the smell of amoxicillin, half a bottle of which I spilled on the carpet of our (rental) apartment when I was trying to get toddler Charlie to take his dose (this was in the time when he kept getting ear infections). When Charlie was much younger, we even had some worries about antibiotic overuse and how antibiotics affected Charlie’s gastrointestinal system.
But the truth of the matter is, especially as the parent of a child with disabilities which include severe speech and communication difficulties and a lot of other ‘issues,’ I’m very glad for medicines that—so far—have been able to keep my son (and let’s face it, the rest of us), healthy.
And if diseases like pneumonia and tuberculosis become impossible to treat, the prognosis for the future health of us all will look very different, indeed.
Photo by Stephen Cummings.