Antibiotic resistance could mean the “end of modern medicine as we know it.” So said Dr. Margaret Chan, director general of the World Health Organization, last month in the keynote speech at a conference on antimicrobial resistance.
Bacteria are evolving to evade antibiotics, the result of our using them excessively to treat illnesses and — in industrial-scale farming — to fatten up cattle. Antibiotic resistance means that diseases, including tuberculosis, that have been curable may no longer be. Indeed antibiotic resistant strains of salmonella, E. coli and gonorrhea all exist now.
Accepting the fact that we are, as Dr. Chan said, “losing our front-line microbials,” some say it is time to “diversify our methods for treating bacterial infections and simultaneously reduce the amount of antibiotics we use,” by looking at treatments used before the development of penicillin.
Why Some Call Antibiotics “Miracle Drugs”
Antibiotics do what we want them to do really, really well. They kill bacteria but not us and have therefore transformed “grave illnesses into mere annoyances, providing doctors with license to shoot first and ask questions later, and do so safely,” writes Maggie Koerth-Baker. But the effectiveness of antibiotics has also been their, and possibly could be our, undoing. Broad spectrum antibiotics kills plenty of bacteria but not all and these surviving organisms that are resistant to antibiotics thrive.
Scientists are seeking to develop new antibiotics, but market forces mean that pharmaceutical companies are under-motivated to develop the next amoxicillin. People only take an antibiotic for about ten days while companies are far more willing to devote efforts (i.e., money) to developing drugs that might, for instance, lower cholesterol and need to be taken every day.
Pre-Penicillin Treatments: Serum Therapy and Biophages
Koerth-Baker describes two pre-antibiotic treatments. Serum therapy was invented in 1890 and involves antibodies, proteins that identify and attack invasive cells. Doctors used to get the antibodies by infecting horses and other animals with bacteria and then dosing humans with the antibodies taken from the animals’ blood.
Bacteriophages are viruses that attack bacteria and are applied right on the skin or jnternally; they’ve been used more in Eastern Europe, especially in places where drugs from the U.S. and Western Europe could not, for decades, be imported.
Both of these treatments are under study and even in use. Serum therapy (with cloned antibodies that are not from any animals) is used to treat cancer and arthritis and federal regulators have approved the use of a number of antibacterial phages in our food supply. Koerth-Baker explains more about these treatments:
Compared with the scorched-earth policy of broad-spectrum antibiotics, serums and phages are downright surgical. Antibodies are incredibly selective about which bacteria they’ll attack and which they’ll ignore. Bacteriophages are only slightly less choosy. Those traits can be a liability. Doctors must determine which bacteria is causing an infection before treating it, leading to potentially deadly delays.
Nonetheless, Dr. Chan and other scientists emphasize that replacement treatments to antibiotics are “more costly, more toxic, need much longer durations of treatment, and may require treatment in intensive care units.”
I’m grateful for what antibiotics can do, but treat them cautiously. They’ve been simply necessary to cure the painful skin infections my severely autistic son gets from time to time. He has a lot of obsessive-compulsive behaviors and it is very difficult to keep such infections from spreading, try as we, and he, might. But I also know that antibiotics also cause him severe stomach distress as they kill off the “good” bacteria as well as the bad in his gut (a probiotic has seemed to help).
Antibiotics are powerful medicines with not-to-be-overlooked side effects. We need to keep on campaigning against the heavy-duty feeding of antibiotics to livestock and be careful ourselves about not taking them in excess. Antibiotics also make it possible to perform certain chemotherapy, hip replacements and organ transplants and to care for preterm infants: they’re simply too valuable for our health to overuse and misuse so that, one day, we not be able to use them at all.
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