A dose of reality with bacteria
A spider bit my friend Brendan in October. Subsequently, he got a Staph Infection and was immediately put on antibiotics. Three months later Brendan is fighting his third infection; the antibiotics aren’t killing the staphylococcus aureus, a bacterium found in the human respiratory tract and on the skin.
This type of scenario is becoming more and more common. More people died of infections than cancer in 2010.
For billions of years, certain bacteria have produced chemicals that protect them from attack by other microorganisms. Some of these chemicals make up the antibiotics used in medicine today. Unfortunately, bacteria are survival experts and are beginning to develop ways of resisting the toxic effect of these drugs.
For example: there is only one useful antibiotic left to treat gonorrhea; 80 percent of the disease is now resistant to the frontline antibiotic, tetracycline.
Taking antibiotics creates “selective pressure” where sensitive bacteria are killed leaving a gap in which any resistant bacteria can flourish. Most frequently, resistant bacteria are spread from person to person via direct contact, environmental surfaces, water and food; global traveling is a major contributor to the increasing spread of such bacteria, exacerbating previously manageable problems of resistance.
This rise in drug-resistant diseases could trigger a national emergency comparable to a catastrophic terrorist attack, pandemic flu or major coastal flooding. Britain’s chief medical officer, Dame Sally Davies, even called the threat an “apocalyptic scenario” this week. She told Members of Parliament that in 20 years’ time, there is a high chance that people going in for simple operations will die of routine infections. The World Health Organization agrees.
Apart from two agents, no truly novel types of antibiotic have come onto the market for 40 years. It is difficult and expensive to develop such medicines, and because they are taken for short courses, unlike, for example, cancer drugs, they don’t usually generate a high income for pharmaceutical companies.
Governments could help in this department by setting up antibiotic pricing policies. One idea would be creating a reimbursement price for drugs that treat resistant infections. Another would be to improve tax credit systems for developers. Grants could also be targeted to support the development of new drugs.
Perhaps a larger problem is the overuse and misuse of antibiotics.
Clearly, the fewer antibiotics a person uses, the less chance of resistance developing. Prescribing practices could be tightened both by doctors and patients who need to understand that antibiotics do not work for viral infections and may not therefore be necessary – a person doesn’t need antibiotics to fight a common cold.
Taking the correct dose of an antibiotic, at correctly spaced intervals during the day, means an active level can be maintained in the body, giving the highest chance that all the harmful bacteria will be killed. It also means limiting selective pressure. Basic hygiene is also important.
If we don’t follow these measures, we will return to the days of survival of the fittest – patients will die of infections that we should be able to treat.