Racing to the Past, Without Antibiotics
We might have to live in a future without antibiotics. Here’s why.
A careless lab mistake in 1928, led to the development of the greatest achievement in modern medicine — Penicillin. The discovery of this game-changer ushered in an era of antibiotics which dramatically helped increase the average lifespan from 47 years in 1920 to about 72 years in 2019.
Sir Alexander Fleming, a Scottish researcher, is credited with the discovery of penicillin. At the time, Fleming was experimenting with the influenza virus in the St. Mary’s Hospital Laboratory in London. Interestingly, he was often described as a careless lab technician. On his return from a two-week vacation, he found that a mold had developed on an accidentally contaminated Staphylococcus culture plate. The mold seemed to prevent growth of the organism.
That spark of curiosity led to ‘Penicillin’ — the wonder drug that helped treat illnesses which were formerly considered severe and fatal, such as bacterial endocarditis, meningitis, gonorrhea and syphilis.
Before the development of antimicrobial drugs, how were infections treated in the 20th century? Bloodletting was one such practice, dating back to 1000 B.C. in Egypt. According to ancient medical theory, the four humors of the body (blood, phlegm, black bile and yellow bile) had to be balanced for good health and infections were thought to be caused by an excess of blood. Hence, excess blood was removed from afflicted patient via leeches, cupping or incisions. Mercury and bromine were used to treat infected wounds and syphilis. Both these chemicals caused more damage to normal cells than infected ones. The treatment for tuberculosis used to be a shift in scenery for fresh air.
Today, we’ve progressed to a better understanding of infections and have devised multiple antibiotics for treatment and prophylaxis. They’re used to treat minor infections like common cold to systemic infections like shock; for preventing potential infections in minor dental procedures and major surgeries like organ transplantation.
Unfortunately, this boon is heading to its expiration date. Nearly a century’s worth of research will become redundant if we don’t take action soon. In spirit of Darwin’s ‘survival of the fittest’, microbes are rapidly evolving to resist the effect of antibiotics, leading to a phenomenon known as ‘antimicrobial resistance’. What this means, is that no drug will be effective in eliminating infections entirely. Are we headed back to the 1800s, an era without penicillin, an era where a common cold could potentially kill?
The rapid emergence of resistant bacteria is occurring worldwide, endangering the efficacy of antibiotics. Antibiotics remove drug-sensitive competitors, leaving resistant bacteria behind to reproduce as a result of natural selection.
This antimicrobial resistance crisis has been attributed to the overuse and misuse of these medications, as well as a lack of new drug development by the pharmaceutical industry due to reduced economic incentives and challenging regulatory requirements.
Aside from irresponsible prescription practices and unregulated over-the-counter sale of anti-microbials, the biggest challenge faced is the lack of interest shown by pharmaceutical industries in finding the solutions to this problem. Since, antibiotics are used for short periods of time and often curative, they are just not as profitable as drugs for chronic conditions like diabetes or cancer. Moreover, infectious disease specialists and microbiologists recommend holding the newly developed drugs as a backup option instead of immediate prescription, for the fear of promoting drug resistance. Instead they choose to use older drugs with similar outcomes. Consequently, this practice leads to a diminished return on investment for the pharmaceutical companies, further diminishing their interest in pursuing antibiotics as a promising field.
The World Health Organization has labelled antibiotic resistance as ‘one of the biggest threats to global health, food security and development’. If no action is taken, drug-resistant diseases could cause 10 million deaths annually by 2050 and an economical slowdown as bad as the 2008 financial crisis. By 2030, it could lead to 24 million people being pushed to extreme poverty.
Action is needed, urgently and imperatively. Right from awareness programs to maintaining a population registry and drug development, there’s an ocean of work that needs to be done and every drop will count. At the level of students studying human health, spread your knowledge to family, neighbors and community. Identify and warn against popping antibiotic pills when not needed. Participate in research studies that pinpoint wrong attitudes amongst health care professionals. Join projects working on antimicrobial drug development. Learn, share and contribute. Make that difference.
