In this blog we’re going to talk about antibiotic resistance, one of the biggest issues facing modern medicine. We cover it as part of our medicine course too: Find out more about studying medicine on a Varsity programme here.
Bacteria are everywhere, invisible to the naked eye and numbering in the billions. One millilitre of fresh water typically contains around a million bacterial cells. Our skin is naturally home to hundreds of different species of bacteria. Many microorganisms are harmless, but there are others in the environment which can kill us if they get into our body. These days, we rely on antibiotics to cure us when we get a bacterial infection. But before the discovery of penicillin in 1928 and its use in medicine during World War 2, even small cuts could be fatal. Needless to say, performing surgery was extremely dangerous, and human life expectancy was much lower than it is today.
Antibiotics are thought to have saved many millions of lives, and they’re an essential pillar of modern medicine. However, bacteria evolve quickly, and the widespread use of antibiotics in human health and agriculture, as well as the limited number of new drugs developed in recent decades, means that many strains of bacteria are becoming resistant to some, or even, most worryingly, all of our current antibiotics.
This antibiotic resistance is a major threat to our health, and if new antibiotics aren’t found, it could make what is now considered to be routine surgery highly dangerous, and render common infections lethal. It’s estimated that drug-resistant infections were already responsible for around 700,000 deaths worldwide in 2016. This poses major challenges for medical practitioners, public policy makers, and pharmaceutical companies.
Unfortunately, development of antibiotics is very limited. Finding new medicines to reliably kill different strains of bacteria is difficult to begin with, and the commercial model common in the pharmaceutical industry does little to incentivise research in this area. Companies develop medicines to generate profits, and so it’s desirable for them to develop medicine which can be used by as many people as possible. However, for a new antibiotic to remain effective, it has to be used as little as humanly possible, kept as a last resort when other options fail, in order to keep bacteria from adapting to it for as long as possible. This makes it unattractive for pharmaceutical companies to invest in antibiotic research.
There is still hope. Researchers were recently able to modify an existing kind of antibiotic, vancomycin, to make it much more potent and defeat any resistance bacteria have currently developed to it. Vaccinations could also be developed to prevent certain specific common infections too. But antibiotic resistance to other drugs is growing all the time. In many developing countries, antibiotics are distributed much more freely than they should be. It is believed up to half of antibiotic use in humans is inappropriate, with the common cold being the most common reason that antibiotics are prescribed, despite being completely useless against viruses. It’s also thought that we may be about to reach the point where antibiotics are consumed by more farm animals than humans, if it hasn’t already been passed. These are commonly used to promote animal growth rather than purely for health purposes.
As societies and governments wake up to the threat posed by resistant bacteria, it’s hoped that through more research and global agreements to improve the regulation of antibiotics, we can ensure that there are still effective drugs that doctors can turn to when more common treatments fail. Regulation is particularly important, as even new drugs won’t be effective forever. We ultimately need to reduce the use of antibiotics in animal husbandry, their availability over the counter and over-subscription by doctors in many countries, otherwise we may find ourselves facing a post-antibiotic era.
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