The excessive use of antibiotics in treating illnesses and in agriculture has created superbugs or drug-resistant bacteria that could undo a century’s worth of medical progress. These superbugs are constantly being created every time bacteria evolve to survive the medications we prescribe which can make them resistant or even untreatable. Most resistance conferring genes are on mobile DNA elements which allow them to be easily transferred among bacteria to encourage their evolution and survival. Within the past 4 years, there has been a sharp increase in the number of infections by bacteria that are resistant to “last-line” drugs or antibiotics that are considered to be the last resort against these invaders.
If this continues, soon, people will not not be able to have routine surgical procedures because of fear of infection. England’s deputy chief medical officer said “I am concerned that in 20 years, if I go into hospital for a hip replacement, I could get an infection leading to major complications and possible death, simply because antibiotics no longer work as they do now.” This would be the end of minor surgeries and necessary major surgeries such as organ transplants. Many researchers say that without action, the death rates from bacterial infection might return to those of the early 20th century! It is difficult to predict how this will affect the cost of healthcare in the next couple of decades and economists do not know how to plan for this change. These superbugs will cause great medical, social, and economic setbacks globally.
Until now, there has been a lot of blaming and finger pointing instead of concrete action. Many blame general practitioners for freely prescribing antibiotics (35 million antibiotics per year) and physicians accuse the general public of expecting a pill for every ailment. In the meantime, the government blames the farming and agricultural industry for loading all of our food with antibiotics.
So what is the solution? There needs to be a sharp decrease in the quantity of antibiotics used and prescribed. The general public needs to be educated on the dangers of overconsumption so that they will not demand antibiotics for every infection. The government needs to do its part by regulating the amount used in our foods. In fact, the entire profit-driven model of antibiotic sales needs to change; these drugs are sold in large volumes with aggressive marketing and physicians sometimes over-prescribe for monetary purposes.
In addition, hospital hygiene needs to be improved and pharmaceutical companies that have been lacking in development in recent years need to dedicate more time and funds to researching new drugs. Fortunately, due to technological advancements in the realm of genetics, researchers can determine the genetic components of a superbug’s resistance and use this information to create “superdrugs.” Overall, researchers understand that there needs to be a “fundamental shift in how antibiotics are developed, financed, and prescribed” in order to protect from the increase in number of superbugs. While embarking on this mission, however, it is important to consider the effect that a sharp decrease in antibiotic use will have in developing nations with a higher infection rate. Citizens of those countries should still have access to the drugs they need and therefore, interventions against these superbugs should be focused locally.
What is being done now? Although it may not solve the root of the problem, scientists from the Antiresdev project are developing an array to test for a total of 206 genes from two different classes of bacteria. The arrays contain DNA probes in wells that light up when a sample of the infection is run through them. This will allow physicians to pin point what the bacteria is resistant to and provide the patient with effective drugs. However, this will not sufficiently curb the rate of superbug development and the fear is that physicians will have to resort to older medications that are more toxic. Antibiotic resistance is predicted to be the largest threat to human health of the 21st century. Doctors who are currently treating antibiotic-resistant tuberculosis in the former Soviet Union are very aware of this.
1. What else can be done to prevent the increase of antibiotic-resistant bacteria?
2. How can the public be most effectively educated?
3. What is our timeline? When will it be too late?
4. What technologies are necessary to combat these superbugs?
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