As an individual who refuses to go to the doctor, unless I am feeling on the verge of death, I was initially surprised when I heard about the issues with antibiotic resistance due to over-prescription. Apparently, it’s normal to rush to the doctors and demand medication at the first sign of a cold appearing. Although comforting, such actions have resulted in a strain of bacteria that now shows resistance to all current antibiotics; including the “last resort”- Colistin. These bacteria carry a resistance gene known as mcr-1. Resistance to all available treatments gives the bacteria the ability to spread rapidly, which leaves us with the threat of a worldwide epidemic.
As of today, numerous antibiotics are available. There are two main groups; bacteriocidal and bacteriostatic. Although well-known, it is often ignored that antibiotics only work on bacterial infections; for example tuberculosis. Antibiotics will not work on viruses, fungi or parasites and in these instances, prescription can do more harm than good. Antibiotics can damage the natural “good” bacteria (or microbiota), which keep our body conditions constant and healthy. Consequently, antibiotics should only be prescribed for serious infections or when the immune system is failing. For the average adult, the immune system will not fail when a bout of flu hits.
During the antibiotic discovery boom of the 1980s, bacterial diseases were considered a thing of the past. For every minor infection and illness, antibiotics were prescribed, which pressurised unnatural and rapid evolution of bacterial strains. Scientists failed to anticipate bacteria would take up arms and fight back against the latest threat to their survival. Because human medicine had pushed resistant bacteria to survive, evolution favoured strains that were unaffected by common antibiotics. “Superbugs” such as MRSA began to spread; these terrors are currently wreaking havoc in hospitals.
Modern society arguably overlooks the research that goes into producing antibiotics. There is a clear lack of understanding for the correct applications for these drugs. Alexander Fleming accidentally discovered the first antibiotic in 1928, during his work with the fungus Penicillium notatum. Fleming’s remarkable observation led to the production of Penicillin. Unfortunately, typical antibiotic discovery is not usually as convenient. The last 30 years has seen a dramatic lag in antibiotic production. The inability to culture many natural antibiotic compounds in a laboratory has inhibited drug development. Meanwhile, the current antibiotics that were revolutionary in the 80’s have lost effectiveness. Worryingly, in 2014 10% of Toronto’s gonorrhoea cases were resistant to treatments. Whilst the general healthy population remain oblivious to the lost efficiency, individuals with weakened immune systems have silently suffered.
January 2015 saw a huge breakthrough; the first novel antibiotic in over 30 years was discovered. Teixobactin was produced by extracts from natural soil microbes; researchers had to overcome many barriers to mimic natural growth conditions and culture this elusive strain in a lab. Teixobactin is now showing promise in human trails. Although a temporary resolve for many resistant bacteria, Teixobactin is ineffective against the mcr-1 strains; posing a large risk for epidemics.
The problem remains very real; antibiotic resistance will re-emerge, leaving us in the same position in another 30 years. Are these “advances” really advances at all, or will we always be in a constant battle with nature for survival? It’s clear that Mother Nature will always be one step ahead. One thing is for sure, antibiotic prescription should not be taken lightly. The more we expose bacteria to, the faster they’ll evolve to evade us again. Doctors and patients both have a responsibility to rely on antibiotics only when desperately needed; this may slow the tide of emerging super-bugs.