SINCE Sir Alexander Fleming, a Scottish biologist, pharmacologist, and botanist (a 1945 Nobel laureate), first discovered penicillin in 1923, hundreds of more potent wider spectrum antibiotics have been added to the medical armamentarium. These lifesaving drugs have been a boon to medical care and benefited millions of patients around the globe.
However, like many good things, antibiotics have been abused by society as a whole, including the medical community. In many cases, they are prescribed without strict medical justification or used for a protracted period, longer than necessary. Individuals who are able to buy them over the counter without prescription in some countries use them ignorantly and unnecessarily, without medical rationale, even for colds which is a viral, not a bacterial, infection, where antibiotics are useless. Besides wasting money, they are endangering their and society’s health and well-being… in the long run, contribute to the superbug catastrophe.
“Superbugs could kill one person every three seconds by 2050, the equivalent of 10 million people a year,” which would “cast us back into the dark ages of medicine,” says the final report a few weeks ago from the Review on Antibacterial Resistance established in 2014.
The “Transformer” bugs
Since bacteria have the ability to adapt to substances being repeatedly used against them and mutate (transform itself) over time to a resistant variety in order to survive, medically resistant strains of the microorganisms soon develop. They are called superbugs, potential killers which would not respond to any antibiotic at all.
When this happens, humans and other animals would be under the mercy of these superbugs. Medically, we would be transported back to the pre-antibiotic era, where a simple wound infection of the hand, arm, or leg could lead to amputation or death, where an easy-to-treat bacterial gastrointestinal infection of today could be a frequent killer once more.
Indeed, it is scary to imagine a world with a pandemic of superbugs, without effective antibiotics. People will be dying like flies, especially today when bacteria appear to be more virulent and more adaptive.
Superbugs are deadly
But this is not science fiction. Today, we already have some superbugs. One of them is the medically resistant tubercle bacilli, where the standard anti-TB regimen is no longer effective and where survival is more of an exception. The more popular one is hospital-acquired MRSA, methicillin-resistant Staphylococcus aureus, which used to respond to methicillin, a simpler and much less expensive antibiotic. Today, MRSA is resistant to many antibiotics. In public, most MRSA infections are skin infections, but in medical centers, this dangerous bug causes potentially fatal blood poisoning, pneumonia and infection of surgical incisions. MRSA is expected to have a death toll of 19,000 annually in the United States alone.
Luckily for patients with MRSA, Bactrim and Vancomycin, clindamycin, minocycline have been found to be still effective against it. However, resistance is now being seen developing even to some of these more potent and expensive drugs.
The emergence, multiplication and spread of superbugs are a threat to the achievements of modern medicine. They would negate and render useless the great advances in pharmacologic science and clinical medicine we have gained so far in our war against bacterial infections.
Warning from WHO
The World Health Organization (WHO) has published and released its first worldwide review of antimicrobial resistance with data from 114 countries and warning the global community of this serious threat to public health.
WHO assistant director-general for Health Security, Dr. Keiji Fukuda, declared, “Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill…the implications will be devastating.”
The report also pointed out that there is a resistance to last-resort treatments, like carbapenem antibiotic against the common intestinal bacterium Klebsiella pneumoniae, which has now spread around the globe. This is now ineffective in more than 50 percent of severe infections it used to cure.
E. coli infection of the urinary tract, which used to respond to fluoroquinolones, is now resistant to the drug around the world. When these drugs first came out in the 1980s, there was zero resistance.
The UK, Canada, Australia, France, Japan, Austria, South Africa, Norway, Sweden and Slovenia have reported treatment failures with third generation cephalosporins, the last-resort treatment for the more than one million gonorrhea patients around the world.
WHO also laments the fact that many nations lack basic systems to track and monitor antibiotic use and resistance, and not many have seriously addressed this issue.
Meanwhile, Brendan Wren, professor of microbial pathology at the London School of Hygiene and Tropical Medicine, is finding ways to develop vaccines against a variety of currently resistant bacteria, including superbugs in hospitals and clostridium
difficle. How to disable bacteria from replicating itself so they do not become antibiotic resistant is also in his laboratory agenda.
Our abuse is haunting us
While bacterial resistance is a natural and expected tendency to a degree, the rapid speed of its development and the number of superbug transformations have been the results of society’s carelessness and abuse in the use of antimicrobial drugs.
For one thing, viral infections in general (colds, flu, etc) do not respond to antibiotics, which are actually indicated only for bacterial infections. A person taking antibiotics frequently and without medical supervision is more prone to develop superbugs in his/her body. That would be tragic.
Our abuse, which includes feeding antibiotics to our farm animal sources of meat, could bring back some old enemies in a drug-resistant and deadly form: tuberculosis, typhoid, syphilis, gonorrhea, klebsiella, diphtheria, etc., which could wipe out countless millions more.
Unless people take this warning seriously and act wisely and responsibly, and unless nations around the world work together to reassess and change how these drugs are manufactured, prescribed and used, and come up with potent new drugs against these superbugs, we, humans, are doomed to lose our war against these deadly bugs. And this could be worse than the plague, known as the Black Death, that killed more than 25 million people (almost half of the
population) of Europe in the 14th century.
It’s really up to us.
