Think For Yourself: Antibiotic Resistance

Do you take antibiotics to cure a cold? IA critical thinker, John Turnbull, takes a look at the growing issue of antibiotic resistance and what you can do to make a difference.

PRIOR TO the development of antibiotics, what we today consider a minor infection could cause serious illness or even death. Antibiotics are credited for the eradication of diseases such as tuberculosis and the control of many others, but have grown in popularity so much that antibiotic resistant bacteria (also known as Superbugs) potentially pose a serious risk to the future of human health.

A little history

Antibiotics as we know them were developed in the early 20^th century; however history reflects that a number of ancient cultures including the Greeks and Egyptians used mould and plant mixtures with antimicrobial properties to treat infections. Ancient Serbians were known to place mouldy bread on wounds to prevent infection, and Russian peasants would use warm soil to cure infected wounds (although records are unclear on the efficacy of this last method).

The modern development of antibiotics is generally thought to start with John Parkington in 1640, who wrote a book on pharmacology that recommended mould as a treatment. In the 1870s, scientists Joseph Lister and Sir John Burdon-Sanderson experimented with antibacterial treatments on human tissue, and Louis Pasteur postulated that some bacteria (such as anthrax) could kill other bacteria.

Building on all of this research, in 1928 Sir Alexander Fleming discovered penicillin. It is fair to say that a dash of luck was involved in this discovery, as he was experimenting on influenza when he discovered that mould had destroyed bacteria on a staphylococcus culture plate. Fortunately, he was able to isolate the active substance in the mould, which was effective even when diluted up to 800 times.

Soon after the discovery of penicillin came a wave of other antibiotics, most notably the Bayer developed Sulfonamidochrysoidine, sold under the brand name Prontosil. This became the first commercially available antibiotic, and lead researcher Gerhard Domagk won the Nobel prize for medicine in 1939.

Since the development of antibiotics, average life expectancy has increased significantly (particularly in developed countries with good access to treatment), and conservative estimates credit antibiotics with saving millions of lives around the world.

How do antibiotics work?

To grossly oversimplify: antibiotics kill bacteria, or stop them from multiplying.

From NPS Medicinewise:

'Antibiotics are medicines used to treat infections or diseases caused by bacteria (and) a range of other infections caused by bacteria, including urinary tract infections, skin infections and infected wounds.'

'Antibiotics work by blocking vital processes in bacteria, killing the bacteria, or stopping them from multiplying. This helps the body's natural immune system to fight the bacterial infection.'

Just to be clear: antibiotics are effective against bacterial infections. Not viruses.

My doctor prescribed antibiotics for my cold …

Then your doctor is part of the problem. Find a better one, or ask them to describe in detail how antibiotics can treat a viral infection.

It is true that many medical professionals will prescribe a course of antibiotics to patients who present with cold or influenza symptoms, but this is little more than a placebo. The recommended treatment for a cold or mild flu is bed rest and lots of fluids, while more serious cases of influenza may require hospitalization.

Antibiotics do not cure colds or flu.

So what has changed in the last 75 years?

Not to put too fine a point on it, but evolution has caught up with us.

From the Centre for Disease Control (CDC):

'these drugs (antibiotics) have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections.'

A major contributor to this problem is over-use and misuse of antibiotics. Patients who take antibiotics for a cold or start a course of antibiotics and don’t finish them because they ‘feel better’ are responsible for exposing bacteria to non-lethal doses of the antimicrobial, leading to the development of resistant strains.

Animal husbandry is also responsible for an increase in antibiotic resistance, as sub-therapeutic doses of antibiotics are used to promote faster growth and prevent disease. This practice can (and does) result in resistant microorganisms in farmed animals, which can then be passed on to humans.

'Over the past years, the use and misuse of antimicrobials has increased the number and types of resistant organisms. Consequently many infectious diseases may one day become uncontrollable. With the growth of global trade and travel, resistant microorganisms can spread promptly to any part of the world.' (CDC.gov/drugresistance)

Can’t we just invent new antibiotics?

That isn’t as easy as it sounds. Since 2009 only 2 new antibiotics have been approved in the United States, and the number of antibiotics in development continues to decline. Simply put, the antibiotics that were easy to discover have already been discovered, so the cost and difficulty of finding new ones continues to rise. From the CDC:

'There is insufficient investment in developing new antimicrobials. Similarly, there is insufficient new research into new diagnostics to detect resistant microorganisms; and new vaccines for preventing and controlling infections.'

Until the situation becomes catastrophic, it is far more profitable for drug companies to focus their efforts on developing treatments for baldness and erectile dysfunction rather than spend money researching treatments for MRSA.

Fortunately, governments of both the UK and U.S. have instituted programs to address this decline, with the Antibiotic Development to Advance Patient Treatment (ADAPT) Act passed in the US in 2013, with the aim of fast-tracking drug development to combat the development of Superbugs. Government funded researchers in the UK are making progress on the development of new antibiotics based on Streptomyces, and combinations of existing antibiotics are having some success at treating antibacterial resistant bugs.

But the problem isn’t going away.

So what can I do?

Not-for-profit NPS Medicinewise is currently running a slightly baffling campaign on Australian TV drawing attention to this issue.

Their website states that you can prevent antibiotic resistance by:

understanding that most people don't need antibiotics for colds and flu because they are caused by viruses
telling your doctor you only want an antibiotic if it is really necessary
taking the right dose of your antibiotic at the right time, as prescribed by your doctor
taking your antibiotics for as long as your doctor tells you to
taking simple steps to avoid infections and prevent them from spreading.

That doesn’t sound too hard, does it?

Conclusion

Inspiring movies like Contagion, I Am Legend and Twelve Monkeys, the problem of antibiotic resistant bacteria has been bubbling in the background of our consciousness since the 1950s. Unfortunately, as the global population increases and international travel becomes more affordable, the potential for an antibiotic resistant pandemic increases greatly.

Fortunately, this threat isn’t insurmountable. You can make a difference. Only take antibiotics when prescribed, finish the course as instructed, and be considerate to others when you’re suffering from an infectious disease.

Think for yourself, but listen to your doctor.

Like what you read? John’s books are now available on Amazon and Kindle. For about the price of a cup of coffee you can take a journey deep into the disturbed psyche behind columns including Screen Themes, Think For Yourself, New Music Through Old Ears and JT on NXT. There’s supernatural thriller Damnation’s Flame, action/romance Reaper, black comedy City Boy and travel guidebook Bar Trek: Europe. Check them out!

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