Are fears of an ‘antibiotic apocalypse’ really going to play out in reality?
In the previous century, antibiotics were one of the biggest breakthroughs in modern medicine. When Alexander Fleming discovered penicillin in 1929, it revolutionised healthcare. But over the past decade, scientists have been saying that we are as a world becoming increasingly resistant to antibiotic drugs.
The word hasn’t just come from people on the fringes of the healthcare profession. In 2016, the Director-General of the World Health Organization told the United Nations that:
“The world is heading towards a post-antibiotic era in which common infections will once again kill. If current trends continue, sophisticated interventions, like organ transplantation, joint replacements, cancer chemotherapy, and care of pre-term infants, will become more difficult or even too dangerous to undertake. This may even bring the end of modern medicine as we know it."
Obviously, the language used in 2016 was intentionally strong. Ultimately, the aim was to make the world sit up and listen. But according to healthcare professionals from countries across the globe, this is an issue that could change the way we treat common infections. It could impact public health in every nation on earth.
The primary problem is this. The drugs that have developed over the past century are starting to lose their efficacy. Unfortunately for us, antibiotics are used throughout medical practice. With almost every operation, infection and medical problem using antibiotics in some form.
From chlamydia to bronchitis, cancer to transplants, antibiotics have been vital to keeping bacterial infections at bay. Today, we are starting to see a return to pre-antibiotic days. Without action, infections such as tuberculosis could become a part of our lives again.
But what action can be taken to reverse the depressing trend? One of the biggest problems is that the issue is exceptionally complex. Scientists also say that the damage has been done, and there is little we can do to change the direction we’re travelling in.
The good news, however, is that we are becoming more aware of the problem. With further awareness, we can help reduce the number of antibiotics prescribed around the world -- especially in industries that involve livestock. The more the public knows about the problem, the more they are likely to agree to reduce antibiotic intake too.
With government bodies, organisations and pharmaceutical companies all working together to help with the issue, we may be able to come up with a viable solution before the spread of resistance develops to critical levels.
How did we become antibiotic resistant in the first place?
The reason why we have, as a planet, become antibiotic resistant is through the overuse of drugs. The more we use antibiotics, the higher the chances that bacteria can evolve, and develop into antibiotic resistant bacteria.
Antibiotics work by altering the processes needed for bacteria to grow. How they go about it depends on the drug itself. Some starve bacteria, whilst others create a protective wall. Unfortunately, bacteria have over the years developed to get around these processes. Like all life on earth, with bacteria, it is the survival of the fittest. And for humans, unfortunately, the fittest are the ones that are making it harder to treat bacterial infections.
It’s not just humans either. Antibiotics have been used to treat agriculture since the 1950s. Farmers use antibiotics in cattle feed, for example, to stop their herd getting sick. Economically, it makes sense. The more fit and healthy cows or sheep, the higher the yield on a flock. The issue with this, however, is that farmers use the same antibiotics for their cattle as we use for our own bacterial infections.
Over the years, this has allowed bacteria to mutate, which has in turn increased our own antibiotic resistance. Sewage from farms also seeps into our river systems and seas. So people who spend time doing recreational activities such as sailing or surfing, or even people who go for a paddle in the summer, are at a higher risk of becoming infected with bacterial infections.
Our modern way of life also has an impact. Bacterial infections, especially the lethal MRSA bug, are able to develop quicker in big environments where a lot of people congregate. Especially sick people. Which makes hospitals potential breeding grounds for antibiotic resistant bacterial infections. Likewise, enclosed spaces such as airplanes make it easier for infections to spread. With more and more of the world population travelling across the globe, it is accelerating our resistance to bacterial infections.
What needs to happen across the board is a reduction in the use of antibiotics. This has to start at first in the agricultural sector. Good practice needs to occur, and farmers need to be selective as to when to give animals antibiotics. At the minute, some in the industry administer them to every animal, even those that are healthy. Vaccinations can help in this regard.
But what about us? Whilst increased awareness will inevitably lead to a reduction in the delivery of antibiotics, we still haven’t solved the problem just yet.
According to the British Medical Journal, 1 in 5 prescriptions for antibiotics in the UK, that are issued by GPs, are inappropriate. Between 2000 and 2010, global antibiotic consumption increased by 30%. More training, better understanding, and a more thoughtful approach to prescribing drugs at the point of service needs to occur if we are to reverse the trend of antibiotic resistance. If we want to be able to fight infections, action needs to be taken across the board.
How pharmaceutical companies are helping to solve the problem of antibiotic resistance
As you might expect, pharmaceutical companies are also trying to find solutions to antibiotic resistance. The issue for most, however, is that bacteria is constantly evolving. Which makes it hard to find solutions. Especially when considering the time it takes to go through research and development. And this is without including the time it takes to get a new drug on the market after extensive medical research.
A further report by the BMJ published this year does indicate that drug companies are starting to tackle resistance. It also suggests that more could still be done. It is, however, very encouraging that pharmaceutical companies are taking this issue seriously. And with more focus over time, new solutions will inevitably be found.
As a global society, we shouldn’t, however, rely on drug companies alone. The biggest issue here is the overuse of antibiotics. Not even the brightest brains in the world of pharmaceuticals can fully understand how bacteria will evolve over time.
Could you can help reverse the trend?
Many of you reading this will be wondering if there are any ways in which you can help to slow the trend of antibiotic resistance. Though there aren’t a huge deal, there are steps that can be taken.
The main point is to never request antibiotics from your doctor if they don’t offer them as a solution. Whilst your tickly cough may feel like the onset of a respiratory infection, there may be non-antibiotic solutions that can help you recover. Likewise, don’t share or use antibiotics with other people, even if you don’t complete a full course.
Most of the other solutions are fairly common sense. Prepare food well. Wash your hands. Choose food that you know hasn’t been treated with antibiotics.Ultimately, the problem is not only caused by us all, it will be solved by us all. The more we are aware as a global society of the impact taking or prescribing antibiotics can have, the higher the chance we have of reversing, or at least reducing, the ever-increasing number of drug resistant infections.