‘The world faces an antibiotic apocalypse’

Sick habit: In America 50% of prescribed antibiotics are not needed or not effective. © Getty

Do we get a thrill out of predicting disaster? This headline is a quote from England’s chief medical officer as scientists gather in Berlin this week for a conference on drug resistance.

One day, three year-old Ashley Pachecho from Venezuela scraped her knee whilst out playing. Her parents cleaned the cut and gave it no more thought. Two weeks later Ashley was nearly dead. Her knee became infected. And due to a shortage of antibiotics, the infection spread, eating away at her lungs.

Fortunately, she survived. But as more antibiotics are made useless by antimicrobial resistance (AMR), Ashley’s story could become the new normal.

Currently 700,000 people die from drug resistant infections every year. By 2050, this could rise to 10 million.

Recently scientists reported that bacteria resistant to the antibiotic of last resort, the drug colistin, are spreading through China. Other drugs are also in danger of losing their efficacy. Dr Luke Moore claimed that doctors increasingly cannot deploy “the most commonly used antibiotics” like penicillin. And according to the World Health Organisation humanity could soon enter a “post antibiotic era” in which “common injuries and minor infections can kill.”

Resistance builds up due to natural selection. For example, antibiotics treating tuberculosis will kill most, if not all, tuberculosis bacteria. But sometimes resistant cells survive. These cells reproduce, creating more deadly strains of the disease. Tuberculosis kills 1.8 million people per year, and cases are increasing.

Over-use of antibiotics among humans is driving the crisis. But another big factor is farming. In the USA 80% of all antibiotics go to animals, with 131,000 tonnes of drugs given to livestock every year. This makes a farm the perfect place to breed drug-resistant super-bugs.

There are solutions. Doctors could prescribe fewer antibiotics. And if people ate no more than 40 grams of meat per day, farms could cut antibiotic use by 66%. Economist Lord Jim O’Neill claimed that these fixes are “not that difficult”, and that all it needs is for “people to behave differently”.

So should we describe the crisis as a potential apocalypse?

Resistance is futile

We must stop this alarmist rhetoric, argue some. Our culture is obsessed with the end of the world. This is not helpful. The truth is that this crisis has ready scientific solutions — the difficulty is going to be convincing people to act differently. Rather than spreading fear and panic, we should be educating people on how they can help.

The danger is extreme, counter others. If solutions are not found then there will be widespread suffering and death. That is a fact. Explaining the issue in this way gets people’s attention. Once the public realise the gravity of the crisis they will be more likely to change their behaviour for the better.

You Decide

  1. Are we obsessed with discussing the apocalypse?
  2. Is it sometimes good to be unwell?

Activities

  1. If you had the power to cure one disease which would you choose and why?
  2. Do some research into the history of penicillin. How was it first discovered? What illnesses has it treated since its discovery? What infections have since developed resistance to the drug?

Some People Say...

“Antibiotic resistance is the greatest threat facing humanity.”

What do you think?

Q & A

What do we know?
According to a 2014 Pew research paper, only five out of the top 50 pharmaceutical companies are engaged in researching new antibiotics. New techniques are also being tested, including using viruses called “phages” to attack bacteria, rather than traditional antibiotics. Only 14% of drugs in development will end up being used by humans.
What do we not know?
The new “phage” treatment has yet to be put through clinical trials, so it is not known how effective it is on humans. As of May this year, 55 new antibiotic medicines are known to be in development. However, we do not know if any of these will be effective.

Word Watch

Scientists
From the American Society for Microbiology.
Colistin
Colistin is known as the “antibiotic of last resort”. It can have serious side-effects including kidney failure and formication — the feeling of having insects under your skin. Historically, it was mainly prescribed to animals. However, with traditional antibiotics becoming ineffective, the drug is being used to treat humans.
Dr Luke Moore
Honorary Clinical Research Fellow from the Department of Medicine, Imperial College London.
Penicillin
Antibiotic which has been effective at treating many different bacterial infections. It was discovered in 1928 by Scottish scientist Alexander Fleming.
Tuberculosis
Infectious disease of the lungs. It has many symptoms including coughing blood, weight loss, and fever.
Driving the crisis
It has also been traditionally argued that patients not finishing a course of antibiotics leads to resistance, as all bacteria may not be fully killed off. However, scientists recently argued in the British Medical Journal that there is not enough evidence to support this claim. The debate continues.

Subjects

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