In 1928 Sir Alexander Fleming a Scottish biologist, pharmacologist and botanist, discovered the very first form of Antibiotic known as Penicillin. As is the case with so many other discoveries, this came about purely by accident– when Fleming noticed how some bacteria he had left in a Petrie Dish had been killed off. This happened because of a naturally occurring penicillin mold ,which had attacked the cellular walls of the bacteria.
Since Fleming’s initial breakthrough, scientists have discovered many other types of antibiotics, some of which have been engineered in a laboratory– an antibiotic works by either killing the bacteria outright, or retarding its growth.
Its important to understand that antibiotics are only effective in treating diseases which are rooted in bacterial infection, e.g syphilis, tuberculosis, salmonella, and certain forms of meningitis etc… They are not however useful, in the treatment of any form of viral disease– since unlike bacterium, viruses replicate themselves by penetrating and entering healthy cells.
At the beginning of the 20th century the average life expectancy of a human was age 40, today that figure has risen to 70. This can be attributed to a combination of several factors– i.e., the pervasive use of antibiotics and vaccines as an integral part of modern medical treatment around the globe, coupled with an increased awareness of the importance of good hygiene and the exponential increase in the development and application of new medical technology.
However, there is now growing concern that the over use of antibiotics is beginning to reverse their efficacy, causing bacteria to evolve and develop resistance to them. According to an online article published by the Mayo Clinic the overuse and misuse of antibiotics is putting people at great risk.
Make no mistake; when it comes to treating many infectious diseases, antibiotics have proved to be invaluable. However they are not appropriate in every case, and prescribing antibiotics when they will have absolutely no effect (e.g for viral infections such as colds and the flu) serves only to accelerate antibiotic resistance.
In the same way that we humans develop a resistance to infections through our immune systems, bacterium also build up resistance to the drugs they are exposed to. This is a natural process and is to be expected. the issue today though lies in the alarming rate at which antibiotic resistance is advancing.
A bacterium which has become resistant to a drug has mutated in some way, either by shielding itself from the drug or by neutralizing the actual drug used. When this bacterium replicates itself it also passes on its drug resistant properties to the other bacteria– not only this, but it can sometimes directly transfer these properties to any surrounding bacteria, effectively providing them with a manual for survival.
According to an article published in Scientific America, the Center for Disease Control and Prevention (CDC) have stated that overuse of antibiotics costs the US Healthcare system upwards of $20 billion each year.
However the article goes on to say that an even bigger issues lie in the overuse of antibiotics in cattle– this is done not only for disease prevention and containment but also to promote growth and weight gain.
As the threat of a post antibiotic looms closer, scientists are battling to find an effective alternative. An article published in Time Magazine states that Dutch micro biotech company Micreos is leading the research in developing new cutting edge techniques to produce a non antibacterial drugs that will fight bacterial infection.
A prototype drug has already been tested in the realms of a modest clinical trial– and the results showed that it was effective in eradicating the MRSA super bug, which is resistant to most antibiotics.
Scientists claim that because the drug works in a completely different way it is less prone to resistance than antibiotics. This new method uses enzymes known as endolysins– which are a naturally occurring form of virus that attack certain bacterial species, whilst leaving other beneficial microbes intact.
The CEO of Micreos echos the positive results of the initial trial by stating that “the development of the new drug marks a new era in the fight against antibiotic-resistant bacteria”, adding that millions of people stand to benefit from this new drug.
Although its encouraging news, this and other similar types of research are in their infancy, and we still need to concentrate on how we can slow down antibiotic resistance. The CDC has laid out certain recommendations designed to help retard the progress of antibiotic resistance , as follows:
- Ask if tests will be done to make sure the right antibiotic is prescribed.
- Take antibiotics exactly as the doctor prescribes. Do not skip doses. Complete the prescribed course of treatment, even when you start feeling better.
- Only take antibiotics prescribed for you; do not share or use leftover antibiotics. Antibiotics treat specific types of infections. Taking the wrong medicine may delay correct treatment and allow bacteria to multiply.
- Do not save antibiotics for the next illness. Discard any leftover medication once the prescribed course of treatment is completed.
- Do not ask for antibiotics when your doctor thinks you do not need them. Remember antibiotics have side effects.
- Prevent infections by practicing good hand hygiene and getting recommended vaccines.
For Healthcare Providers
- Prescribe antibiotics correctly – get cultures, start the right drug promptly at the right dose for the right duration. Reassess the prescription within 48 hours based on tests and patient exam.
- Document the dose, duration and indication for every antibiotic prescription.
- Stay aware of antibiotic resistance patterns in your facility.
- Participate in and lead efforts within your hospital to improve prescribing practices.
- Follow hand hygiene and other infection control measures with every patient.
For Healthcare Facility Administrators
- To protect patients and preserve the power of antibiotics, hospital CEOs/medical officers can:
- Adopt an antibiotic stewardship program that includes, at a minimum, this checklist:
- Leadership commitment: Dedicate necessary human, financial, and IT resources.
- Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
- Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
- Action: Take at least one prescribing improvement action, such as requiring reassessment within 48 hours to check drug choice, dose, and duration.
- Tracking: Monitor prescribing and antibiotic resistance patterns.
- Reporting: Regularly report to staff prescribing and resistance patterns, and steps to improve.
- Education: Offer education about antibiotic resistance and improving prescribing practices.
- Work with other health care facilities to prevent infections, transmission, and resistance.
Imagine a post antibiotic era where we were forced to live in a disease ridden world, with threats such as the black death, and the plague spreading uncontrollably and killing off thousands of people.
A few years ago this might have sounded like the synopsis of a screen script for a new outlandish movie. The truth however is somewhat more sinister– if we don’t wake up to what’s happening here and take responsibility to do our part in helping to slow down antibiotic resistance, we could well be heading back to the dark ages.