A Post-Antibiotics Future? | Maryn McKenna

Most of us know that bacteria can develop resistance to antibiotics: hardly surprising given their generational cycles can be as short as 20 minutes.

What’s not so well known is that this process is now leading us (seemingly inexorably) towards a crisis. Already, many bacterial infections are resistant to all but one or two types of antibiotics, some are even “pan-resistant”. In other words, untreatable with current drugs:

In 2009, three New York physicians cared for a sixty-seven-year-old man who had major surgery and then picked up a hospital infection that was “pan-resistant” — that is, responsive to no antibiotics at all. He died fourteen days later. When his doctors related his case in a medical journal months afterward, they still sounded stunned. “It is a rarity for a physician in the developed world to have a patient die of an overwhelming infection for which there are no therapeutic options,” they said, calling the man’s death “the first instance in our clinical experience in which we had no effective treatment to offer.”

Because the reliable life cycle of new antibiotics is often so short, pharmaceutical companies have mostly backed away from developing new variants. It’s too expensive and takes too long. The medical armoury is therefore emptying out and new weapons against infection are (at best) likely to be a long way off.

It doesn’t help that antibiotics have been used so indiscriminately over the years. Resistant bacteria were always inevitable (something that Sir Alexander Fleming emphasised right from the start back in the 1940s) but our carelessness has turbocharged the process. For example, something like 80% of all antibiotic usage by weight is in agriculture and, despite decades worth of warnings from scientists and researchers, in the US at least there’s no sign of a policy change.

Before reading this article, I hadn’t considered how critically embedded antibiotics are in the “miracles” of modern medicine. Without them, much that we take for granted would be either impossible or exceptionally dangerous: chemotherapy and radiation treatment or anything else that involves suppressing the immune system; most intensive care because it requires openings into the body, and in particular the bloodstream; many surgical operations; implantable devices or body part replacements, and so on.

And then there’s everyday life. Simple scrapes or insect bites could once again, at worst, be fatal and diseases like pneumonia would be a death sentence for a substantial minority. It hardly bears thinking about.

Is Maryn McKenna being unduly alarmist? I don’t think so: in any case, she’s certainly not alone in her concerns. In September, the Centres for Disease Control and Prevention (CDC) issued a report entitled “Antibiotic Resistance Threats in the United States, 2013”. It’s described in the Executive Summary as “a snapshot of the complex problem of antibiotic resistance today and the potentially catastrophic consequences of inaction.”

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