Antibiotic resistance has reached a tipping point; our last resort drug is failing.

Antibiotics have been our mainstay treatment for bacterial infections since the discovery of penicillin in 1928. Infectious diseases kill more people worldwide than any other single disease. Infectious diseases can be caused by bacteria, viruses, fungi, or other one cell bugs called protozoa. Antibiotics only work in treating bacterial infections and not any of the other types of infections. Unfortunately, because of the ease and effectiveness of antibiotics, they have been over-prescribed for illnesses that they will have no effect on. In addition to over prescription, the over use of antibiotics in livestock and commercial products (soap and hand sanitizers) has led to the development of resistance to the drugs in bacteria. The problem has now become critical. Bacteria are becoming resistant to our last resort treatments.

The tricky thing with bacteria is that they can grow rapidly. E.coli for example can double their numbers in 20-30 minutes. That means that in the span of an hour you can go from 1,000 cells to 8,000 cells. This rapid growth rate means that any bacteria that are able to resist the killing action of your antibiotic will rapidly become the dominant type in your group of cells. For example, if all but 10 of your cells above die (because they are resistant to the antibiotic) then in 1 hour you will have 80 bacteria that are antibiotic resistant and in 5 hours you will have over 300,000 resistant bacteria. Resistance can spread very quickly. So far, resistance has been developed to all but the last of our drugs.

Unfortunately, bacteria that carry a gene to breakdown these last resort drugs have been discovered in Denmark and China. These drugs, called Polymyxins, are used to treat bacterial infections that are resistant to all our other available antibiotics. The most common of these polymyxins is Colistin. Since they are our last resort drug this means that they should only be used in extreme cases. However, in China, these Polymyxins are used to fatten up livestock. Annually, 12,000 tonnes of this antibiotic are used in China to make livestock grow faster and this use can directly lead to antibiotic resistance. For this reason, there has been a strong push to ban their use in livestock growth in Europe. Clearly the world is not very good at preventing antibiotic resistance because Colistin is the fifth most commonly used antibiotic in European livestock and in India, Colistin is commonly used to treat human and animal infections. This over use is going to be our downfall. If the resistance gene is indeed present in the densely populated countries of China and India, then it will not be long till we have full resistance to these drugs.

There are a number of things the public can do to help prevent antibiotic resistance. Don’t get antibiotics for viral infections, they wont do anything and just add to the overuse of antibiotics. Part of this responsibility falls on doctors who tend to overprescribe antibiotics in clinics. Additionally, stop using antibiotic soaps and cleaners in your house. If you want to disinfect and kill bacteria, then use bleach or other cleaning agents. Also, support butchers who sell meat raised without the use of antibiotics. The animals don’t need them if they are housed properly. Finally, if you are prescribed antibiotics make sure you take them all. By not finishing your prescription you are leaving some bacteria alive and promoting the formation of antibiotic resistance.

Scientists are working feverishly to develop new, better antibiotics that the bugs aren’t resistant to. Let’s hope that the research gets the funding it needs to push these discoveries forward. It is a scary future without antibiotics that work. A future where a simple ear infection is untreatable.

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