For a long time, there have been newspaper stories and covers of magazines that talked about “The end of antibiotics? (question mark)” Well, now I would say you can change the title to “The end of antibiotics – period.”
That’s Dr. Arjun Srinivasan – one of an impressive lineup of doctors and scientists on “Hunting the Nightmare Bacteria”, an episode of PBS Frontline that explains how we have come to the end of the antibiotic era. Not “in danger of coming to” the end of the line, but inexorably now arriving there.
Basically, we’re returning to the pre-antibiotic era when people routinely died from infections that, for the last hundred years, have been treated with a simple course of penicillin and other antibiotics that followed.
The more antibiotics we use, the more the bacteria adapt and find ways around them.As part of the balance of nature, bacteria and fungals (which is basically what antibiotics are) are constantly evolving – finding ways around each other, developing new resistance to each other, and finding a new balance.
But over the last 50 years, antibiotics have been badly overused, and the bacteria have been evolving more rapidly, now becoming super-bacteria, and modern medicine simply can’t keep up with the need to develop new antibiotics that will take the place of the now –ineffective ones.
Dr. Srinivasan: Antibiotics were one of [the most], if not the most, transformational discoveries in all of medicine. Infections are something that we struggled to treat for many, many years, for centuries before the advent of antibiotics, and infections were a major cause of death before the advent of antibiotics.
They’re not only indispensable in treating general infections that come along; they’re an essential part of all kinds of critical medical procedures – surgeries, chemotherapy, arthritis treatments and so many more treatments that require antibiotics because they open the body of potential infections or weaken the immune system.
But the more antibiotics we use, the more the bacteria will find ways around them as they adapt and evolve.
Dr. Srinivasan: This is a phenomenon that plays out in nature. Most of the antibiotics that we have available to us now were derived from products in nature. So penicillin was an agent that was excreted by molds in order to kill bacteria. Eventually bacteria will evolve, and they’ll adapt ways around that to overcome that obstacle.
… The more you use an antibiotic, the more you expose a bacteria to an antibiotic, the greater the likelihood that resistance to that antibiotic is going to develop. So the more antibiotics we put into people, we put into the environment, we put into livestock, the more opportunities we create for these bacteria to become resistant.
…We also know that we’ve greatly overused antibiotics and in overusing these antibiotics, we have set ourselves up for the scenario that we find ourselves in now, where we’re running out of antibiotics.
… We’re in the post-antibiotic era. There are patients for whom we have no therapy, and we are literally in a position of having a patient in a bed who has an infection, something that five years ago even we could have treated, but now we can’t. …
The Frontline episode shows a young girl getting a scratch in the school playground and picking up an uncontrollable infection that her parents and doctors are still trying to contain. She’s one of the survivors – so far.
We see a young man picking up an infection while traveling, and being sent to a top National Institutes of Health hospital ICU, where he undergoes a series of amputations in an effort to stay ahead of the infection that’s creeping up his leg.
We see an infection spreading through the ICU and then through the hospital itself as patients succumb to it and die.
Some bacteria have learned to do more than just resist antibiotics; they develop enzymes that literally chew them up; they change their outer wall to stop the antibiotics getting in; they can even pump the antibiotics back out. And some of the most dangerous kind are doing all of these at once. More than 80 percent of all antibiotics are being fed to animals at factory farms.
The big drug companies don’t want to do the expensive research (frequently a billion dollars) for a new antibiotic because, unlike drugs you take for life (e.g. Lipitor), the idea with antibiotics is to take them for only a few days. So it doesn’t make business sense to make that investment. Some of the companies, like Pfizer, are pulling out of the antibiotic field altogether.
Meanwhile, more than 80 percent of all antibiotics are being fed to animals at factory farms – not just in an attempt to ward off the massive bacterial infections that constantly threaten animals in overcrowded conditions, but also because they have the effect of making farmed animals grow faster and fatter.
So whether or not you’re deliberately taking antibiotics for medical reasons, you’re dosing up on them as they find their way into your food if you eat animal products and as they find their way into the environment just generally.
There have been a number of studies that show that when you give antibiotics to animals, especially to animals that we then eat, there are antibiotics that get into their systems that can develop resistance, and then when we eat the food, we can be exposed to those resistant organisms.
We also know that if antibiotics are used in animal feed that they can end up in animal waste, so we can end up with antibiotics in our water supplies, and it’s that type of low-level presence of antibiotics that can also lead to issues with resistance.
… The CDC believes quite firmly … that we should never be using antibiotics in agriculture or in people for any other purpose than to treat infections.
If you spend any time around hospitals, if you eat animal foods (including dairy and eggs), if you have a weakened immune system or may be going on drugs that weaken your immune system, or really whoever you are, you should watch this TV program. You can see it online, and there’s an entire website of additional information, including the interview that’s quoted above.