Are we headed towards a post-antibiotic era?

Are our ''magic bullets' against infections about to become obsolete?

Sesha Subramanian
19th November 2018
Photo by on Unsplash

The Pasteur Institute in Paris, France recently published a report on the rising incidence of antibiotic resistance across the globe – highlighting a major problem in the medical world today. In Europe, 400,000 people are infected by antibiotic-resistant bacteria every year, and 25,000 die from their infections.

When penicillin was discovered in 1928 and later when antibiotics began to enter common use in the 1940s, they had a huge impact on the Second World War, and were even hailed as “magic bullets”. Thus, they began to be overused to a large degree to treat infections – even minor ones that ordinarily would not need antibiotics.

Naturally, Alexander Fleming – the discoverer of penicillin – figured that there would at some point be a time where bacteria would become resistant to this new class of drugs. He said that "the microbes are educated to resist penicillin and a host of penicillin-fast organisms is bred out which can be passed to other individuals and perhaps from there to others until they reach someone who gets a septicemia or a pneumonia which penicillin cannot save."

Antibiotic resistance is a phenomenon where bacteria that are initially susceptible to a particular line of antibiotic treatment eventually fail to respond to the same treatment, forcing the use of either a different line of treatment or a drug with a higher potency.

Bacteria are capable of acquiring genes from resistant bacteria that confer resistance to antibiotics. A given individual may be a carrier of a resistant bacterial strain in the gut microbiota, without experiencing any health problems or apparent symptoms. All it takes is for this individual to be infected by pathogenic bacteria, and the resistant strain can transfer its resistance genes to these new bacteria.

The phenomenon may occur quickly and may even be aided by antibiotics.

One of the main issues with antibiotic resistance is that it delays the administration of appropriate treatment to the patient. There are no rapid tests to detect resistance and while research is being carried out in that avenue, today it still takes at least a day or two before the resistance is identified through a sensitivity test and the treatment is changed.

Another, more immediate way to combat antibiotic resistance is to try and prevent its cause. Antibiotic resistance has its roots in the overuse of antibiotics, so prescribing the appropriate antibiotic and at an appropriate dose for an appropriate time period goes a long way towards alleviating the problem. Getting even one of these factors wrong will prove to be detrimental for both the patient and would aid the development of resistance to the drug.

Combating antibiotic resistance now involves a multipronged approach. Awareness must be raised as to the efficacy (or the lack of it) of antibiotics on various diseases.

For example, antibiotics are of no use in a viral infection. This prevents large scale misuse of antibiotics – especially in the form of self-medication.

There is also a focus on developing newer, more powerful antibiotics, which would form the second or the third line of treatment in various conditions.

One other solution could be to try and prevent the spread of resistant bacteria from one individual to another, but that is easier said than done.

All in all, antibiotic resistance is a growing problem which requires large scale action under an umbrella organisation like the World Health Organisation (WHO) as well as active public participation from both the medical and the non-medical community to combat it.

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