Thanks to medicine, humanity has coped with many threats to health and life, but today we are faced with a new type of crisis: dangerous bacteria are becoming immune to drugs designed to destroy them. We have less and less means of counteracting bacterial strains that have developed resistance to antibiotics. What do we do?
When an infection is found that is unresponsive to standard antibiotic therapy, doctors are forced to use stronger, more aggressive antibiotics or combinations of antibiotics, which in itself can cause undesirable health effects.
How did we end up in this situation, and is the situation really as bad as it seems? And most importantly, what can doctors, researchers, and the public do to counter the ever-growing threat of antibiotic resistance?
The situation is terrible indeed. According to the latest data, in the US alone, over 2.8 million people become infected with drug-resistant bacteria each year, resulting in over 35,000 deaths per year.
The Centers for Disease Control and Prevention (CDC) system first raised the alarm in 2013 when the first report on antibiotic resistance was published. Since then, the number of reported infections of this kind annually has risen from 2 million to 3 million. In 2018, the WHO published a report showing that many bacteria are also becoming resistant to alcohol-based disinfectants used in healthcare facilities.
That many bacteria no longer respond to first line and even second line drugs means significantly higher health risks and worse outcomes; Routine surgeries, organ transplants, and chemotherapy also become dangerous.
A recent report from the CDC highlights that antibiotic resistance in pathogens is not just a U.S. problem, it’s a global crisis. But what brought us to the breaking point?
There are several answers.
The first and perhaps most obvious cause is the overuse of antibacterial drugs.
Many people mistakenly perceive antibiotics as a panacea that cures any illness, such as influenza and other respiratory viral infections. However, antibiotics are only effective against bacteria. When such a drug is used inappropriately, it kills symbiotic bacteria, which in turn upsets the delicate balance in the microbiota inhabiting the body. This is dangerous to health.
Another reason is that bacteria naturally tend to evolve and mutate; some bacterial strains that are not completely eradicated (“undertreated,” as we call it) eventually find ways to adapt and develop protection against previously effective antibiotics. And when we misuse or overdose antibiotics, it allows these strains to spread and grow rapidly, sometimes giving rise to new, multidrug-resistant populations.
In the United States and elsewhere in the world, pharmacies are prohibited from selling antibiotics without a prescription, but, nevertheless, the mass of people somehow finds the opportunity to purchase antibacterial agents without having a doctor’s prescription. In addition, in some cases, antibiotics are prescribed in an irrational dosage or with an error in choosing the type of drug, which also contributes to the development of the crisis. It is estimated that between 30 and 60 percent of antibiotic prescriptions are unnecessary.
Another reason is that antibiotics are not only used to treat people. In some cases, the prescription of antibiotics for veterinary purposes is fully justified, but recent studies reveal the true extent of the problems that arise from the addition of antibiotics used in human medicine to the feed of farm animals [Lakhta Clinic: see the material “Antibiotic resistance is increasing sharply”]. According to these studies, up to 80% of antibiotics sold (in the US) are purchased for use in livestock. The goals are to increase growth rates and prevent infections in livestock. However, there is more and more evidence of a rapid increase in drug resistance now in those bacterial cultures that cause infectious epizootics. This contributes to the development of a general antibiotic crisis.
In the face of a growing threat, policy makers are forced to pay more attention to developing measures to use antibiotics more cautiously, and the research sector to look for effective ways to overcome drug resistance in bacteria (for example, using bacteriophages instead of drugs).
Dr. Jess Jacob , a specialist at the Center for the Study of Drug Resistance at Emory University (Atlanta, USA), encourages everyone and everyone:
“Use antibiotics when absolutely necessary, but not just in case. Discuss this with your doctor. Yes, just wash your hands often. And finally get the vaccines that will save your lives and stop the spread of drug resistance.”
