Will humans lose the battle with microbes?

August 7, 2012 By Daniel J. Stone

Consider an all-too-common scenario: You're burning up from a high fever after a routine surgical procedure, and an infection specialist is called to help treat your problem. You assume that a short course of antibiotics will quickly turn things around. But the specialist candidly admits: "I'm sorry, I can't treat your infection. You've got a resistant bacteria, a super bug."

Any of us might hear those frightening words sooner than we think.

once seemed like a miracle weapon in our fight against microbes that have plagued mankind for millenniums, killing untold numbers of people with wounds and serious infections. But we're in danger of losing that weapon. Over the years, bacteria have grown increasingly resistant to these drugs. We've squandered an invaluable resource that we've overused - some might say abused. The drug industry is spending too little to develop alternatives. Only a concerted effort by government, and the public can avert a crisis.

The antibiotic era started less than a century ago with the discovery of the antibacterial drug sulfa. After World War II, the emergence of penicillin allowed doctors to cure a vast range of potentially crippling, if not fatal, infections of the urinary tract, the and other parts of the body. These antibiotics did not target a specific infection site but unleashed a lethal attack on the body's trillions of bacteria. Of course, some bacteria survived. These Darwinian "fittest bugs" not only persisted but had the uncanny ability to pass on their genes, which allowed them and other bacteria to survive the next antibiotic assault.

The battle was on: humans versus the bugs.

Each side started with substantial advantages. The bugs enjoyed staggering numbers, boosting that fuels selection of increasingly resistant bugs. Medical science responded with novel antibiotics to kill the hardiest of these bugs. Who will win this epic struggle between genetic diversity and human ingenuity? After nearly a century, the bugs are emerging with the upper hand.

And we bear the blame.

Our first mistake has been the failure to respect our opponent or even to recognize the landscape of the battlefield. Doctors have fueled resistance to the drugs by their willingness to prescribe antibiotics for non-infectious medical problems such as colds, viral syndromes or other conditions for which antibiotics are useless. We also have allowed agro-business interests to routinely feed antibiotics to livestock, a practice that increases animal growth. The U.S. livestock industry uses nearly 30 million pounds of antibiotics annually, or about four times the amount prescribed by doctors for their human patients, according to the U.S. Food and Drug Administration. Not surprisingly, resistance that takes hold in livestock crosses eventually into humans.

The workings of the free market have given the bugs another big break. Development costs for major drugs routinely reach into the hundreds of millions of dollars. Pharmaceutical companies are reluctant to invest these huge sums to produce antibiotics, which doctors prescribe for a short time until an infection clears up. Instead, drug companies prefer to sink their research dollars into drug treatments for chronic conditions, such as diabetes or heart disease, that patients may use for decades, making it much easier to recoup development costs and generate profits. As a consequence of this misalignment between profit incentives and clinical needs, it has been many years since the development of a game-changing class of antibiotics.

Preventing the bugs from winning will require prompt action. We need government to reduce regulatory barriers to the development of new drugs and to subsidize new antibiotic research. President Obama recently moved in this direction by signing legislation that will extend antibiotic patents an additional five years. That small step will help, but much more needs to be done to give industry incentives to reopen the research pipeline to discover and market new and effective antibiotics.

We also need to take smarter, more cautious approaches to protect the fading usefulness of our current crop of drugs. The government can help on this front by restricting agro-business antibiotic use to the treatment of sick animals and eliminating the use of antibiotics for enhancing growth.

Like many primary-care doctors across the country, I struggle with the antibiotic resistance issue every week, as I explain to patients that antibiotics just won't help their viral cold or flu symptoms. But doctors should not have to fight alone. If we want to prolong the antibiotic era for our children and grandchildren, we need to do more. It's time for government and industry to call up the heavy artillery before the battle is lost.

Explore further: Drug-resistant infections: A new epidemic, and what you can do to help

Related Stories

Drug-resistant infections: A new epidemic, and what you can do to help

November 10, 2011
(Medical Xpress)—Are you aware that colds, flu, most sore throats and bronchitis are caused by viruses? Did you know that antibiotics do not help fight viruses and that using them for viral infections only decreases their ...

Fighting drug-resistant 'super-bugs': UCLA expert offers protection tips

May 11, 2011
The new "super-bug" CRKP, known officially as carbapenem-resistant Klebsiella pneumoniae, is just the latest in a series of emerging drug-resistant strains of bacteria that pose a serious threat to human health. CRKP ...

Canada should ban off-label antibiotic use in agriculture: CMAJ

June 4, 2012
Canada should ban off-label use of antibiotics in farm animals because it contributes significantly to antibiotic resistance in humans, states an editorial in CMAJ (Canadian Medical Association Journal).

Recommended for you

Male hepatitis B patients suffer worse liver ailments, regardless of lifestyle

July 25, 2017
Why men with hepatitis B remain more than twice as likely to develop severe liver disease than women remains a mystery, even after a study led by a recent Drexel University graduate took lifestyle choices and environments ...

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Research examines lung cell turnover as risk factor and target for treatment of influenza pneumonia

July 24, 2017
Influenza is a recurring global health threat that, according to the World Health Organization, is responsible for as many as 500,000 deaths every year, most due to influenza pneumonia, or viral pneumonia. Infection with ...

Scientists propose novel therapy to lessen risk of obesity-linked disease

July 24, 2017
With obesity related illnesses a global pandemic, researchers propose in the Journal of Clinical Investigation using a blood thinner to target molecular drivers of chronic metabolic inflammation in people eating high-fat ...

Raccoon roundworm—a hidden human parasite?

July 24, 2017
The raccoon that topples your trashcan and pillages your garden may leave more than just a mess. More likely than not, it also contaminates your yard with parasites—most notably, raccoon roundworms (Baylisascaris procyonis).

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.