Antibiotic Resistance: An Approaching Apocalypse?

Some say the world will end in fire, some say in ice– but science argues that it will most likely end via antibiotic resistance.

In an April 2016 speech at the United Nations, Dr. Margaret Chan, Director of the World Health Organization (WHO), declared that “The world is heading towards a post-antibiotic era in which common infections will once again kill. If current trends continue, sophisticated interventions, like organ transplantation, joint replacements, cancer chemotherapy, and care of pre-term infants, will become more difficult or even too dangerous to undertake. This may even bring the end of modern medicine as we know it." This declaration may sound like an apocalyptic exaggeration, but it is, in fact, an increasingly pressing phenomenon which has deadly consequences. Explained simply, antibiotic resistance occurs post-antibiotic treatment when the surviving bacteria mutate in such a way that they are no longer affected by the antibiotic and then go on to transmit these resistant genes to other bacteria via the process of conjugation (bacterial mating). These antibiotic-resistant bacteria can be transmitted easily from person to person in the same way that normal bacteria or viruses spread, meaning that in a sense antibiotic resistance is ‘contagious’. Take for example the recent case of ‘super-gonorrhea’ documented in the UK, a case which marks the first time a venereal disease has shown high-level resistance to multiple antibiotics. However, gonorrhea is hardly unique with respect to its evolving antibiotic resistance--inability to treat clostridium dificile (a digestive system bacteria) was conservatively estimated by the United States’ Center for Disease Control to have caused 15,000 deaths in 2015 alone, while WHO estimates place the number of drug-resistant tuberculosis (DRTB) cases of TB at nearly half a million. The epidemic of DRTB is especially severe in India, where the exponentially increasing number of cases of multiple drug-resistant tuberculosis (MDRTB) mean that the two most commonly used drugs--isoniazid and rifampin, which have the unfortunate effect of becoming eventually toxic--become ineffective in treating TB.

The development of new antibiotics designed to combat infections which have developed resilience against currently widely-used drugs, such as penicillin, is a solution which can only truly be implemented at the governmental level, along with the need to reduce antibiotic overprescription by physicians. Fortunately, there are preliminary measures being taken--Europe recently prohibited the use of antibiotics as a method of promoting growth in livestock, a method intended to prevent future antibiotic resistance in humans through ingestion of antibiotic-treated meat. However, the urgency to find alternative treatments has also led scientists to ingeniously innovative sources of healing--one of which can be found within our very own kitchen cabinets. A study performed by the UK’s Dr. Moses Murandu found that applying cane sugar to wounds severely inhibited bacterial growth--a finding strengthened by the fact that these same strains of bacteria grew unchecked in the control group whose wounds were not treated by sugar. The trial also included diabetic patients with the aim of alleviating fears that applying sugar regularly to wounds would prove unsafe--and given that sucrase, the enzyme necessary to absorb sucrose, is only found within the body, applying sugar topically poses no risk of imbalancing insulin levels. Honey was found to have even more advanced antimicrobial properties--when applied to cutaneous wounds, it has the ability to accelerate healing and clearing of infections--but its price hinders it from being utilized as frequently in developing countries, where more inexpensive forms of topical treatment are most desperately needed given the higher expense of antibiotics.

The establishment of the National Antimicrobial Monitoring System (NARMS) by the CDC, the founding of the Antibiotic Resistance Center by Emory University (Georgia, USA), and the introduction of a Global Action Plan by the WHO as well as the discussion of antibiotic resistance at the UN’s 2016 General Assembly are all large-scale means by which international actors are attempting to combat antibiotic resistance. On the individual level, we can protect ourselves by thinking twice before readily seeking out antibiotics for treatment and being conscious of how meat we consume has been treated.

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