The Quest For New Antibiotics
“… There is the danger that the ignorant man may easily under-dose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” Alexander Flemming
During his 1945 Nobel Prize acceptance speech, Flemming, who discovered penicillin, warned against the true danger of antibiotic resistance. That day has arrived. Unless we develop new methods to fight superbugs, antibiotic resistance risks ruining all the progress we’ve made in medicine thus far. And time is running out.
Last year, Dr. Sally Davies, chief medical officer for England, called the problem a “ticking time bomb,” adding that antibiotic resistance is akin in magnitude to climate change. And the Center for Disease Control and Prevention has been blunt about the seriousness of the threat, calling antibiotic resistance “one of the five greatest health threats facing the nation.”
At fault is the overuse of antibiotics — by doctors who prescribe them when they aren’t needed, and by conventional farmers who are using the drugs preventively on their cattle and poultry. There are also countries in the world like Nicaragua where you can go into a pharmacy and buy the antibiotic and self medicate.
Resistant bacteria can cause infections that are harder to treat, requiring the use of stronger medicine with greater side effects. Antibiotic-resistant infections can also result in longer periods of illness, more hospitalization, and may even result in death, in cases where all treatments fail.
In 2012, the WHO reported 450,000 cases of tuberculosis in 92 countries where multiple drugs used to treat them were found ineffective. And by 2050, drug resistant tuberculosis may result in 75 million deaths!
Growing resistance also puts complicated medical procedures such as heart surgery, organ transplants, and chemotherapy in jeopardy, because they rely on the availability of effective antibiotics.
In its 2013 report, “Antibiotic Resistance Threats in the United States,” the Centers for Disease Control stated that up to half of the antibiotics used in human treatments and a large portion of antibiotics used in animal treatments were unnecessary and inappropriate.
If your doctor were to prescribe an antibiotic that no longer works for you, it could kill all the beneficial bacteria living in your GI tract, thereby allowing the bad bacteria to colonize an entire organ or even take over your entire body.
For instance, when I developed pneumonia, the antibiotic my doctor prescribed didn’t work, and the infection simply spread to my other lung, forcing me to the hospital, where I had to take an even stronger intravenous antibiotic. It took me more than a year for my immune system to recover.
Antibiotic resistance is a much scarier crisis than Ebola.
Did you know that 80 percent of all antibiotics sold in the United States are used on livestock and poultry rather than humans? The majority aren’t even given to animals that are sick! Instead, it’s normal practice in the meat industry to mix these drugs with food and water day after day because they’re housing cattle, pigs, and poultry in filthy conditions. A side effect of these antibiotics that farmers also dig is that it makes them grow faster and fatter too.
In 2011 (the most recent year for which numbers are available), nearly 30 million pounds of antibiotics were sold for meat and poultry production in this country, compared to 7.7 million pounds sold to treat sick people, says Maryn McKenna, a science journalist at work on a book chronicling the history of antibiotic use in livestock production.
Antibiotics were not created to be used preventatively! The growing use of antibiotics in animal feed is giving rise to superbugs, or microorganisms – mostly bacteria – that carry several antibiotic-resistance genes.
Incidentally, livestock do not properly break down the antibiotics they consume. So when they poop, these antibiotics enter the environment through soil and water and, when ingested by humans, they retain the capacity to promote antibiotic resistance.
Check out this video from the NRDC:
In fact, once these drug-resistant bacteria develop, they can spread far and wide. According to the NRDC, drug resistant bacteria can also travel on meat or hitch a ride out of animal feedlots on workers who handle contaminated animals or meat. “Antibiotic-resistant bacteria can even “teach” other bacteria how to be resistant; this “knowledge” can even be passed on from harmless bacteria to pathogenic bacteria.”
Can anyone say YIKES?
Amazonian Tribe and Bodily Bacteria
Scientists just discovered that the hunter-gatherer Yanomami tribe of southern Venezuela harbor the most diverse microbes in their digestive tracts that we’ve seen — roughly 40 percent more than humans living in industrialized societies, according to a study in the journal Science Advances.
The researchers also discovered that the tribes people exhibited antibiotic resistant genes, despite remaining relatively isolated from the ‘modern’ world for more than 11,000 years and never being exposed to antibiotics. Here lies proof of how rapid antibiotic resistant bacteria can actually spread.
This suggests that “antibiotic resistance is ancient, diverse, and astonishingly widespread in nature—including within our own bodies,” says anthropologist Christina Warinner of the University of Oklahoma in Norman. “Such findings and their implications explain why antibiotic resistance was so quick to develop after the introduction of therapeutic antibiotics, and why we today should be very concerned about the proper use and management of antibiotics in both clinical and agricultural contexts.”
These drug-resistant bugs could have been picked up from the natural environment such as the soil. Alternatively, antibiotic resistance (AR) genes could have also reached the Yanomami via traded objects or a chain of human contact that reached antibiotic-exposed populations.
The Race To Find New Antibiotics
“The last hope for the human race’s survival, I believe, is in the rain forests of tropical Asia,” says Dr. Christophe Wiart, one of the last working ethnopharmacologists who travel into the wilderness to look for plants that can be turned into medically-viable drugs.“The pharmaceutical wealth of this land is immense,” he told VICE.
Alas, he says, identifying medicinal plants isn’t a common skill anymore in our pill-centric world.
“One of the reasons a lot of these drugs probably haven’t been found is ’cause, first of all, it’s hard to find the plants, because they’re in the fucking jungle, and you got to come here and get into the jungle.
And then, second of all, you’d [never] expect new antibiotics to look like the craziest plants in the jungle.”
Once specimens are gathered, his team run the plant matter through a battery of tests to extract its constituent chemicals, figure out what they are, and then try them against an array of bacterial antagonists to see if they’ll make good medicine.
Unfortunately, this process can take years for each chemical, and that’s not even getting into the human trials that are required to bring a new drug to market, which can take up to a decade and billions. Up until recently tackling the problem was not a priority since antibiotics are drugs that must be used briefly and sparingly (read: little profit).
The Race For Life
Finally there are signs this might be changing. In March 2015, The White House released a 60-page comprehensive plan to tackle antibiotic resistance, titled the “National Action Plan for Combating Antibiotic-Resistant Bacteria.”
The goals of the National Action Plan include:
1. Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections.
2. Strengthen National One-Health Surveillance Efforts to Combat Resistance.
3. Advance Development and Use of Rapid and Innovative Diagnostic Tests for Identification and
Characterization of Resistant Bacteria.
4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other
Therapeutics, and Vaccines.
5. Improve International Collaboration and Capacities for Antibiotic-resistance Prevention,
Surveillance, Control, and Antibiotic Research and Development.
Hopefully with stricter policies, and better ways to fund and stimulate the basic re-search needed to discover and develop new candidate antibiotics, our current reality will change. If not the consequences for our world will be dire.
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