The Battle of Bacteria: Antibiotic Resistance and its Consequences

By Telyse Masaoay

Global attention seems centered on subjects like the conflicts in the Middle East, the politics behind the Iran nuclear deal, the economic threats of China’s financial stability, and even the 2016 United States’ presidential election. As a result, other critical topics appear to be sidelined, such as antibiotic resistance, an issue that “is now a major threat to public health” according to the World Health Organization.  No longer an impending concern, antibiotic resistance is an important problem communities are currently facing.

        Antibiotics were first introduced quite primitively through the practice of using molds of microorganisms to fight microbial infections in ancient societies in India, China, Greece, and Egypt. In 1928, Alexander Fleming, a Scottish biologist, discovered penicillin through his work with the fungus Penicillium notatum. Mass production of penicillin in 1945 and the discovery of a host of other antibacterial drugs led to a revolution in medicine in the 20th century. The Allied Forces in World War II used penicillin to treat soldiers with gangrene, which reduced the likelihood of limb amputation, fought off infections, and increased the probability of survival for many injured combatants. Following the war, antibiotics flooded the medical market and as the National Center for Biotechnology Information explained, “A surge of discovery of several such antibacterial and antifungal antibiotics accompanied with a new generation of semi-synthetic drugs initially led to euphoria that any infectious disease could be successfully controlled using antibiotics.”

        Today, antibiotics are prescribed and used at unprecedented levels around the world; many countries even provide over-the-counter access to some treatments.  Additionally, using antibiotics to supplement livestock feeding is a common practice globally.  This leads overuse of antibiotics in medicine and agriculture, which becomes problematic when considering the dangerous effects of antibiotic resistance, or, the ability of microbes to grow in the presence of a chemical (drug) that would normally kill them or limit their growth. The explanation of antibiotic resistance at the biological level is complex, but the sum of it all is that at their simplest level, bacteria are able to mutate and adapt to antibiotics. Over time experts have shown that increased consumption of antibacterial drugs has a positive correlation with increased resistance.

This phenomenon was most recently outlined in the first global report of antibiotic resistance. Conducted by the World Health Organization (WHO), it gathered data from 114 countries. Experts have warned for years that increased dependency on antibiotics would have disastrous effects on the ability of entire populations to combat infections that we have not viewed as major threats for decades; these predictions are coming to fruition with a few examples outlined by the WHO’s study. For example, in countries such as the U.K., Canada, Australia, France, Japan, Norway, South Africa, Slovenia and Sweden, Gonorrhea is being treated primarily with antibiotics that were once considered last-resorts. Simultaneously, these last-resort antibacterial methods have been increasingly linked to the appearance of aggressive, drug-resistant strains of the sexually-transmitted disease, which make the aforementioned antibacterial approaches less effective. The WHO’s report also mentions that similar issues have been recorded with influenza, HIV, malaria, and tuberculosis treatments on a global scale.

Even developing countries, which are not using antibiotics at the same level as developed nations, are still being touched by the drug-resistance. As Susan Brink  of NPR notes “MRSA, a dangerous staph infection often contracted in hospitals that does not respond to many antibiotics, is found at high rates in the United States, Romania, Portugal, Vietnam and India — rich, middle-income and poor countries alike.”

Due to its clear global presence, it is important to examine the extent to which antibiotic resistance can and will cause problems. Dr. Keiji Fukuda, WHO’s Assistant Director-General for Health Security, explains why antibiotic resistance is so consequential, “Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill.” We are entering a time period in which modern medicine could be setback, ironically, because of the use of modern medicine. Those who have contracted infections are now at risk of being sick for longer interludes with an increased risk of death because of the developed drug-resistance of microbes. This issue has the potential to increase hospital stays and medicinal costs—putting the ill out of work for longer periods and affecting the health of whole groups exposed to these evolving strains.

Fortunately, there are steps that can be taken by individuals, healthcare providers, and public officials to address antibiotic resistance. At the most basic level of deterrence, people can avoid using antibiotics unless they are prescribed them, refuse to share medicine with others, and follow all prescription instructions laid out by their doctors.  The solution with respect to healthcare providers and policymakers lies in the regulation of antibiotic prescription and dosage.  It is essential to decrease the use of antibacterial drugs for simple infections and invest in new methods for disease control and prevention. Dr. Ramanan Laxminarayan, director for the Center for Disease Dynamics reminds the public “In the absence of antibiotics, resistant bacteria more easily die out… In many cases, if we stop overusing antibiotics, resistance will go substantially down.” It is time to alter the mindset that antibiotics are miracle medicines; if not used appropriately they can be as harmful to global health as they are helpful.

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