The Post-Antibiotic Era—A Bomb, The “SuperBug” Bomb, Starts Ticking Away For Disaster

superbug-bacteria-find-india-waterAs a student who actively participated in high school sports, it was common for many of us, especially those of us who were involved in contact sports to contract staph infections. Through sharing a towel, coming into contact with someone’s spit on the ground, and any other imaginable way, the infection circulated amongst us. During my junior year of high school, I unfortunately contracted a staph infection—the bacteria, Staphylococcus aureus, one of the most common bacteria responsible for causing staph infections. After visiting the doctors’ office, I was prescribed an antibiotic that had to be taken for a week. After the week of antibiotic treatment, my symptoms had subsided; the once puss-covered inflamed yellow-green scab was now nothing more than a mere scar.

Recently, the World Health Organization (WHO) announced publicly of an urgent concern: A staggering rise in the incidences of people who are infected with untreatable “superbugs”. The troublesome thing about these “superbugs” is not simply the fact that these bacteria are antibiotic resistant, but they are also strains of bacteria that are responsible for causing the most common of infections and diseases known to humans, for example, staph infections, like the one I’ve experienced during my junior year of high school. In response to the urgent sounding of alarms by the WHO, the Unites States Congress, both the House and Senate, has put forth new proposals in dealing with this rising problem. The main objective is to promote the development of stronger antibiotics, as well as increase the payments for Medicare. By doing so, the results are two-fold: First, the potential development of an antibiotic capable of combating these “superbugs” may be synthesized. And second, the rise in Medicare payments will promote patients to finish their treatments fully (often patients stop mid-way of a treatment), retard the over-prescription of antibiotics to patients by healthcare professionals, and finally, prevent patients from sharing antibiotics with others. Though I am glad that the United States government and health organizations around the world are trying their best to find a method substantial enough to combat these “superbugs”, I believe they are approaching this problem wrongly. The development of these “superbugs” is rooted in, none other than the overuse, misuse and abuse of antibiotics. Trying to develop a newer, stronger antibiotic will ultimately set up the human race to witness one once harmless and curable bacterial infection/disease, to become the culprit of an uncontrollable pandemic—much more harmful and detrimental than the bacteria responsible for causing the black plague, Yersinia pestis, which has claimed many human lives.

Currently, in the United States alone, 23,000 men, women, and children lose their lives yearly fighting against antibiotic resistant “superbugs”, but it does not just end here. Around the world, the rise of much newer, much stronger, and much more harmful “superbugs” are making it impossible to treat and cure the once curable bacterial infections and diseases: gonorrhea, pneumonia, blood infections, and staph infections, just to name a few, have become impossible to treat with current, conventional antibiotic treatments. For example, staph infections caused by Methicillin-Resistant-S. auerus (MRSA), are responsible for 19,000 deaths in the United States alone. Roughly, 82% of all “superbug” related deaths in the United States are caused by staph infections! Even the antibiotic prescribed to me during high school is not capable of treating the MRSA staph infections of today!

Since the discovery and development of the first antibiotic by Alexander Fleming, in 1928 (Penicillin), over the years, humans have developed an abuse for this “luxury medication”. For more than half a century, antibiotics helped combat bacterial infections and diseases that were once known to clam the lives of humans. Thus, it is only reasonable for both healthcare professionals and patients to become overly dependent on antibiotics. And because of this over dependence on antibiotics, every symptom diagnosed by a healthcare professional is perceived to be curable by the use of antibiotics.

A new research from Brigham and Women’s hospital in Boston, suggests doctors overprescribe antibiotics to patients, as well as ill-prescribe antibiotics unnecessarily. The research found that the majority of prescriptions are for patients suffering from minor soar throats and acute bronchitis; about 60% of all soar throat patients, and 73% of all acute bronchitis patients are prescribed antibiotics. Both these symptoms can be dealt with our immune system, without the aid of antibiotics; the prescription and use of antibiotics for these symptoms are unnecessary in the first place (will be explained later). Because of the constant demand for antibiotics by patients, as well as the old habits, prescribing antibiotics years and years, of healthcare professions, a serious problem has emerged from this overdependence of antibiotics.

Although the class of medication categorized as antibiotics all function to treat bacterial infections and diseases, but the target and use of each antibiotic is different. Many antibiotics target specific aspects/components of a bacteria, for example, some antibiotics, such as Penicillin are bactericidal (directly targets the bacterial cell wall), while others, such as Tetracycline are bacteriostatic (target the biological/biochemical mechanisms responsible for growth, development, and division of bacteria). Depending on the bacteria causing the infection or disease, some antibiotic work more effectively than others. As a result, healthcare professionals assign antibiotics accordingly. And for this exact reason, antibiotics must not be shared amongst friends and families: 1) the antibiotic may be completely ineffective, and 2) exposing antibiotics frequently to your body potentially results in the development of “superbugs” (explained later).

As mentioned briefly before, most patients demand for antibiotics when healthcare professionals diagnose them with a minor soar throat or acute bronchitis. For the majority of cases, soar throats and acute bronchitis are symptoms of viral infections, which are caused by the common flu or cold. For these viral symptoms, antibiotics are ineffective, and most certainly, incapable of treating/curing the illness either, because antibiotics target key components of bacterial features (bactericidal) or biological/biochemical pathways (bacteriostatic). Furthermore, by consuming unnecessary antibiotics, the probability of one bacterium acquiring antibiotic resistance increases. Even though the symptoms may be viral in origin (e.g., sore throat), bacteria still coexist with us (on our skin, and inside our bodies) all the time. By introducing antibiotics, selective pressure, or survival, for antibiotic resistance is forced. Constant, unnecessary use of antibiotics will ultimately force the “good” bacteria, coexisting within us, to acquire resistance to antibiotics.

In fact, the survival of the fittest occurs in all living organisms, and in this context, the survival of bacteria even in the presence of antibiotics. Bacteria are responsible for making vitamins we are unable to make, breakdown certain foods we cannot digest, and keep our bodily environment in check. For these reason, in our body, there are more bacteria than our own cells. The majority of these bacteria are present in our intestine (for reasons stated previously); the minority of them (both good and bad) circulates throughout our bodies, as well as resides on the extremities of our bodily surfaces. When environmental pressures are presented, for example, the introduction of antibiotics, selections for bacteria able to survive occur; the bacteria are forced to mutate and evolve into strains that are resistant to antibiotics. By acquiring such mutations, those select bacteria possess the ability to survive and persist even in the presence of antibiotics.

Bacteria also possess another disturbing quality. Aside from easily mutating into strains that are antibiotic resistant, bacteria are also capable of sharing (both giving and receiving) those antibiotic resistant mutations through the methods of conjugation, transformation and/or transduction. Because bacteria possess such ability, even a harmless, “good” bacterium can share the antibiotic resistant mutant quality with a harmful, infectious bacterium, for example, Methicillin-Resistant-S. auerus (MRSA). By exploiting such mechanism(s), the once killable bacteria, such as Klebsiella pneumoniae, Escherichia coli, S. aureus, and many more, which are responsible for causing infections/diseases, such as gonorrhea, pneumonia, blood infections, and staph infections, have become incurable by current, conventional antibiotics.

The first global report with data from 114 countries on “superbugs” concluded with the WHO stating that these “superbugs” are capable of evading the hardest-hitting antibiotics—a class of drugs called carbapenems—are now found all over the world. With this disturbing fact at hand, the United States congress put forth new proposals and methods for combating the “superbugs”; the development of newer, stronger antibiotics. But we mustn’t forget how “superbugs” arose in the first place. From doctors overprescribing and miss prescribing antibiotics, to patients demanding, misusing, and even abusing antibiotics, the once treatable and curable bacterial infections have now become “selected” for antibiotic resistance. Even if an antibiotic stronger than carbapenems were to be developed, we still mustn’t forget the abilities bacteria possess. Bacteria are capable to mutate into strains resistant to antibiotics, as well as share those mutated DNA amongst other bacteria. With this in mind, I find the methodological approach the U.S. Congress and other health organizations are taking to combat the “superbug” problem to be off-putting. If the trouble started with our over dependence of antibiotics, then why should the solution be: create newer antibiotics?

In the end, it feels as if we are setting up ourselves for an uncontrollable pandemic. If, for some disaster, “superbugs” evolve once more, the human race will surely suffer; the lives lost during the black plague will seem miniscule. To prevent such mishap from occurring, I believe that both the Congress and health organizations around the world should approach the “superbug” problem from another angle: investigation of another perspective that does not require the dependence of antibiotics, for example, natural alternatives.

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