Scientists and public-health officials are a careful bunch who don’t often paint doomsday scenarios. That is, unless they’re talking about the issue of antibiotic resistance. More and more, as we learn that the threat of drug-resistant superbugs could literally spell our end, antibiotic resistance has become a worry akin to climate change: an overwhelming but intangible menace that can be difficult to rally around.
Despite dire warnings about the health impact of antibiotic-resistant bacteria, the issue is still abstract for many, industry has blocked efforts to tackle it, and legislation to address it has repeatedly flopped. We continue to abuse and squander one of the greatest and most life-saving gifts science has bestowed on us. The lack of action is baffling and only makes the problem of antibiotic resistance more terrifying.
1) Superbugs could soon kill more people than cancer
Deaths attributable to antibiotic resistance — or AMR — compared to other major causes of death. (Review on Antimicrobial Resistance)
There are billions of bacteria that live in and around us, most of which help us survive and thrive. But sometimes, we are exposed to bacteria that can make us sick. Antibiotics are chemicals from organisms in the world around us that can kill off these harmful microbes. In addition to curing us when we’re ill, these wonder drugs revolutionized medicine and changed the scale of modern food production.
But the use of antibiotics has a major downside: the more we consume them, the more quickly they stop working. Since Alexander Fleming discovered the first antibiotic (penicillin, in 1928), he and many other scientists, public-health officials, and doctors have been sounding alarm bells over “antibiotic resistance.”
Antibiotic resistance refers to a natural phenomenon that happens in response to the medicine. Bacteria multiply by the billions, and typically a few will randomly develop a mutation in their DNA to outsmart the pharmaceuticals designed to kill them. This situation is magnified by the fact that we overuse antibiotics and often take them in incorrect doses. When we don’t finish a course or when we give them to animals in very low doses to fatten them up, we create environments in which the weakest bugs are killed off but the strongest “superbugs” survive.
In recent years, this misuse has sped up the natural process of resistance, rendering some antibiotics useless and causing experts to warn that we are at the “dawn of a post-antibiotic era” that amounts to a health “nightmare” and “catastrophic threat” on par with terrorism.
Deaths attributable to antimicrobial resistance every year by 2050. (Review on Antimicrobial Resistance)
In the US alone, antibiotic-resistant infections are associated with 23,000 deaths and 2 million illnesses every year. We’ve already seen a number of bacterial infections — gonorrhea, carbapenem-resistant enterobacteriaceae (or CREs), strains of tuberculosis — that no longer respond to any of the drugs we have.
Overusing antibiotics also kills off the good bacteria in people’s bodies, potentially wreaking havoc on our microbiomes and weakening our immune systems. This means more people get sick, stay sick for longer, and die from resistant infections that we have no cure for — while the costs of treatment of antibiotic resistance go up.
A recent report commissioned by the UK government contains an alarming prediction: by 2050, antimicrobial-resistant infections will kill 10 million people across the world — more than the current toll from cancer.
This nightmare scenario isn’t that farfetched for one simple reason: we keep failing to muster the action needed to stave it off. There has been an incredible amount of inertia in medicine, and the agricultural sector has for years denied the science for economic and political reasons.
2) Medicine would be undone without antibiotics
With the discovery of bacteria-fighting antibiotics, such as penicillin in 1928, the maternal mortality rate dropped, too, as the drugs made childbirth and cesarean sections much safer. (Slate)
It’s not an overstatement to say that most of modern medicine and our health hinges on the effectiveness of antibiotics. Whenever you go to the hospital for an operation — a hip replacement, an ACL repair, heart surgery — almost without exception, doctors will give you a dose of antibiotics to prevent infection. Antibiotics also make the cesarean section, one of the single most life-saving procedures on the planet, possible.
Without antibiotics that work, common medical procedures like hip operations, C-sections, or chemotherapy will become more dangerous, and some medical interventions — organ transplants, chemotherapy — will be impossible to survive. In one piece, science writer Maryn McKenna describes a world before antibiotics and what we’ll face again when the ones we have fail:
Before antibiotics, five women died out of every 1,000 who gave birth. One out of nine people who got a skin infection died, even from something as simple as a scrape or an insect bite. Three out of ten people who contracted pneumonia died from it. Ear infections caused deafness; sore throats were followed by heart failure.
“It’s almost unimaginable,” said professor Kevin Outterson, of Boston University School of Law, “how going back to a pre-antibiotic era would affect US health care.” Jirka Taylor, an analyst at Rand Corporation, said, “If you had a 5 percent chance of contracting an infection that had a 40 percent case fatality rate, would you still be interested in submitting to a relatively mundane procedure such as hip replacement, when your survival did not depend on it?”
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