how are we fighting antibiotic resistant bacteria and what will we do when our antibiotics will no longer have effect?
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In the past, we made new antibiotics that the bacteria couldn’t resist. If you were born in the 1960’s, you probably got penicillin for an infection, but when you were a teen in the 1970’s you probably got amoxicillin, as a young adult in the 1980’s ciprofloxacin, clarithromycin in the 90’s, and so on.
The problem now is that there are fewer antibiotics in development, and they aren’t as effective. If you are hopeful, you say that antibiotics will be replaced with other treatments; if you are a pessimist, you say people are going to start dying again from meningitis.
We are fighting antibiotic resistant bacteria with other antibiotics (reserve antibiotics) that are only used against bacteria when other “normal” antibiotics fail.
If we at one point will have antibiotic resistant bacteria that’s also resistant against all these, then we’re fucked and better put a huge amount of money into finding a bunch of new antibiotics as soon as possible, otherwise more and more people will be dying from illnessess that are perfectly treatable today.
One of the reasons, and I don’t know how much weight it has, is that a lot of people stop taking antibiotics as soon as their symptoms disappear. In some of those cases, the bacteria remaining will mutate to survive those antibiotics, resulting in more resilient/resistant bacteria. The old whatever doesn’t kill you makes you stronger. But for the bacteria, not us.
Those more resilient bacteria grow and give you another infection, then they get passed to other people, and the old antibiotics don’t work for them or you.
Back in the day antibiotics got prescribed for all kinds of things, even if you didn’t really need them (like allergies). Now medical professionals are more cautious and stress that you have to finish your whole course of them, even if you feel better.
My son has been living this nightmare for almost three years.
He has a pseudomonas living in his leg that has lymphedema. The pseudomonas gets angry and my son gets severe sepsis. He has had it 15 times in the space of a year and a half. It is technically antibiotic resistant but each time they try with the strongest antibiotics for the hospital stay then I treat him with IV meds every 8 hours at home for a month.
We work with some of the top infectious disease doctors in the country and after this many episodes we’ve all agreed that there is no next step or answer. You maintain as long as you can but the bug will eventually outsmart the medicine and/or the medicine will become more than the human body can take. In the meantime besides antibiotics the skin treatments are medicated soap and bleach baths every day. I have to be honest. I would rather that the doctors be as honest with me as they are and tell me that they just don’t know rather than make things up to make me feel better.
The antibiotics are available but people also have to take the rest of the routine seriously to stave off the infection. Clean living area, bleach and lots and lots of hard work. Doctors can only do so much.
Hopefully we will continue to find new antibiotics to combat resistance. Otherwise we will revert to dying from infections at a much higher rate, as we used to prior to the invention of antibiotics.
There’s active research going into something called “bacteriophages”.
Now for the eli5: for millenia a war has been fought between bacteria and bacteria-killing viruses called bacteriophages. Both adapting against the other since longer than humans have existed.
The hope is we can eventually use those viruses to kill resistant bacteria
The war between bugs and drugs is an ongoing arms race. It will continue forever and constantly adapt. Sure , it’s possible for the bugs to eventually “win” and become resistant to everything we throw at them, but that’s probably unlikely due to a super important concept in biological evolution: trade-offs.
Trade-offs are a result of limited resources in the world, and is the reason it is impossible to create the so-called “Darwinian Demon,” a hypothetical super-species that has evolved perfect genes to live forever and constantly reproduce. The problem is such a creature would consume every biological niche and every resource until there was nothing left and it would die. Instead, every adaptation that evolves in a species comes at some cost. An example of this is that after we developed antibiotics and vaccines, suddenly the rate of cancer in humans skyrocketed.
Bacteria have the same problem. So many have become penicillin-resistant by developing an adaptation called beta-lactamase, which is an enzyme that destroys a critical part of the penicillin drug. But now they are susceptible to clavulanic acid, which blocks that enzyme and allows penicillins to do their thing. That’s just one example.
Some bugs are kinda dumb and just don’t adapt well. Streptococcus species (like the one that causes strep throat) fall in that category, and are still regularly treated with early antibiotics. Some of the most challenging bugs are the ones that cause hospital acquired infections, such as Klebsiella pneumoniae. They survive in hospitals despite all the antibiotics there and therefore become multi-drug resistant and extremely tricky to treat. When doctors aren’t sure what drug to use, they can send samples to the lab for susceptibility testing. Usually they can find something. If not, they’ll need to explore other options depending on the location and severity of the infection.
Like I said earlier, it’s an arms race. As bugs develop drug resistance, we put a lot of work into figuring out how, then create new drugs to attack the new adaptations. Sometimes it’s easier than others, but the biggest problem of drug resistant bacteria is more likely to be rising healthcare costs due to the need to novel drugs. I doubt we get to a point where we simply can’t find a way to fight the bugs anymore. It’s just gonna get more expensive.
Moral of the story: listen to your doctor when it comes to appropriate antibiotic use. Don’t demand antibiotics when they tell you it’s not necessary, and always finish the entirety of your prescription. Irresponsible antibiotic use is just going to increase costs of healthcare and limit access even more.
There are three major types of antibiotics penicillins, macrolides and fluoroquinolones which are able to target differences between bacteria cells from human cells to fight infection and how if antibiotics are badly used they can speed up the rate of antibiotic resistance. https://youtu.be/04brjRdc02w
To add to all the panic, we actually need some of the good bacteria to function. So you can imagine how complicated it gets. There is also bits of evidence that dementia and many immune disorders are actually from bacteria in our gut.
“How are we fighting antibiotic redistant bacteria?”
For the most part we don’t. If we really wanted to slow down the process of bacteria becoming ever more resistant we would need to prevent overuse of antibiotics.
We could stop overusing antibiotics in meat production, but we don’t. We could reduce overuse in humans by establishing mandatory and efficient guidelines on when to use which antibiotic, but in most parts of the world people can buy antibiotics like sweets.
We do put some effort in finding new treatments for bacterial infections, but its not a big market (yet).
“What will we do when our antibiotics will no longer have effect?”
Thousands of people died from untreatable bacterial infections today. It will be millions in the future.
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