Antibiotic resistance (poll)
| 12 August, 2010 | Richard P. Grant |
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The front page of The Guardian featured an article highlighting the apparent waning efficiency of antibiotic efficiency due to the global spread of certain drug-resistant bacteria.
NHS takes a closer look behind the headlines, but what do you think? Is it likely that we will be dealing with infections in the UK that are completely resistant to antibiotics within 10 years? Or is this simply a case of media hysteria? Poll over in the right-hand bar.
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I would find it hard to answer either way. I think multidrug resistance is a serious and potential threat, and there have been recommendations for some time that reports, such as that published by Walsh et al. in Lancet Infectious Diseases, be published and acted upon.
Molecular epidemiological studies are a crucial underpinning to work on predicting antimicrobial resistance (PAR), especially when these elements are associated with, or are in the same ecological niche, as promiscuous mobile genetic elements, and arising in nosocomial environments.
However, whilst the a/biotic pipeline could certainly have been considerably better stocked, the efforts of numerous small biotechs and academic researcher looking at alternatives to the rather poultry introduction of new a/biotic classes, seems to be chronically undervalued. There are valiant efforts to target bacterial virulence, the mechanisms of horizontal transfer, and to inhibit the means by which bacteria resistant antibiotics – in all cases rendering more time for new drug discovery, but crucially more time in clinical therapy.
“Is it likely that we will be dealing with infections in the UK that are completely resistant to antibiotics within 10 years? Or is this simply a case of media hysteria?”
Yes, if the funding is not made available and we rely on the efforts of a (majority) disinterest of large pharmaceuticals to invest in new drug class leads, we will be dealing with increased prevalence of multidrug resistance – as we already are in isolated pockets with some strains of Gram (+)ve bacterial pathogens.
Media hype should be reflective, and not doomsaying. They should be pointing out the threats, but identifying the huge efforts being taken to provide alternative solutions – brought about by the lack of real investment. We know so much more about bacteriology, molecular epidemioloigy and drug discovery now than we did in the heyday of a.biotic discovery. A/biotics were used for years without a full understanding of their mechanisms, nor the mechanisms of resistance. Many instances of a/biotic resistance spread could (and should) have ben predicted and prevented.
Ironically, some of the systems biology, high-throughput infrastructures that have been stealing so much of the research funding pot (that could have gone into a/biotic and resistance research), could actually now be of some considerably use in speeding up the whole process of recognising new resistance determinants, tracking their spread and identifying resistance trends that can be exploited to clinical benefit.
Thanks for the thoughtful comment, Jim.
The government BY LAW forces the metal iron into ALL of our flour. Iron has been shown to render antibiotics somewhat ineffective. UNTIL the government disallows the addition of a substance to our food which destroys antibiotics effectiveness we will NEVER be able to kick all the infections. They have even begun to add iron binding substances to our deodorants in order to withdraw iron from the bacteria which NEED it in order to survive. The recent findings of hepatitis being found in the sweat of Olympic wrestlers makes one think the simple fact these high iron people sweat out iron and NOW feeds infection on the skin will make it very bad for anyone who comes in contact with these high iron sweating people.
These two articles explain it.
This is not media hysteria. I know well these problems, personally and in my work. 37 years ago, after being plugged for years with antibiotics I now know I didn’t need, I became allergic to all classes. A few years later, I became a mother, and constantly refused antibiotics for my two children, which was a nightmare, because I was always considered irresponsible, and a bad mother for doing so. My reasoning was that I wanted my children to be able to have antibiotics if they really needed them. That is now moot, because I failed to realise that because others didn
A noted by Richard Grant and Tom Hennessy, antibiotic resistance is a serious problems that must be addressed by multiple approaches. The niche that has become the haven for multiple resistant bacteria remains nosocomial, and there are many recommendations pertaining to infection control that need to be fully implemented. There have been recommendations over four decades about measures to limit selectively the use of human therapeutic antimicrobial agents as growth-promotants in agriculture. The overuse of antibiotics by physicians remains a primary source for sustaining the population of resistant microorganisms in the general populations. As noted previously, steps ought to be taken to reduce selective pressures for sustaining resistant populations. There are proactive steps to control antibiotic resistance, including the development of new inhibitors and new strategies for the use of current antimicrobial agents, coupled with re-colonization. There is a problem that the news media need to address so that an informed public can insist on using the knowledge we have and can acquire to control antibiotic resistance. The picture is not grim, but cautionary.
We have established large facilities to feed animals where disease mutation is a certainty. If we want to create antibiotic resistant diseases we should simply continue feeding corn to cattle and treat these cattle with the antibiotics that humans use. This will continue to get worse since the economics of short term gain outweigh the long term considerations, and since no effective international regulations will exist in the foreseeable future. Clearly hospitals will continue to increase disease resistance by offering treatments that will be overcome by more resistant strains.
If we were to find alternate suitable feed for cattle other than corn we might be able to reduce some problems there. It seems likely that the use silage,
No.
I have much more faith in Microbiologists and Chemists to be that pessimistic.
Yes we have seen a dearth of really new antibiotics of late, but fear not, we, that is to say the collective scientific community, will find new and, I would dare say, better ones.
Fear not, but I would suggest funding this R&D with earnest, I have been know to be wrong once or twice.
I note you are in R&D yourself, Matthew. It is your living.
Who do you propose should pay your bills while you take your time, doing the required work? And if it was that important to the pharmaceutical companies, wouldn’t they have done that already? And if not, why not?
That aside, the medical profession has myopically abused antibiotics, and that continued malpractice must stop.