Antibiotics can be lifesaving when administered appropriately. Ever since the discovery of Penicillin, the first antibiotic, this medicine has reduced suffering among billions of people. However there is a general restraint shown in using antibiotics both in preventing and in treating bacterial infections. It is well known that the first rule of antibiotics is trying not to use them and the second rule is trying not to use too many of them.
This regulation stems from the likelihood of mutation and spread of certain bacterial strains that are resistant to the drug. The spread of these antibiotic resistant strains or “superbugs” cannot only render the drugs obsolete but also lead to a pandemic of life threatening diseases.
In a recent statement, the World Health Organization (WHO) confirmed the rise of antibiotic resistance. This alarming news report further elaborated that all antibiotics used today would become ineffective by 2020 unless significant progress is made in finding new drugs. It has already been reported that two key antibiotics no longer work in more than half of people being treated in some countries.
In a firewall system in IT security, there are several barriers protecting data. Similarly, there are medicine protocols that classify the drugs from the front line to last resort to protect the human body. The risk with using last resort antibiotics is not only the increased side effects but also the development of microbes that are resistant to all other antibiotics.
In the subcontinent (India, Pakistan, Bangladesh and Sri Lanka) antibiotics misuse is rampant. An average Indian takes about 11 antibiotic pills a year which is several folds higher than the use in developed countries.
There are three main reasons for the pill popping culture:
1) The over prescription of antibiotics by the General Practitioners (GPs)
2) Availability of the drug over the counter and self-medication
3) Lack of awareness and enforcement
GPs have a responsibility on their hand in dispensing drugs not only diligently but also prudently. In the subcontinent, drugs are prescribed irresponsibly by many medical professionals, who like their patients are looking for a quick fix.
Furthermore many drugs that should be available only through prescription can be purchased over the counter from many pharmacies. In many a cases, antibiotics are self-prescribed by patient as it saves both time and a hefty doctor’s fee.
Note that there is also a shortage of medical practitioners in the subcontinent in general and patient to doctor ratio is five times high compared to OECD countries (1700 to 1 in India compared to 310 to 1 in Denmark). Therefore in many areas, a patient may have to travel several hours to access basic medical care.
The lack of awareness also sees majority of the patients not completing the full course of medicine which is compounding the problem.
Although there are explicit instructions for pharmacies for dispensing these drugs but the rarity of enforcement measures in the developing world has led to perilous culture of using drugs unsustainably.
Another area where antibiotics are being excessively used (not just in subcontinent but all over the world) is in the rearing of livestock. The overuse of anti-biotic as a preventive drug even for stress related ailments in animals almost makes the human consumption of the drug pale into insignificance. Take the example of USA where 80% of the antibiotics are fed to farm animals (Poultry and Livestock). It shouldn’t be therefore come as a surprise that the reoccurrence of MRSA is becoming more and more common.
Many scientists are optimistic and feel that antibiotics have continuously evolved since the discovery of penicillin and as long as this trend keeps pace with the resistance, the wellbeing of human race is secure. However data suggests that the rate of discovery of new antibiotics has dropped significantly. Since the discovery of penicillin more than 100 antibiotic compounds have been found but the last major antibiotic was found in 1987.
This brings up the question: Is a panic justified?
Fortunately, there is room for cautious optimism with the recent discovery of Teixobactin. Teixobactin is the first new antibiotic to be discovered in almost 30 years and the drug can be in the public domain within 5 years.
The mode by which Teixobactin is discovered is also something that has excited scientists. It was cultured from the soil bacteria using the iChip Technology. It should be noted that soil bacterium has been incredibly difficult to culture until now. Although historically, most of the antibiotics were produced by screening soil micro-organisms, but the arrival of synthetic techniques in the 1960’s heralded the end of this organic practice. Despite showing early promise, since 1987 the progress in engineering bacteria in labs has plateaued and therefore it was important that the original method was revisited. It should be noted that almost 99% of uncultured soil bacteria remains to be explored and can potentially have several other antibiotics hidden in them.
The World Health Organization needs to pursue holistic measures that will not only restrict the over prescription of the antibiotics in the developing world but also expedite research in finding new drugs. Educating masses can also go a long way curbing the rate of increase in antibiotic resistance.
Antibiotic apocalypse warnings are not new. However the frequency of warnings has lately increased and therefore we must as a species not get complacent. Along with global warming, the resistance to antibiotic is the new “major global threat”. A worldwide plan of action is needed right now.
In HG Wells’ novel, War of the world, human race was saved from extinction by the very bacteria we fight against day in day out. Let’s hope in the future, extra terrestrials don’t turn up at our doors with Antibiotics in their armoury.