Health officials warn of antibiotic 'apocalypse'

Source

The rise in drug resistant infections is comparable to the threat of global warming, according to the chief medical officer for England.

Prof Dame Sally Davies said bacteria were becoming resistant to current drugs and there were few antibiotics to replace them.

She told a committee of MPs that going for a routine operation could become deadly due to the threat of infection.

Experts said it was a global problem and needed much more attention.

Antibiotics have been one of the greatest success stories in medicine. However, bacteria are a rapidly adapting foe which find new ways to evade drugs.

MRSA rapidly became one of the most feared words in hospitals wards and there are growing reports of resistance in strains of E. coli, tuberculosis and gonorrhoea.

Prof Davies said: "It is clear that we might not ever see global warming, the apocalyptic scenario is that when I need a new hip in 20 years I'll die from a routine infection because we've run out of antibiotics."

She said there was only one useful antibiotic left to treat gonorrhoea.

"It is very serious, and it's very serious because we are not using our antibiotics effectively in countries.

Possible solutions will be included in her annual report to be published in March.

Empty arsenal
The World Health Organization has warned the world is heading for a "post-antibiotic era" unless action is taken.

It paints a future in which "many common infections will no longer have a cure and, once again, kill unabated".

Prof Hugh Pennington, a microbiologist from the University of Aberdeen, said drug resistance was "a very, very serious problem".

"We do need to pay much more attention to it. We need resources for surveillance, resources to cope with the problem and to get public information across.

But he said it was not a problem entirely of the UK's making.

"People are going abroad for operations, going abroad for, let's say, sex tourism and bringing home gonorrhoea which is a big problem in terms of antibiotic resistance - and then there's tuberculosis in many parts of the world.

Prof Pennington said the drugs companies had run out of options too as all the easy drugs had been made.

"We have to be aware that we aren't going to have new wonder drugs coming along because there just aren't any."

Click to expand...

Not something earth shattering, as we've known this for quite some time, but still kind of scary to think about. But what is there to be done?

Discuss stuff

Looks like the responsibility is going to fall in equal halves upon the drug companies and the common citizens. They have no choice but to keep developing antibiotics regardless of how difficult it may become because lives are potentially at risk, but we also have to watch our own backs by being safer than we are. If you contract gonorrhea, then the least you could do is not pass it on.

Sweets Witch said:

the responsibility is going to fall in equal halves upon the drug companies and the common citizens.

Click to expand...

This is something which I cannot agree with enough. I feel like people are heavily under-educated in general about not only personal hygiene, but also in the use of drugs, how they work, and why it's so important that they be respected. The main three ways in which people misuse antibiotics which spring to mind for me are:

-the use of antibiotics against non-bacterial diseases.
-the ignorance of the guidelines regarding the use of antibiotics - namely, "complete the prescribed course" or something along those lines.
-the improper disposal of antibiotics.

The first of these should hopefully be obvious; in general, transient diseases are caused by bacteria, viruses or parasites - only one of which is actually harmed by antibiotics and even then, usually only specific antibiotics. I've seen a lot of people come down with things like the flu - caused by the influenza virus - and throw antibiotics at it. For starters, that's a perfectly good waste of antibiotics but that's not the real problem here; the problem is that any harmful bacteria in your body which have not yet got to the stage of causing disease are being unnecessarily exposed to antibiotics. While they could be destroyed by the antibiotic, they're also here given the opportunity to become resistant to that which is being wrongly used. Antibiotics are being subscribed less and less over time because this is what's causing the resistance - bacteria which, through exposure to an antibiotic, become resistant to it. Using an antibiotic when it is neither prescribed nor necessary is simply asking for this problem to be made worse. Antibiotics should be used as sparingly as possible in the sort of situation we're in here.

The second often confuses people a tad. They take the antibiotic, their infection dies off, and they feel fine again. Should the antibiotics be expensive or have unpleasant side-effects, they want to be rid of them so they stop taking them, thinking that their disease has been cured. The problem here is that rarely when you feel better after an infection is the species causing the infection totally removed from your body. The likelihood is that there's simply not enough of a species to be causing symptoms present any more, thus making you feel better. If, at this point, antibiotics are to stop being taken, you're opening up a huge window of opportunity for the bacteria to become resistant to it. The antibiotic will linger at very low concentrations for a long while and, as above, the bacteria will continue to be exposed to it and will potentially take advantage of that. They're then able to become resistant and transmit to other individuals. A real example of this I can think of is the use of antibiotics treating tuberculosis - these medications have some particularly nasty side-effects which really discourage people from taking them after symptoms have cleared up, but the causative species is pretty well-known for being able to develop resistance to the antibiotics used to treat it, become resistant, and come back later as a more dangerous, drug-resistant form of TB. Worse still, since it's such a hard to detect and easy to transmit bacterium, it spreads silently and quickly to others - infecting them too with the drug-resistant TB. By not completing the course, and ensuring as far as is reasonable that bacteria are completely destroyed, people open up this veeeery nasty can of worms. It really needs to be made more clear why people are required to continue treatment, even if they feel better. It's not for only their good.

As for the last one, the proper procedure that I'm aware of for disposal of antibiotics is to bring them back to where they were purchased from and they'll be properly destroyed. However, a lot of people think that their kitchen sink does the job just as well. It doesn't. What it does do, however, is exposes the God-knows-how-many species of infectious bacteria present in sewers to very low antibiotic concentrations. They will absolutely thrive on this in terms of resistance; by exposing them to such low concentrations of antibiotics you're giving them ample opportunity to resist those antibiotics. A seriously dangerous move with potential implications for so many people.

So... yeah. None of these three things are at all down to drug manufacturers and none of these are things which I feel the general population is properly educated on. Indeed, the research is more than there into new forms of antibiotics - at university I'm involved in some of that myself and I know a lot of work is going on in general regarding new types of antibiotic altogether which bacteria are unable to resist. A really popular and interesting one right now is the use of 'phage' therapies - where bacteriophages, harmless viruses which are able to infiltrate bacterial cells, are used to combat bacteria without harming human cells. It's sort of like fighting fire with fire except the fire we're using isn't going to burn anything but the bacteria. It's a really interesting and potentially extremely effective method of treating bacterial infections.

This is definitely a war not lost by a long shot, but we're going to have to change what sorts of antibiotics we're making and we're going to have to educate people properly on their use. Right now things are looking bad for antibiotics as we generally know them, and indeed a "post-antibiotic era" in that sense would be an apt description, but we're not going to lose to bacteria just yet.

but viruses are human too

It's all about how to receive the data. Your teacher can be the most brilliant person that's the best at describing facts in an understandable way, but if you don't listen, you won't be able to get that knowledge, because you're too busy not doing what's right for learning. The same here; if we're not going to take the meds correctly, even if we build shrinking machines for doctors to personally go split the bacteria in half, nothing will be a permanent solution (I don't know, maybe they get consciousness and run away from doctor-looking people) unless people know how to use it correctly.

Doctors need to be educated to the procedures and their reasons for those procedures (which happens already), and those same doctors need to be required to force those facts into patients who are taking antibiotics (which maybe not so much already). There's no other alternative, honestly, unless you sign a peace treaty with the bacteria or something.

Razor Leaf is right. The worst part it (At least in my country) is that stuff like this isn't taught anywhere except med school. I've seen and heard about a lot of people taking antibiotics on their own, for diseases that aren't supposed to be treated by antibiotics. If the public stays uneducated about this stuff much longer, a post-antibiotic era is inevitable.

However, maybe that isn't such a bad thing. In 2009, Italian researches have invented a "spider pill", a pill design to walk through the colon in search for cancer, and in 2010, in the Federal Institute of Technology, Switzerland, researches invented a flea-sized drone designed to go straight into the eye and cure blindness. At first, it seems that this doesn't have to do anything with our topic, but it does. Adam Savage from Mythbusters predicts that this technology, the "micro-robots" designed to enter your body and cure illness, will advance far enough to replace white blood cells and cure diseases such as infections, cancers, blood cloths and other. Maybe, just maybe, a post-antibiotic era will speed up the advancements in this technology.

I have mix feelings about this issue. On one hand, this is a necessary way for natural selection because the human population is way over their carry capacity, and the laws of nature say that if one species crosses the line, their population soon goes down via predators, lack of food, and diseases. Bacteria shares an important role in the ecosystem to keep living organisms at bay from overpopulating other areas, which is why they evolve. We're simply wasting a lot of money that should've been used for alternate resources and deal with global warming rather than on antibiotics that bacteria will eventually resist as the years go by. On the other hand, this situation will lead to something similar to Contagion, which is pretty scary. As modern humans, we don't like the idea of dying from fatal diseases, and we want to save the infected to keep our species alive for generations to come.

Razor Leaf said:

I've seen a lot of people come down with things like the flu - caused by the influenza virus - and throw antibiotics at it.

Click to expand...

This entire post is excellent but I had to quote this bit. I'm beginning to come down with the flu so as mum was going to the doctor today, I asked her to get one of those "THIS'LL KEEP YEH FEELIN' 'EALTHY" medicines in the chemist. I specifically asked her to not get an antibiotic as, well, it's a bit pointless. Mum then texted me to tell me she had indeed gotten an antibiotic anyway. And I think she's really quite typical of the world's mindset - people can get antibiotics incredibly easily so they get them for the sake of it, not knowing the risks of doing that. To be fair though, antibiotics do SEEM to work when someone has the flu, so the attitude isn't that surprising. If anything, it's the doctors' fault for giving the antibiotics out. They should know better.

Pinkie-Dawn said:

I have mix feelings about this issue. On one hand, this is a necessary way for natural selection because the human population is way over their carry capacity, and the laws of nature say that if one species crosses the line, their population soon goes down via predators, lack of food, and diseases. Bacteria shares an important role in the ecosystem to keep living organisms at bay from overpopulating other areas, which is why they evolve. We're simply wasting a lot of money that should've been used for alternate resources and deal with global warming rather than on antibiotics that bacteria will eventually resist as the years go by. On the other hand, this situation will lead to something similar to Contagion, which is pretty scary. As modern humans, we don't like the idea of dying from fatal diseases, and we want to save the infected to keep our species alive for generations to come.

Click to expand...

As much as I agree that humans are overpopulated and the planet would be better off without us, I'd rather live in a world overpopulated with humans than die a slow, painful, bacteria-induced death, and I reckon you would make the same choice were you faced with death by TB, or whatever.

If there is no "money" in the cure. There is no cure.
Maybe all of these diseases could be erased from the face of the planet, but we all know that companies need to make money in order to stay in business.
I've worked in the care industry, I've seen good care homes and bad ones, I've heard nightmare stories of healthcare. In the end there is no surprise that these "super bugs" known as MRSA are affecting public hospitals in the United Kingdom.
If you go to a hospital usually the doctors/surgeons are the ones who speak very clear English, are articulate and know what they are doing. Most nurses on wards are immigrants who chose to work in healthcare because they are always in demand for people, same as being a support/care worker. Most of them their English is very limited so how can you expect them to be able to "follow instructions to perfection" when they can't understand what you are talking to them about.
Diseases CAN be cured but the companies have to make profit off of the cure otherwise it is not viable. Just as the same as the NHS is a failing system because providing free healthcare to a population which has grown faster than what the government foresaw back in the past is too late for them to go back on the promise of free healthcare.
If you want to survive in this world do what you can to be fit, healthy and avoid fast food, alcohol,smoking and any dangerous activity.

Also there are many natural remedies and cures to common illnesses such as just drinking plenty of fluids, eating healthy, keeping active/fit,making sure your house,clothes and furniture are clean.

This is why I'm not fond of medicine. It has ultimately made us more vulnerable through a process of merely patching over problems. Our immune systems haven't had to combat the problems during the success period of these drugs, and now what? Something like when smallpox first hit the Americas, I assume.

This is troublesome indeed. Overpopulation has caused many problems and I think this particular subject will only get worse. (population keeps growing and medicine becomes rarer and less effective) I have always wondered about medical companies job and how they make money. Im not going to start a conspiracy theory debate here. But I just want to think about those few creedy people in them. If they think about infecting people would bring them more money I am sure they would do it... :/

I... kinda want to step in here and clean up two things which've been said so far that I feel to be huge misconceptions. They are the idea that this is the natural selection of humans at work and that we've not yet cured diseases because people aren't willing to invest the money.

For the natural selection argument - no, it's not the selection of humans at all here. It's natural selection of the bacteria leading to issues caused for humans so saying that this is alright because it's picking out the humans who can survive is... objectively wrong. Natural selection isn't at work with humans here - it's pot luck whether or not an individual is unlucky enough to play host to a bacterium that manages to evade the action of antibiotics. It's present on the bacterial level and really shouldn't be confused with natural selection on the human level which, although is still present in some areas, isn't at work here.

As for the money one - not sure where these claims are coming from that someone somewhere getting paid more will allow us to cure diseases. I don't think people often realise just how difficult a disease can be to simply cure and I don't think people realise that throwing money at something won't just make it work. Believe it or not, a hell of a lot of hard work is going on to try and fix stuff like this and to say that it's not because the money isn't there is hugely undermining the hard work of people who actually put the R&D time into new drugs. A perfect cure to any disease that isn't incredibly rare is going to bring in huge profits for drug companies and huge recognition in the industry for the research teams who came up with them. Those cures just aren't there because we've not yet got to them.

Renpuu said:

I've worked in the care industry, I've seen good care homes and bad ones, I've heard nightmare stories of healthcare. In the end there is no surprise that these "super bugs" known as MRSA are affecting public hospitals in the United Kingdom.
If you go to a hospital usually the doctors/surgeons are the ones who speak very clear English, are articulate and know what they are doing. Most nurses on wards are immigrants who chose to work in healthcare because they are always in demand for people, same as being a support/care worker. Most of them their English is very limited so how can you expect them to be able to "follow instructions to perfection" when they can't understand what you are talking to them about.

Click to expand...

You've worked in care homes which employ nurses who can't understand what you're talking about? Nursing qualifications are seriously hard work (or at least, in the UK, which I assume is where you are given your NHS reference) to get and to say that an immigrant can just come over and waltz into a care home without knowing what they're on about... sounds kinda off to me. An immigrant nurse is just as articulate in their field as an immigrant doctor is. Nursing is a tough profession that you've gotta have worked hard for and have had a good amount of educational experience in to be able to enter into fully. Not honestly too sure why you feel nurses are inarticulate or incapable of following instructions.

This could have been avoided by the proper use of antibiotics to begin with.
I'm not making wild general accusations her I'm just saying that I personally know people who would catch a cold and think "Some antibiotics aught to do the trick" And just pop two leftover pills. It worked of course but by taking them the individual is not allowing their immune system develop a tolerance for minor infections which makes it harder to protect against more serious ones. This possibly affects future children as well.

Of course some diseases like gonorrhoea naturally adapt quickly to antibiotics so it's not all about taking them only when absolutely necessary. What we need is more medical professionals helping to find a permanent cure.

The infections that doctors say could kill you from a minor operation in the future are just advanced versions of what we have today. So let your children lick windows and stuff because it's good for their immune system. Having your child wash their hands 3-4 times a day (not including after using the bathroom) is dangerous, they will get sick more often and to a greater extent. This is a trend these days with all the fancy detergents that kill "99.99% of bacteria".
Surely this will be a major factor in the infection rates of the future.

Sounds like a classic case of natural selection. I could spend hours doing research and talking about this, but Razor Leaf has pretty much said everything I could probably come up with and more (way to make me feel intellectually inadequate; yes, I AM sensitive about my "IQ size.").

As for the immune systems comment Cassino mentioned, I somewhat agree with you, many people need to give their immune systems more of a chance to develop naturally, but some people just can't come up to snuff, so they need certain medicines to survive. You could argue that letting people with vulnerabilities and immuno-deficiencies survive in a population and reach reproduction age to pass on in-advantageous immunity traits might be a bad thing, but then that's just devolving into a eugenics discussion and the ethics behind eugenics are...questionable at best.

I think there was a similar problem before concerning insects and pesticides. Don't recall what the solution was there

It's the human arrogance that somehow we're better than natural selection. Humankind throws a big middle finger to nature with antibiotic soap and hand sanitizer, and nature's like "O RLY? HAVE SOME OF THIS, THEN"

And natural selection trumps our idiocy once again, with some nice untreatable boils and abscesses that like to rupture every couple of weeks. How's that for a middle finger?

The solution to this is not more, nor is it less. Antibiotic soap needs to go. Why? Antibiotics protect our immune system externally, meaning our white blood cells see virtually no action. This creates terribly weak immune systems that can't rely on themselves alone to fight regular bugs, much less MRSA.

Making things worse, we've got some totally drug resistant TB spreading around in Africa right now.

http://life.nationalpost.com/2013/0...rn-outbreak-of-bacteria-would-be-untreatable/