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The Post-Antibiotic Era
Since the first antibiotic (penicillin) was discovered by Alexander Fleming in 1928, which was then readily available to the public in 1943, we entered the antibiotic age wherein minor infections that could be fatal could be readily cured. However, at the same time, antibiotic resistance, and the speed of this, has meant that the production of new antibiotics has been a constant struggle to keep up.
The danger of antibiotic resistance has been a danger understood from the outset but generally ignored by the wider community. When penicillin was first released it could be bought over the counter and within 2 years resistance emerged. While antibiotics today are generally not so readily available, we still have the following problems leading to misuse and acceleration of resistance:
Unfortunately for us the bacteria can evolve resistance to new antibiotics much faster than we can research, test and produce new products. In addition to this, pharmaceutical companies are not actively persuing research into new antibiotics as companies lack economic incentive to do so. There are predictions that by 2050 as many as 10 million people a year will die from infections that have previously been treatable using antibiotics. The danger of this situation has become more well-known (e.g. with public advertisements, main-stream news stories) however, is it a case of too little too late? Have you ever taken antibiotics prescribed by a doctor when you didn't need to? Do you think the developed world will take appropriate action to more strictly regulate the use of antibiotics before it is too late? |
My doctor as a baby never prescribed antibiotics and my parents never gave me any because they new I would build up a resistance to them, which would hurt me in the future when I would need them more.
Antibiotics are more effective on me now (I think). Antibiotics ALMOST helped my bronchial spasms, but not really. my spasms got better and better, then they got really, really bad one day. So eh. |
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Unfortunately, the baceriophages still have the same fundamental issue as antibiotics - the bacteria they are selected to kill can still evolve resistance. The resistance should at least take longer to occur than it has with antibiotics (due to the targetted nature of bacteriophages). Hopefully the use of bacteriophages in the future will use the history of antibiotic abuse to avoid the acceleration of resistance we have seen. |
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There are further issues, though. Imagine a doctor telling a patient, "I'm going to prescribe you a virus to help deal with your MRSA infection (for example)". People who know what a bacteriophage is and how it works might in theory be okay with this, but the general public? No way in hell - at least, not any time soon. We live in a time where anti-vaxxers still exist, so this would be a step way over the line and would end up with even greater distrust in medical care. It'd be difficult to introduce phage therapy in a way that doesn't cause at least a degree of backlash. There's also the question of safety. A stable phage strain that works effectively against its target is pretty safe to use, but as I said earlier, these things evolve fast. Due to their typically very simple genomes and enormous replication rates, phages can undergo very rapid changes with little specificity or relevance to their role as an anti-bacterial agent. Could they suddenly start infecting eukaryotic (in this case, human) cells? Very unlikely, but not inconceivable, and very scary if it does happen. How about gut flora? Much more feasible. As much as we want these guys to be our friends, if they're administered routinely and in high quantities to an individual full of bacteria for them to replicate in, there's very likely to be some degree of mutation and somewhere along the line you're going to get a rogue phage or two that isn't working like the rest of them. If these phages become active against gut flora then that could have disastrous consequences for the host. While the sort of people who like to cause problems in medicine by sensationalist news stories and headlines and whatever absolutely love this argument, it's actually pretty valid and is a sort of spanner in the works for phage therapy. I think phage therapy has a lot of potential and will eventually see use, but it has a lot of obstacles to overcome and the general public would need a lot of education on how these things work before they're actually viable for use. Quote:
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All I know is that I am actually terrified of world where antibiotics are rendered moot.
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It might be a little naive of me to say this, but with one's health "an ounce of prevention is worth a pound of cure."
Most of the people I know are the types who will still go to school or work if they don't feel well. (Unless they're really feeling unwell.) It's because they don't feel like they have much choice. Gotta work, gotta pay the bills, and there's not much you can do if, like one person I know, you've been told that you need to come into work unless you're vomiting. (And this is in a food service job!) So lots of people are out in public spreading whatever they have when they should be home and/or seeing a doctor. |
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In addition to this, there is no control over the evolution of the bacteriophage to your benefit. It may or may not happen, and the timescale is uncertain: it's not something you can rely upon. As a result, it is more likely going to be a case of catch-up in a similar manner to antibiotics, creating new bacteriophages to attack the evolved bacteria. This will still take time (although I expect much less time than an antibiotic). Quote:
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