The Post-Antibiotic Era is Finally Upon Us

Antibiotics have rightfully earned their place as one of the most important medical advances of the 20th century. Many of you reading this are alive today because of antibiotics, as are many of your parents and grandparents. It’s a marvel of the modern world that has given us so much life.

Unfortunately, we abused this gift. We used these antibiotics so much that now, many of the infections we used to be able to treat have evolved to resist them. These “superbugs” now threaten to derail decades of medical progress.

Someday soon we may be living in what scientists have dubbed, the “post-antibiotic world.” This is a world where the slightest nick or cut could be a death sentence, and where infections that were once conquered can make a devastating comeback. Unfortunately, the beginning stages of this new era have finally arrived.

The last line of antibiotic defence against some serious infections is under threat, say experts who have identified a gene that enables resistance to spread between bacteria in China.

The gene, called mcr-1, allows a range of common bacteria, including E coli, to become resistant to the last fully functional class of antibiotics, the polymyxins. This gene, they say, is widespread in bugs called Enterobacteriaceae carried by both pigs and people in south China and is likely to spread worldwide.

The gene is easily transferred from one strain of bacteria to another. Enterobacteriaceae are capable of causing a range of diseases, from pneumonia to serious blood infections. Some of the strains of Enterobacteriaceae with the gene have epidemic potential, say experts in the Lancet Infectious Diseases journal.

“These are extremely worrying results,” said Prof Jian-Hua Liu from South China Agricultural University in Guangzhou, author of the report. “Our results reveal the emergence of the first polymyxin resistance gene that is readily passed between common bacteria such as Escherichia coli and Klebsiella pneumoniae, suggesting that the progression from extensive drug resistance to pandrug resistance is inevitable.”

Keep in mind that the only reason why these “polymyxins” were still effective, is that they are an older class of antibiotics that are rarely used, due to their toxicity. It’s a last resort for people infected with bugs that are resistant to everything else. Once this resistance spreads there will be a whole host of superbugs out there, to which there will be no antibiotic treatment options.

The fact that an outdated treatment is the best our hospitals have to offer, just goes to show that modern science isn’t up to the task of creating new antibiotics. This field of research isn’t like computers, where new advances keep arriving every few years with precise regularity. It seems that antibiotic research, at least as we know it today, has finally reached its peak. And even if science could invent a new antibiotic, what’s to stop future pathogens from becoming immune to it as well?

I suspect it wouldn’t take long, because human behavior isn’t going to change any time soon. In a sense, antibiotics fall under the “tragedy of the commons.” Any unregulated resource that is commonly shared by everyone, will eventually be destroyed. We all need to act in our own self-interest to survive and thrive, but when that instinct is applied to a resource that doesn’t belong to anyone, we quickly abuse that resource. Because human beings don’t want to be sick, and because livestock owners want to produce more food, any new antibiotic that is invented will inevitably be abused until it is worthless for everyone.

So it’s time to accept that the post-antibiotic era is unavoidable. We’ll either have to invent an entirely new method of treatment, or go back to some of the treatments we used in the early 20th century. Perhaps we’ll utilize some mixture of the two. In any case, antibiotics are very close to becoming useless, and until alternative solutions are ironed out the world is going to be quite a bit more dangerous than it was before.