Friday, 2 October 2015

Resistance

Photo credit: NIAID


Recently I came across a documentary "Resistance" and it opened my eyes to a whole world of antibiotic resistance. Regardless of your preexisting interest in public health, once you learn a little about antibiotic abuse, you won’t be able to ignore it.

I always believed that too much of antibiotics is not good for health. Often when a doctor prescribes a 5 day medicine course and if I feel well after 2-3 days I skip the last day. I mean I know doctors say you should complete the course but I thought it was only so that the microbe doesn't come back again. Unfortunately I was in dark like most of the people.

what are antibiotics and what does it mean by antibiotic resistance?

In a very broad  term, antibiotics are poisons which kills bacteria but doesn't kill us. But that's like a Cinderella story, and we know life ain't that straight. So what happens is, when we give antibiotic it either kills the bacteria but if it survives what we have is a survivor bacteria who is even stronger than before! Which means the medicine which you are using today to fight against a particular bacteria may not work tomorrow. Simply because they have become immune to it.

Why do bacteria become resistant to antibiotics?

There are number of reasons, top most being evolution or as best said "survival of the fittest" which is a natural phenomenon. However, the current higher-levels of antibiotic-resistant bacteria are attributed to the overuse and abuse of antibiotics. It is very important that we dwell into details of how we are overusing or rather abusing antibiotics which in turn helps them get stronger

  1.  Giving wrong doses of antibiotics to people
  2. People take wrong doses or because they don't take full prescription 
    (When stopping taking antibiotics early or just when symptoms subside, there could still be a few infectious microbes left which would re-populate with greater resistance to that antibiotic) 
  3. Give antibiotics to healthy beings (including animals)
  4. Excessive spraying of antibiotics in fruits and vegetables
  5. Exposure of antibacterial agents through everyday items we use. From hand wash to dish wash!
And these are not imaginary or futuristic talks, about 70 percent of the bacteria that cause infections in hospitals are resistant to at least one of the drugs most commonly used for treatment. Some organisms are resistant to all approved antibiotics and can only be treated with experimental and potentially toxic drugs. For example Neisseria gonorrhoeae (the cause of gonorrhoea) are now almost always resistant to benzyl penicillin due to over usage of penicillin.

Antibiotics play a gigantic role in fighting infectious diseases. At first glance, it may seem that antibiotic resistance is only going to effect a small range of diseases. But truth is without antibiotics, we can't even have a surgery! It will falter the entire medical system.

Today almost all the livestock we consume are being fed with antibiotics as a precautionary measure. Farmers or poultry folks cant afford to take risk because it's not as profitable. We keep spraying antibiotics randomly one after another thinking we are protecting ourselves. True we manage to kill lot of microbes, but the one's that manage to survive are going to be immune to everything we have. What if one of these microbes is disease causing? What then? We will be left completely disarmed.

Of course, one can argue that even human beings are not fragile and we can get resistant too to these microbes. Yes , we can. But how are we going to achieve that? Today we stay far away from earthly stuffs. We hardly get our hands dirty or dig our feet into unknown environments. At the first onset of fever or illness we gobble up antibiotics! We are so overcautious that we have cocooned our body into this pompous being. We are rusted whereas these microbes are very much active and "in shape".

Surely if the situation is this critical there must be lot of research going on and pharmaceutical companies would be coming with new and improved antibiotics.Right?

From 1983 to 1987 there were 16 new antibiotics made and approved by the FDA, from 2003-2007 there were 5, and since 2008-2011 there have only been 2.(source)

Why is pharmaceutical companies not investing in antibiotics?

It takes an average of 12 years for an experimental drug to travel from the laboratory to your medicine cabinet. That is, if it makes it. Only 5 in 5,000 drugs that enter preclinical testing progress to human testing. One of these 5 drugs that are tested in people is approved. The chance for a new drug to actually make it to market is thus only 1 in 5,000. Not to mention billions spent for the potential risky affair.

Now looking into the antibiotic resistance pattern, it is very much possible that by the time drug reaches market it would have already become resistant to that drug! So you see, its a catch 22. Why would investors invest money in something so risky when they can make huge profit out of something like Lipitor or even Viagara which gives long term returns and bound to be blockbusters.

Are we doomed?

Well, being a optimist I would say, not yet. What we need is awareness as to what is happening, why it is happening and what we need to do to prepare ourselves for future. As an individual, we can always choose to follow some minimum precautions, like taking antibiotics only when we really need to and taking the full prescription or avoiding overuse of antibacterial products. Of course, it is a tiny step but its a step we are obliged to take.

"Each generation doubtless feels called upon to reform the world. Mine knows that it will not reform it, but its task is perhaps even greater. It consists in preventing the world from destroying itself."
                                     -Albert Camus









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