What Is Antibiotic Resistance? And What Comes Next?

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Jul 29, 2016

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The discovery of penicillin in 1922 ushered in a golden age of medicine. But with antibiotic resistance a growing problem around the world – particularly in India — the wonder of the wonder drug may be waning.

Enough articles have been written on antibiotic resistance that we all know our part in the solution: Don’t take antibiotics for viral illnesses; don’t quit a prescribed antibiotic before finishing the course; don’t pop a broad-spectrum pill when a targeted antibiotic will do; don’t use so much hand sanitizer.

But in the throes of illness – and especially in diving back into unfinished business upon recovery – it’s easy to forget or ignore. Because it worked this time – and that’s what matters, right?

What is antibiotic resistance?

Antibiotic resistance is a slow process of basic evolution: Bacteria battle the antibiotic we take to neutralize them. At the end of a course of treatment, there is always a chance a few hardy, unharmed bacteria cells linger – not enough to make us sick, but enough to watch from the sidelines, so to speak, and learn how to fight the antibiotic taken.

These leftover bacteria then recode their DNA to retain the knowledge. It’s a genetic mutation that allows them to level up.

This alone doesn’t mean antibiotic resistance. Resistance isn’t completed in one person, in one treatment. But as the mutant bacteria get passed around, they become stronger and stronger until one day, they perfect the genetic formula to resist all effects of a particular antibiotic and become antibiotic resistant bacteria.

Basically, they become X-Men of the bacteria world.

Stopping a course of antibiotics midway all but ensures bacteria still survive, even if it’s not enough to make you sick again (though that’s a strong possibility), and have the opportunity to become superbugs.

Taking broad-spectrum antibiotics – developed as a second line of defense when bacteria started to become resistant to targeted antibiotics – just makes this process possible for more types of bacteria at once, speeding up the process to becoming bacteria resistant to antibiotics.

You see, it’s possible for you to have several pathogens in your body at once, but some may not be in large enough quantities to do you harm. When you blast your body with a broad-spectrum antibiotic to fight one or two strains, you’ll get better, certainly. But in the process you create an opportunity for all of these other bacteria not making you sick to level up anyway.

The same thing happens when you take an antibiotic – narrow or broad spectrum – for a viral illness, except you won’t even have the benefit of feeling better. The antibiotic attacks pathogens not making you sick and gives them the opportunity to become antibiotic resistant bacteria.

Overuse of hand sanitizer contributes to antibiotic resistance in a similar way, depending on what kind you use. Alcohol-based versions are fine, despite popular belief, though they don’t beat soap and water.

But many antibacterial sanitizers, soaps, and toothpaste contain an antimicrobial compound called triclosan, which bacteria can become resistant to. (Staph, which can cause pneumonia or TSS, already has.) Most concerning, triclosan can be passed through breastmilk, which can compromise baby’s underdeveloped immune systems.

It may seem wise to preemptively attack these small pockets of pathogens, but there’s a reason we have immune systems. Most of the time, our bodies can take care of pathogens without any help. In fact, the human skin itself is a physical barrier with antimicrobial properties that prevents germs from getting in.

Again, antibiotic resistance isn’t an instant process in one person taking a single course of broad-spectrum antibiotics or using hand sanitizer every once in a while. But the more people who do this, and the more frequently they do it, the stronger the bacteria we share.

Is the damage done in India?

Probably – to antibiotics, that is, but not necessarily to humankind.

You’d be excused for thinking it is the end of days, though. The indiscriminate use of antibiotics has brought us on the cusp of what some experts call the post-antibiotic era, when even the strongest antibiotics fail to neutralize bacteria, and routine illnesses once again become dangerous.

In India, it’s doesn’t seem far off; we’re already the world’s top consumer of antibiotics – and not because we have one of the world’s largest populations. We have the world’s second-highest number of multi drug-resistant tuberculosis cases.

And, in 2014, a report documenting thirteen cases in Chennai became the world’s first evidence of resistance to colistin, the last fully effective antibiotic. Similar, isolated cases have since popped up in Delhi, Pune and Mumbai.

At this point, it may seem crazy to say don’t panic, but – don’t panic. Seriously. These cases are very few and far between. The likelihood of you or a loved one catching an infection with complete antibiotic resistance is tiny.

And there are some very exciting forays into post-antibiotic solutions, too. From biochemicals that shut down bacteria’s survivor genes or compounds that initiate self-destruction, to capitalizing on bacteria’s natural enemies like bacteriophages (viruses that infect bacteria) and bacteriocins (proteins tailored to fight bacteria), to revisiting how naturally antimicrobial metals can be used against bacteria (without damaging cellular chemistry).

But until one of these treatments is approved for use, we all have to do our part. And that may mean having to be a little patient mid-suffering and a little diligent even when we feel better.

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Written By The Swaddle Team

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