Feeling too full of bobance and bounce? Then you might take a look at a new report from the American Academy of Microbiology. It begins: "The struggle against antibiotic resistance is a war we will never win. The strength of trillions upon trillions of microorganisms, combined with the ancient force of evolution ... will inevitably overpower our drugs."
The report, which emerged from a colloquium of scientists last year, isn't telling us to do the public health equivalent of buying a Hummer in the face of inevitable climate change, but urging a multi-pronged approach to dealing with a problem that will never go away. Call it moderation management, if you will.
And though it's popular these days to point to a) the use of antibiotics in agriculture, or b) inappropriate prescribing as the causes of all our MRSA woes, what the scientists are saying, instead, is:
Yes, these things contribute, but antibiotic-resistance is always going to happen. It's a matter of evolution, of survival of the fittest. Unless someone comes up with drugs that no bacterium could ever, ever develop resistance to, then if the drugs are used -- even if entirely appropriately -- it's just a matter of time. Helping the process along is the sheer number of microbes that teem the planet, the above-mentioned trillions and trillions. This allows even very rare changes in bacteria that render them resistant to occur fairly quickly.
After the miraculous discovery of penicillin in 1928 and its development as a drug in the 1940s. By the 1950s, penicillin-resistant Staphylococcus strains were already on the upswing. (Here's an interesting review of the history of antibiotics and antibiotic-resistant bugs in a Japanese journal.)
"We have to find a way to coexist with resistance," the new report states. We need to slow it, the authors say, and contain it.
They urge, among other measures, the following:
- Better and quicker diagnostic tools so that patients can be treated with the right antibiotics sooner;
- Better, extensive and well-coordinated surveillance, so we know what antibiotic-resistant bugs are out there and how their numbers are growing;
- A lot more research to understand how resistance develops in human bodies, as opposed to in petri dishes in labs -- the two can be very different;
- More understanding of the contribution those antimicrobials we're so fond of in our hand-wash might contribute to future resistance;
- What happens when antibiotics and antimicrobials end up in sewage sludge -- this and other places in the environment could be little hothouses for the development of resistant strains.
- More money and effort toward the development of new antibiotics. Back in the heyday of antibiotic discovery, new antibiotics were there for the finding in samples of dirt. These days, such searches come up empty-handed -- or rather, they come up with the same drugs that others have found before.
There is also an interesting sidebar examining the problem of antibiotic use in agriculture, as "growth promoters" when rearing animals. (This practice is banned in Europe.) That issue isn't without its complications: Animals reared without the use of such growth promoters can end up sicker -- and need more antibiotics -- later on. "More studies are urgently needed," the scientists conclude.
Photo Credit: Visuals Unlimited