Bacteria are everywhere. They can be found in soil, in water, in the air, behind your ear, on your tongue and in your gut. In fact, there are around ten times more bacterial cells within your body than actual human cells. They are unavoidable, and in many cases these bacteria are useful and shouldn’t be avoided. We all know that if we do get infected with more threatening bacteria that our GP will prescribe antibiotics and we should feel fine and healthy in a few days. However, sometimes it is not so simple and this is becoming the case more and more often.
Antimicrobial resistance, the resistance of bacteria and other microbes to the drugs we use against them, has been declared as a “global health emergency” by the UN and it is growing fast. Professor Dame Sally Davies, the Chief Medical Officer for the UK has said that we “have reached a critical point and must act now on a global scale to slow down antimicrobial resistance”. A UK based review on antimicrobial resistance has predicted that by 2050, if we carry on as we are doing so, antibiotic resistant infections could cause up to 10 million deaths per year. To put this into perspective, that’s more deaths than those caused by all cancers combined.
So what happens when we run out of antibiotics that bacteria aren’t resistant to? David Cameron, former UK Prime Minister, made a statement in 2014 saying that a scenario where antibiotics no longer work means we would be “cast back into the dark ages of medicine”. No antibiotics would mean that simple and routine surgeries would dangerous to carry out. Millions more women would die in childbirth. Chemotherapy would be almost impossible. The smallest wound could be potentially life-threatening.
Years ago, when antibiotic resistance was infrequent, it would be solved by simply finding a new drug to replace the drug the bacteria were now resistant to. However, there are a limited number of natural antibiotics that don’t cause harm to humans and drug companies put little to no money into funding antibiotic research. So nowadays it is not so easy to just come up with a replacement antibiotic. Replacing antibiotics with more antibiotics would only allow us to avoid the crisis until bacteria become resistant to these new drugs as well. And so, we must look beyond new drugs to be able to solve the antimicrobial resistance crisis.
The most practical and sustainable route to slowing down antimicrobial resistance must be through hygiene and diagnosis. The MRSA crisis was not controlled through the use of a new and more potent drug, it was controlled through an increase in hospital hygiene. Improved hygiene reduces the risk of infection, and with no infection then there is no need for treatment with antibiotics. Misuse of antibiotics tends to be through lack of diagnosis or misdiagnosis when patients go to their GP. Current diagnostic tests are time consuming and complex, and therefore diagnosing whether an illness is due to bacteria or a virus can be difficult. Many GPs will prescribe antibiotics without knowing the cause of the disease, and often this leads to antibiotic being uselessly used against viral infections. New quicker diagnostic tests, and therefore more accurate prescription of antibiotics, could be the key to slowing the progress of antibiotic resistance.