An alarming public health crisis is on the horizon: the rise of superbugs, or bacterial infections that are resistant to antibiotic treatment. Antibiotics have been essential to our society since their discovery in 1928. It’s estimated that penicillin, the first antibiotic, has saved up to 200 million lives. In addition to fighting common illnesses, antibiotics have been key to developing many modern surgical procedures, as they help surgical wounds resist bacterial infection.
The dangers of antibiotic resistance
Antibiotics have become so important to modern medical care that it may be difficult to even comprehend at first what a world without them would mean. As bacteria becomes resistant to antibiotics, our medications become less and less effective. Without them, ordinary infections such as strep throat will be considered potentially life-threatening. Diseases that are currently rare in the developed world, such as tuberculosis, could return at epidemic proportions. Superbugs are especially threatening to populations like the elderly or immunodeficient who are more susceptible to bacterial infections.
It’s scary to think about, but we all need to. Medical officials agree that we’re closer to superbug domination than you might think. The World Health Organization’s Global Antimicrobial Surveillance System has received reports of 500,000 people across 22 countries worldwide with antibiotic-resistant infections. This is likely an underestimation of actual superbug occurrence, as the surveillance system operates in more high- and middle-income countries than low-income ones where access to medical treatment can be more difficult to obtain. Penicillin resistance rates were as high as 51% in some reporting countries. The CDC has estimated that superbugs kill about 23,000 Americans per year, a figure comparable to the 38,000 who die in car crashes.
Healthcare research is a constantly evolving field and has received substantial economic investment nationally and globally. The NIH alone gives about $30 billion in grants to medical research studies every year. The medical community at large is aware that superbugs are a pressing and growing threat. So how did we get here, and why are superbugs still a huge concern for the future?
Antibiotic resistance is, in some sense, a natural evolutionary process. When a bacterial infection encounters effective antibiotics, the entire infection is destroyed through a combination of medicine and the body’s immune system. But bacteria, like all other living organisms, experience slight genetic mutations as generations reproduce. If a bacteria experiences a mutation that helps it survive an antibiotic, it will be able to reproduce in the future. As antibiotic use continues, the resistant bacteria survive and reproduce as the non-resistant bacteria are wiped out, creating a larger and larger resistant population.
The thing is, many people are taking antibiotics when they don’t need them due to misdiagnosis or over-prescription (many healthy people can fight off mild bacterial infections on their own). When we have a bacterial infection, antibiotics wipe out both the dangerous bacteria and the “good” bacteria living in our bodies. This is fine every once in a while to take care of a problematic infection, but If there isn’t a bacterial infection to treat in the first place, then losing this good bacteria simply weakens our immune systems further until these helpful, disease-fighting bacteria colonies can be rebuilt. Now, a drug-resistant bacteria lurking in our bodies that our immune system could have destroyed on its own is given free reign, with weakened immune defenses and few bacterial competitors taking up space and resources. That resistant bacteria strain can then be passed on to other people.
Medication development delays
While at least 90% of resistant bacteria in the US can be treated with “the last line of defense” antibiotics, entirely antibiotic-immune strains have already claimed lives in the U.S. and abroad. The rate of superbug development can be drastically slowed down by responsible antibiotic use, but it’s clear that we need to develop treatments to combat this evolving threat.
Essentially, medical researchers have to outrace superbug resistance, developing new approaches faster than bacteria can overcome them. To win the race, medical researchers would need access to huge amounts of data, including live and real-world datasets to understand how different types of bacteria are mutating and evolving in the real world in real time. Separately, antibiotics are meant as short-course medications and don’t bring in a substantial profit for the companies who produce them, but the process to develop new ones is incredibly expensive. New antibiotics that come onto the market to be treated as “last resort” medication to slow the development of bacterial resistance are even less profitable. This is a critical issue between the pharmaceutical industry interests and the health research needed by patients.
Superbugs are scary, but they are not an insurmountable problem as long as we start acting now. Influential groups such as the CDC are already working to combat antibiotic overuse and misuse. National health agencies are beginning to incentivize research and development processes for new antibiotic treatments, attempting to counter unproductive economic conditions.