WHO predicts that by 2025, first-line antibiotics may lose their effectiveness due to resistant bacteria. Let’s figure out why scientists consider this problem a disaster of modern medicine
Why antibiotic resistance is dangerous
Antibiotics are substances that fight microorganisms—bacteria or fungi, destroying or inhibiting their growth and reproduction. They are obtained from fungi (for example, penicillin was isolated from molds) and even some bacteria. In addition, there are many synthetic, artificial, and antibacterial drugs.
Thanks to antibiotics, modern doctors can cope with many infections and serious complications that could previously be fatal for patients: sepsis, pneumonia, tuberculosis, meningitis, syphilis, and so on.
Antibiotic resistance is the resistance of some microorganisms to antibacterial drugs. Many antibiotics that were actively used before have now lost their effectiveness – bacteria can suppress their effect and even completely neutralize the medicine. Diseases caused by resistant strains of bacteria are very dangerous: standard therapy is not suitable for such diseases, and they can cause complications and death.
The emergence of “superbugs”—multidrug-resistant microorganisms that are resistant to several antibacterial drugs at once—has seriously complicated the treatment of many diseases. In order to cope with some resistant infections, doctors use antibacterial drugs that are toxic to the body, which are not used under normal conditions due to the large number of side effects.
If the necessary measures are not taken, then by 2050, according to the WHO, deaths due to antibiotic resistance could reach 10 million people annually.
When did antibiotic resistance appear?
The era of antibiotics began at the end of the 19th century when scientists began searching for substances that could selectively act on bacteria without damaging human cells. Thus, in 1909, chemist Paul Ehrlich, after much research, created arsphenamine based on arsenic, “drug 606,” which destroyed Treponema pallidum, the causative agent of syphilis. This breakthrough gave hope to the most hopeless patients, but the drug was toxic and was no longer used in the middle of the 20th century.
In 1928, British microbiologist Alexander Fleming discovered the first “modern” antibiotic – penicillin, which effectively dealt with bacterial infections and was not dangerous to the human body. In 1939, researchers Ernest Chain and Howard Florey isolated the active substance of penicillin and tested it on mice.
Later, the technology for mass production of the drug was developed, and already in 1942, patients began to be treated with the antibiotics. It was actively used in hospitals during the Second World War: it saved people in serious conditions, with infectious complications after wounds. After the war, the drug became available to ordinary people. Penicillin quickly became known as the “miracle drug.”
The massive distribution of antibiotics led to natural consequences: they began to be used everywhere as a “cure for everything,” often unnecessarily, for example, to treat viral infections. Scientists began to sound the alarm: the first cases of ineffective antibacterial drugs due to antibiotic resistance were recorded in the late 1940s.
How do bacteria become resistant to antibiotics?
Bacteria may be naturally resistant to some antibiotics: for example, if the microbe does not have a “target” for the drug to act on, or if the bacterial cell wall is impermeable to the drug. However, the problem of natural resistance is relatively easy to solve: effective antibiotics are selected for bacteria, taking into account the characteristics of their structure and reproduction.
Acquired resistance is one of the mechanisms of adaptation and protection of bacteria and other microorganisms, – fungi and viruses. The development of resistance is associated with changes in the genetic material of the microbe—mutations—and the further transfer of resistance genes to other strains and even species of bacteria.
There are several different resistance mechanisms that bacteria use:
- Bacteria secrete special enzymes that neutralize the antibiotic. The most famous example of such a substance is beta-lactamase. Thanks to it, many bacteria have become resistant, for example, to penicillins.
- Changes in bacterial structures to which the action of the antibiotic is directed – targets. So the antibiotic will not be able to realize its effect.
- Changes in cell functioning. Some bacteria can modify their life processes to avoid the target structures of antibiotics. In this case, the drug will not harm the bacteria.
- Reduced cell wall permeability. This will prevent antibiotic molecules from penetrating the bacteria.
- Accelerated removal of antibiotics from bacterial cells.
Why is antibiotic resistance developing so quickly?
The main factor provoking the development of resistance in bacteria is the incorrect and excessive use of antibiotics. Often drugs are used unnecessarily, for example, to treat ARVI and influenza – viral infections for which antibiotics are generally ineffective.
In addition, many people take them incorrectly, not following the dosage and treatment regimen. As a result, the drug cannot reach the required concentration in the blood. Some bacteria survive and become resistant.
Another problem is the incompetence of the doctors themselves: they prescribe antibiotics for any infectious disease without finding out its cause. Each antibiotic has a spectrum of action – a list of bacteria that it can treat. There are broad-spectrum and narrow-spectrum drugs.
Theoretically, it is advisable to determine the causative agent of infection in each patient and select an individual treatment regimen for him. However, in practice, doctors often have to prescribe antibiotics at random, assessing symptoms and choosing a drug based on data on the bacteria that most often provoke the disease suspected by the clinical picture.
In addition, many specialists prefer to immediately prescribe broad-spectrum medications—those that act on a large number of different pathogens. Bacteria that for some reason survive exposure to an antibiotic can transfer resistant properties to other strains.
Another problem influencing the development of resistance is the widespread use of antibiotics in agriculture, often without veterinary supervision. Animals transmit resistant bacteria to humans.
Ways to overcome antibiotic resistance
To cope with resistant infections, scientists are actively developing new antibacterial drugs. In 2017, WHO presented a list of priority pathogens – the most significant and dangerous resistant microorganisms, to combat which it is urgently necessary to create new antibiotics. The list was updated in 2022.
In addition, scientists are exploring alternative ways to combat antibiotic resistance. One promising direction is the study of bacteriophages – viruses that selectively destroy bacteria. While phages cannot replace antibiotics, experts are actively exploring the possibility of using these drugs. Other methods, such are the use of immunostimulants, antimicrobial peptides, lysines, etc., require further scientific research.
In addition to finding alternatives to antibiotics, efforts to curb the spread of resistant strains are critical. First of all, antibiotics should be sold only with a prescription from a doctor. Even though this is officially the case in the USA, in practice, drugs can often be purchased without a prescription.
Controlling the use of antibiotics in agriculture is another necessary measure. Drugs should be used only under the supervision of veterinarians and in cases where they cannot be avoided.
Correct and conscious use of antibiotics can at least delay the onset of the “post-antibiotic era” and reduce the number of multidrug-resistant strains.
Here’s what everyone can do to curb antibiotic resistance:
- Take antibiotics only as prescribed by your doctor. There is no need to take the drug “for prevention” or “for a cold.” If a specialist says that you do not need an antibiotic, do not “prescribe” it to yourself.
- Follow the regimen and duration of antibiotic use. Do not stop taking the medicine early, even if your symptoms have passed.
- Do not take antibiotics that are “advised” to you by non-professionals. Different diseases require different medications. A doctor can best assess your symptoms.
- Try to follow infection prevention measures to avoid taking antibiotics.
