I guess with new and antibiotic-resistant strains of bacteria, it is an uphill battle now. But I have to wonder: Will there ever be a time when there will be NO antibiotic that can kill bacteria?
I know just reading stories from the past are very sobering. George Washington was in constant, and horrible, pain from all the abscesses he had in his gums. Childhood ear infections typically and eventually went to the bone, and were fatal. In fact, the majority of children didn’t survive childhood. Is this what awaits us?
Keep in mind that the genes that confer resistance to each type of antibiotic aren’t necessarily particularly useful for bacteria not being assaulted by that antibiotic, and might even be selected against if those antibiotics stopped being used.
In other words, if we stopped using antibiotics that work like penicillin long enough, the bacteria may lose their resistance to them.
What evolution gives, evolution takes away: It seems that there’s a selective pressure to lose resistances that aren’t needed, which means if we rotate drugs we’ll cycle resistances as well in a somewhat delayed phase; the bugs resistant to the oldest drug will lose out to their relatives not resistant to it, which will be killed off rather effectively once we cycle back around to that drug.
What nobody wants to mention is the return of in-patient care: The only reason we have serious drug resistance problems is antibiotic misuse, and the only reason people can misuse antibiotics is because they’re trusted to take them at home. If we have a serious problem with resistant bugs, we’ll go back to the old days and do all antibiotic treatments on an in-patient basis so people can’t stop taking them when they feel better.
It has already been mentioned that resistant bacteria are likely to become unresistant over time and under the right circumstances.
Someone has already mentioned nanotech; If we can develop artificial targeted antibodies, nanomachines or other technologies that can target infections in a different way than antibiotics, we may even have a better solution than antibiotics. I think the odds are good of seeing something like that developed before we run out of effective antibiotics entirely. (Say, in 50-100 years).
In addition, medical technology gives us some options to treat symptoms of an infection that weren’t available hundreds of years ago. These options aren’t nearly as cheap or effective as good antibiotics, but they should still prevent a total return to pre-antibiotic days. For example, we can do surgeries to remove tissues and drain fluids. George Washington would surely have been helped by modern dentures. These are not good solutions - we’re in for tough times, I think - but we’re not doomed.
This is not necessarily true. There has been a dearth of antibiotic research for a very long time. While antibiotic missuse has played a very large part in the resistance problem, this fact is often overlooked. Research should have been able to keep up, but it didn’t because antibiotics aren’t profitable.
Another possibility, as reported in Good Germs, Bad Germs, is using benign strains of bacteria to out-compete harmful strains.
The book notes one early outbreak of a hospital-acquired resistant bacteria that was controlled using that method. The bacteria was infecting babies in the nursery, who would leave the hospital looking healthy, but sickening and often dying soon after. They were able to identify the bacteria, which was a variation of a common nasal bacteria.
While they were looking for an anti-biotic that would work, an analysis of the patterns of the illness revealed that the babies who were cared for by one particular nurse had a much larger chance of going home healthy and staying that way. So they did nose swabs of the nursery nurses.
All of the nurses had typical variants of the bacteria. The identified ‘healthy nurse’ had a variant that none of the others had. So they grew a store of that variant and began testing. Babies who were swabbed with that variant went home healthy and stayed that way.
Once the treatment was proven, all babies born at the hopital were swabbed, allowing a robust, non-lethal variety to dominate the nasal niche. Problem solved.
The book points to research on the human microbiome and speculates that in the future disease control will include management of populations within a person’s microbiome.
While developing nwe antibiotics is quite difficult and exspensive, the good news is that bacteria resistant to one don’t get resistance to all, and becoming resistant to a wide swath of them is unlikely. So we do have the “big guns” to pull out when neccessary.
Actually, that’s not really true. Antibiotic resistance tends to be towards full classes of antibiotics, and you can count the number of classes on your hands. For example, a bacteria that is resistant to penicillin will likely also be resistant to Keflex. Then of course, you have multiple-drug resistant bacteria that develops it’s resistance in other ways that apply to most classes. One method of resistance is over expression of ABC transport, which is a method cells have to move harmful chemicals from the cell. We need to develop good ways of blocking this resistance method.
Wouldn’t it help to get the penicillin or whatever in a one-time shot rather than (supposedly) taking all the pills? I’ve tried to get the shot because I hate the pills, and was told that I could, but it would cost a lot more and insurance wouldn’t cover it. Maybe if someone invented a way to get the antibiotic in like a shot only without pain, and cheaply, more people would choose that method because of convenience. Penicillin shots are painful!
We’re forgetting about vaccines. Why would a for-profit pharmaceutical company concentrate on, for example, developing a vaccine against strep throat when they can sell multiple prescriptions of antibiotics to the same person over the course of a lifetime?
Yes, I’m cynical.
No, you’re misinformed. Vaccines don’t work equally against all disease because not all bacteria are made equally. Some mutate less often than the others, so you can vaccinate against e.g. Pertussis or meningitis. Others mutate suddenly and unexpectedly, like the current EHEC strain of otherwise harmless E. coli Bacteria. For example, there is no vaccine against Lyme-Borreliose, although given the huge problems an infection has and that there is no good treatment, a company could make a good profit from a widely distributed vaccine.
Since there is no alternative prescription to really treat Lyme-Borreliosis, there is not the conflict of interest you assume.
Besides, it may surprise you, but not all research is done by US pharma companies. There is research done outside the US, in Europe for example, and a lot of that explicitly at Universities and hospitals to remove the for-profit orientation. The national govt.s, ministries as well as EU programs give money to specific research because it’s in their interest to combat diseases.