“When I trained, I never imagined I wouldn’t’ be able to treat an infection. I went in to cure and here I am with a patient I can’t cure”.
Dr. Andrew Morris, MD, SM(Epi), FRCPC; Medical Director, Antimicrobial Stewardship Program, Sinai Health System/University Health Network
Maybe I’ve watched too much Walking Dead, but when I see national coverage on the quiet evolution of “Super Bugs”, I get a bit nervous. Like so many of the issues we humans face today, the very serious worry that antibiotics are going to stop working is a consequence of our own super intelligence. We make effective medicine that obliterates bacterial infections, but then surviving bacteria becomes a little bit stronger, more ‘super’ if you will.
So we—as clever humans—say: "No worries, we’ll just make more effective medicine later!"...and so on.
It’s the “so on” part that we seem to take for granted. We get an infection, go to the doctor, and she throws us a prescription.
Claire Brownell reports in The Financial Post that, “Decades of antibiotic overuse have led to an increase in infections from bacteria that have developed a resistance to them, rendering the drugs that have conquered pneumonia, rheumatic fever and tuberculosis powerless (1).”
The World Health Organization has warnedthat "without immediate action, the world is headed for a post-antibiotic era. Infections and minor injuries that were once easily treated could become deadly as bacteria evolve to outsmart our existing antibiotic drugs." Furthermore, The Public Health Agency of Canada has called it one of the biggest health risks facing the country (1). The World Bank predicts that by 2050, drug-resistant infections could cause global economic damage on par with the 2008 financial crisis (2).
This is a multi-layered question. Brownell explains that part of the issue is incentive. Pharma companies like money (I get it, who doesn't) and because antibiotics only take a few days to work, they’re not as profitable as the drugs that are used to manage chronic conditions (ie. think more sick = more money).
Adding to that, expensively developed new antibiotics are sometimes held in reserve, meaning they don’t get used (sold), and so Big Pharma decides to invest its Big Money elsewhere. I know, I know, it kind of sounds like an evil conspiracy theory... but thems the facts.
“I’m on antibiotics” doesn't just mean you’re fighting pneumonia. It could be a urinary tract infection, strep throat, or even acne (3). Worse, over-reliance and overuse is VERY common. Whether it’s a doctor prescribing prematurely before test results come back, patients using leftovers (BAD!) or patients pressuring doctors for a “quick fix” (4).
To add insult to injury we’re ingesting a lot of antibiotics in other ways too. You know that juicy burger you just popped off the BBQ? Chances are it's giving you a trace dose of antibiotics. In the US,approximately 80% of all antibacterial drugs are used on animals (5) and we eat those animals 😟.
According to the Mayo Clinic, any bacterium that survives an antibiotic treatment can then multiply and pass on its resistant properties — ie. any bugs that survive the attack of antibiotics get stronger, and then give birth to stronger super-bug babies. Some bacteria can "event transfer" their drug-resilient properties to other bacteria (4)... I don't know about you, but that really freaks me out.
Resistance is inevitable, but the pace and extent to which it happens is where we’re having the most impact.
*KEY NOTE* Don’t get me wrong here, antibiotics rock and are an amazing part of modern medicine. I remember when they got rid of my first UTI, I was ready to sign up for the official antibiotic super-fan club. But there’s no denying that we are very quickly developing a serious problem that’s scary and the way we use antibiotics is a big part of the problem.
Here's my 3-step guide to preventing the super-bug apocalypse:
So ask follow up questions to your doctor. Use antibiotics deliberately and slow down the evolution of the nightmare monster super-bug!
Questions? Comments? Collaboration ideas? Let's chat!
(1) Brownell, Claire. "Super Bugs: They're a Health and Economic Crisis and There's No Cure In Sight." Financial Post, December 3 2016.
(2) "By 2050, drug-resistant infections could cause global economic damage on par with 2008 financial crisis."The World Bank. N.p., 20 Sept. 2016.
(3) "Antibiotics: List of Common Antibiotics & Types."Antibiotics: List of Common Antibiotics & Types - Drugs.com. Ed. L. Anderson. Drugs.com, 23 Aug. 2016.
(4) "Antibiotics: Misuse puts you and others at risk."Mayo Clinic. N.p., 12 Dec. 2014.
(5) "Antibiotic Resistance."Congresswoman Louise Slaughter. N.p., n.d.