In the early 20th century, pneumonia was known as the “captain of the men of death”. A scary name for a scary infection. But since then, there has been a huge mindset shift for both physicians and communities alike. If you live in an area with access to quality healthcare, pneumonia usually means a trip to the doctor. There, they prescribe you medicine, and you recover in about one week. But in the early 20th century it was very scary, with a death rate between 30%-40%. What caused this shift? Antibiotics.
What are antibiotics?
In 1928 Alexander Fleming discovered Penicillin, the first mass-produced antibiotic. It launched the antibiotic era, revolutionizing the treatment of communicable (infectious) diseases worldwide. An antibiotic is a medication that destroys or slows the growth of bacteria. Antibiotics treat bacterial infections such as pneumonia, Strep throat, Rheumatic Fever, Urinary Tract Infections, etc. They do not treat common colds or flus. Different antibiotics work in different ways.
Many of these drugs (such as penicillin) target the cell wall. Cell walls are what give bacteria cells strength and integrity, with the primary molecule providing this strength being peptidoglycan. The cell wall provides the strength needed for bacterial survival. Antibiotics stop Peptidoglycan production, weakening the wall. Other antibiotics prevent DNA replication. For bacteria cells to multiply and carry out infections, they must be able to asexually reproduce (make copies of itself). Certain antibiotics block the bacteria from making copies of itself which kills the infection. Another common way antibiotics fight off infection is in preventing the production of proteins. In bacteria cells, ribosomes are small sites in the cytoplasm that make proteins. When a drug blocks key molecules from binding to the ribosome, proteins cannot be produced. Proteins are important in carrying out cell functions, including replication, therefore without proteins cells cannot function properly and die.
What is antibiotic resistance?
Antibiotics kill germs and are essential in helping our bodies fight against infection. They are essential in surgical procedures, for people with weakened immune systems, and the general public (when accurately prescribed). However, with the discovery of antibiotics, there was also the acknowledgment of antibiotic resistance. Antibiotic resistance is also known as antimicrobial resistance or drug resistance. It is when bacteria develop the ability to not be destroyed by the drug. These surviving germs keep multiplying. This leads to deadly infections that leave us with limited available treatments.
Most bacteria die when exposed to antibiotics. The immune system then destroys the few surviving bacteria. However, when the immune system fails to kill the remaining bacteria, that bacteria spreads its drug-resistant properties. There is an exchanging or collecting of immune DNA between bacteria cells, which spreads this immunity. Even different types of bacteria cells can exchange immunity. This may lead to something called a superbug, which is immune to multiple antibiotics. Many Superbugs can be acquired in hospitals where there is a larger population of those infected with drug-resistant infections.
In the US, it is estimated that every year at least 2.8 million people develop an antibiotic-resistant infection. Sadly, over 35,000 die. When an infection is discovered to be drug-resistant to the drug commonly used for treatment, alternatives are used. These alternatives mean using different drugs or higher doses of drugs, resulting in more costly and toxic treatments. Antibiotic resistance is a public health crisis partly because increasingly often, even the last resort drugs are losing effectivity.
Why is this happening?
Some cases of resistance are naturally occurring, but a large proportion are acquired due to socioeconomic and behavioral factors. These may include misuse of antibiotics by both health professionals and the general public, poor-quality medicines, inadequate hospital infection control practices, inadequate surveillance, and poverty, among other reasons. To combat the continuing pattern of acquired drug resistance there must be effective prevention and control. To achieve this there must be more education on the appropriate use of antibiotics for the general public who self-prescribe as well as public health dispensers and prescribers. Additionally, when antibiotics are unnecessary there must be readily available alternatives. There must be stricter guidelines in hospitals to prevent the growth and spread of antibiotic-resistant bacteria. Finally, there must continue to be research into new antibiotic classes and strict control of any discovered.
I think that education about antibiotic resistance is important because its increasing rate is largely due to the public’s misuse of them. I have heard about this public health crisis before but I did not know that much about it. It is a topic that becomes known in the media for a short period of time, despite the importance of continuous education for the general public. It is scary to think that the treatments we rely on are becoming less effective. Because of this fear, I feel as though it is easy to try to ignore. I find it important to remember that it is the bacteria that become resistant to drugs, not our bodies. That this crisis is serious, but as bacteria adapt, our research continues, and new treatments will be discovered.