Did Fleming foresee the death of antibiotics?

Think back to the last time you cut or grazed yourself. Can you imagine that cut becoming infected with bacteria – so seriously infected that you couldn’t fight it? Before the discovery of antibiotics, if that happened, there was nothing much anyone could do. Streptococcus pyogenes caused half of all post-birth deaths and was a major cause of death from burns. Staphylococcus aureus was fatal in 80 percent of infected wounds and the tuberculosis and pneumonia bacteria were infamous killers.

All this changed with the development of antibiotics. After Fleming’s chance discovery of penicillin in 1928, the first antibiotics were developed and in widespread use within 10 years. Bacterial infection, as a cause of death, plummeted. Between 1944 and 1972 human life expectancy jumped by eight years – an increase largely credited to the introduction of antibiotics.

As early as 1945 though, scientists were issuing warnings about antibiotic misuse, Alexander Fleming himself warned:

“The greatest possibility of evil in self-medication is the use of too small doses so that instead of clearing up infection the microbes are educated to resist penicillin and a host of penicillin-fast organisms is bred out which can be passed to other individuals.”

Signs of antibiotic resistance had emerged within the first few years of antibiotic use. However, in the 1950’s and 1960’s, resistant bacterial strains seemed not to matter as there was always a new antibiotic being developed to combat them.

Towards the end of the 60’s, new classes of antibiotics were no longer being developed and drug companies started to turn their attention elsewhere.

Half a century later both the UK and US medical authorities are issuing serious warnings that we may be returning to the dark days of the pre-antibiotic age. Antibiotic-resistant bacteria are out of control in some countries. In Greece 68 per cent of Klebsiella infections tested in 2011 were carbapenem resistant.  Carbapenem are last-resort antibiotics, the last line of defense against superbugs like MRSA. Greece has also reported some cases of E. coli, the most common cause of urinary tract infections, that are resistant to carbapenem.

This is no surprise as Greece has the highest rate of antibiotic use in the EU. Similar problems exist in Asia “You can get any antibiotics easily in pharmacies [without prescription],” including carbapenems, says Danilo Lo Fo Wong of the World Health Organization. 

Fortunately, there are new antibiotic drugs are in development, a 2011 survey at the University of Genoa, Italy, found that no fewer than six novel antibiotics that work against multidrug-resistant Enterobacteriaceae had gone through early trials. However, none has been able to attract pharmaceutical-industry funding for the expensive final trials.

Since 1990 a total of eight major pharmaceutical companies have abandoned antibiotics  – only three still develop them. Part of the reason is that there simply isn’t much money in it, says Chip Chambers of the University of California, San Francisco. Unlike pills for chronic conditions like heart disease, antibiotics are taken for a week or two. What’s more, any new drug that kills resistant bacteria will deliberately be used as little as possible to slow development of resistance to it.

Governments are putting in measures to increase funding for antibiotic development but even if development resumes, “we are looking at the next 10 to 15 years with no drugs to treat many of these infections”, says Chambers. “It’s like going back to the pre-antibiotic era,” warns Toleman. Then, people routinely died of what we now consider minor bacterial infections. It is not an era we want to see again.

Sources: http://www.abc.net.au, New Scientist

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