• Question: I have heard that due to the extensive useage of antibiotics that more and more bacteria are becoming superbugs and becoming resistant to different kinds of antibiotics.What steps have been taken to prevent all antibiotics from becoming obsolete?

    Asked by Darren to Mark, Linda, Arporn Koi, Franco, Claire on 11 Jul 2016.
    • Photo: Franco Falcone

      Franco Falcone answered on 11 Jul 2016:

      @Darren Absolutely correct! We have used antibiotics rather foolishly, for example to protect apple trees and pears from bacterial disease, spraying antibiotics with airplanes, or feeding them to livestock to increase their growth rate by 10 0r 20%!. As a result, in combination with insufficient hygiene in hospitals, antibiotic resistance is spreading. This is more of a problem in countries with a laxer attitude to antibiotics use. Countries with strict guidelines such as Norway and The Netherlands have less problems with ‘superbugs’, but as people travel so do their germs. So this is becoming a very serious threat and there are already some bacteria that are resistant to all known antibiotics.
      One has to bear in mind that resistance to antibiotics will always occur; antibiotics are produced by other bacteria or fungi, and the producing microorganisms have to be resistant to their own antibiotics, meaning that for any natural antibiotic, the matching resistance genes already exist in nature. So it is only a question of how long it will take for these genes to reach the bacteria living on our skin or in our guts.

      The problem is addressed at multiple levels:
      – development of new antibiotics. This is difficult, expensive and sooner or later we will run out of new targets. And as I explained above, it is only a matter of time before resistance spreads, usually only a few years after introduction of the antibiotics
      – development of new drugs that target the mechanism of resistance; for example if resistance is caused by a pump which pumps the antibiotic out of the bacterium, if you can develop a new drug which blocks this bacterial pump, you can used the old antibiotics again
      – development of alternative strategies which were successfully used in the past, e.g. bacteriophage therapy. Bacteriophages are viruses which kill bacteria (but not humans). The positive thing about bacteriophages is that they evolve as rapidly as bacteria, so if bacteria become resistant, the phages also adapt and can kill them again. Problem is that they are very specific, so you need a certain type of bacteriophage for a certain type of bacteria.
      – reduction or ban use of antibiotics in agriculture or for animal breeding. For example, in the EU (not sure what will happen in the UK after Brexit) antibiotics are banned from being used in the food, however they can be used to treat the animals if there are sign of infection, so that’s a loophole and they end up being used very often.
      – better regulations and restrictions regarding the use of antibiotics (this is where Pharmacists can make an impact) for example antibiotics should not be prescribed for viral diseases such as flu, because they don’t work against viruses. Also important to take the full course, even if symptoms have disappeared, e.g for 5 ot 7 days. If you stop after one or two days because you are feeling better, you are selecting for bacteria with intermediate levels of resistance, which will not have been killed by the shorter treatment but would have been killed eventually
      – Better hygiene in hospitals, isolation of patients with resistant superbugs.
      – Monitoring of antibiotic resistance at the international level

      The list is longer, I just wanted to give you an idea of the complexity and difficulty of the task!

      Hope this helped!

    • Photo: Arporn Koi Wangwiwatsin

      Arporn Koi Wangwiwatsin answered on 11 Jul 2016:

      Hi Darren,

      Yes, antibiotic resistance can be pretty (actually, very) dangerous to humankind. There are now better controlled in some part of the world for when the antibiotic will be given to patients, and also at least in the UK, you cannot buy antibiotics over a pharmacy counter without a prescription, and some antibiotics are reserved for use only in severe cases. More studies are also going into developing new antibiotics… However, there are some part where these controls are not enforced, and the problem is that diseases know no border so resistant bugs from else where can spread to other part of the world… There are also excessive used of antibiotics in farming and agriculture too, adding the pressure to the bugs to develop resistance.

      It is also important to raise awareness and educate people how antibiotic resistance happen so that people can play their best part in preventing it from getting too much worse.