The danger with writing “Part 1” at the end of any post title is the fact that you have to follow up on your threat… I mean, promise. Last time we looked at how bacterial antibiotic resistance can occur. Antibiotic resistance poses a huge public health problem, with notable diseases, such as tuberculosis, being resistant to multiple drugs. Which is obviously REALLY BAD! So what do we do about it?
The 1940s to 1970s represented a golden age for antibiotics, with many new compounds, including penicillin, being introduced. However, we have seen a decline in antibiotic discovery, and a rise in antibiotic resistance in bacteria. Think Cold War – it’s an arms race between humans and bacteria. Humans with antibiotics, and bacteria with evolving resistance.
Drugs are currently prescribed in a hierarchy of most common to least common to avoid the emergence of resistance. Certain drugs, called drugs of last resort, are kept in reserve so that we have something to use if a bacterium is resistant to all the more common drugs. But eventually bacteria begin to develop resistance even to these drugs. Because, as you saw in the video last time, given enough time and exposure, eventually a mutation will arise that will allow bacteria to become resistant to whatever we throw at them.
Although we are still discovering new antibiotics, the possibility of a post-antibiotic era has become a distinct possibility. Imagine the world before penicillin, where just a small scratch could kill you. That’s what we’d have once again. Not just that, but it would mark a regression in medical advances – making chemotherapy, routine surgery, and organ transplants impossible!
Right then, so after that depressing paragraph – is there hope? Well of course. Why else would I be writing?
While there has been a decline in antibiotic discovery, new antibiotics are still being discovered, and researchers are actively looking for them. The problem is that only 1 in 5 antibiotics ever makes it to the shelves, and it can take 3 – 5 years to become available on prescription even after clinical trials. Add to this the poor return on investment compared to a long-term medication, and it’s understandable that companies aren’t all leaping to invest.
So here’s where that exciting discovery comes in (at last, sighs the reader!). Star shaped (kinda) polymers called SNAPPs (structurally nanoengineered antimicrobial peptide polymers), have recently been made, which are able to kill multiple drug resistant bacteria. Ok sure, you say, but now the bacteria will just become resistant to them too. The special thing about SNAPPs is that, unlike your standard antibiotic, they use multiple mechanisms to kill bacteria, making it much more difficult to develop resistance. Although SNAPPs have not yet made it as far as human trials, they offer us a new angle for fighting resistant bacteria.
In the meantime, let’s concentrate on the small things that we can do to contribute to preventing antibiotic resistance in bacteria. Like finishing our antibiotics courses, not trying to treat colds or flu with antibiotics, and quite simply by washing our hands and being aware of hygiene in order to prevent the need for antibiotics.
By happy coincidence, it also turns out that this week is the “World Antibiotic Awareness Week”. If you’re interested in learning more on this topic, check out some of these pages:
Lam, S.J. et al., 2016. Combating multidrug-resistant Gram-negative bacteria with structurally nanoengineered antimicrobial peptide polymers. Nature Microbiology, 1(11), p.16162. Available at: http://www.nature.com/articles/nmicrobiol2016162 doi:10.1038/nmicrobiol.2016.162
Ventola, C.L., 2015. The antibiotic resistance crisis: part 2: management strategies and new agents. P & T : a peer-reviewed journal for formulary management, 40(5), pp.344–52. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422635/