We live in an age of instant gratification, an age in which the resources of the world are at our fingertips. When it comes to pharmaceuticals, the desire for an instant cure is especially pervasive and especially dangerous. A study released in September by the Center for Disease Dynamics, Economics, and Policy (CDDEP) revealed alarmingly high rates of antibiotic resistance around the world. Most antibiotics attempt to treat or prevent bacterial infection. Resistance arises when bacteria survive in spite of the introduction of an antibiotic. The trend of increasing antibiotic resistance has only come to light in the last 20 years or so. The pattern appears across the world, regardless of the economic status or quality of healthcare in a nation. Within the next few decades, routine infections could become untreatable.
The most basic way to understand these effects is to see antibiotics as a shared resource. When one person uses antibiotics to treat, say, a common cold, most of the infectious bacteria targeted by the antibiotic are wiped out. However, the strongest, most durable strains of bacteria survive. These bacteria have mutated to evade destruction by the antibiotic. After most of the other bacteria in the system are wiped out by the drug, these stronger bacteria multiply and thrive on the surplus of resources newly available to them. After many generations of mutation and building resistance, large populations of bacteria that are unaffected by the original antibiotic grow. These difficult-to-eradicate bacteria infect others, and the cycle of growing resistance continues. What might have begun as a simple, treatable infection can eventually transform into a lethal threat. If the trends of increasing antibiotic resistance continue as they have over the past century, invasive surgeries may become impossible due to the risk of infection. Millions will die from once-treatable bacterial infections.
The CDDEP has created interactive maps that reveal geographical trends in drug and antibiotic resistance. The data were collected from over sixty countries including India, Thailand, Vietnam, Kenya, South Africa, Australia, and New Zealand. Increased antibiotic consumption in middle-income countries seems to be a result of higher incomes; people in these countries can now afford to self-treat their own colds by buying antibiotics from pharmacies without a prescription. The larger trends in antibiotic infection show that once-declining levels of lethal bacteria are now resurging. For example, resistant E. coli have been increasing; in India, nearly 80% of E. coli are resistant to mainstream drugs. Furthermore, the CDDEP found growing resistance to carbapenems, a class of antibiotics that were initially created as a last-resort option in treating lethal bacterial infections, including E. coli.
The bottom line is that there has been a marked decline in the effectiveness of antibiotics. New antibiotics are a temporary solution to a problem that is growing more threatening every year. The CDDEP report presented several strategies to help combat antibiotic resistance, including fighting infections through better sanitation and vaccines, and encouraging better hygiene in hospitals. The report also encourages larger-scale reform of the current system of financial incentives. The current system encourages physicians, hospitals, and the pharmaceutical industry to overuse antibiotics; instead, the system should incentivize antibiotic stewardship by restricting the use of antibiotics. Additionally, the CDDEP encourages finding ways to make antibiotic resistance an issue that is addressed in the political sphere so that long-lasting policies can be implemented.
A fundamental shift is needed so that antibiotics are not overused. However, until widespread legal measures are taken to fight against antibiotic resistance, patients must monitor their personal use of antibiotics for the sake of the well being of future generations.
Khush Dhaliwal is a freshman in Morse College. Contact her at firstname.lastname@example.org.
(Featured image from Wikipedia.)