Post-Antibiotic Might Look Like Pre-Antibiotic

An article at Matter looks into what we could reasonably expect when antibiotics fail en masse. It begins with the death of a fireman, less than 80 years ago:

I had always heard Joe had been injured at work: not burned, but bruised and cut when a heavy brass hose nozzle fell on him. The article revealed what happened next. Through one of the scrapes, an infection set in. After a few days, he developed an ache in one shoulder; two days later, a fever. His wife and the neighborhood doctor struggled for two weeks to take care of him, then flagged down a taxi and drove him fifteen miles to the hospital in my grandparents’ town. He was there one more week, shaking with chills and muttering through hallucinations, and then sinking into a coma as his organs failed. Desperate to save his life, the men from his firehouse lined up to give blood. Nothing worked. He was thirty when he died, in March 1938.

Penicillin-resistant staph emerged in 1940, while the drug was still being given to only a few patients. Tetracycline was introduced in 1950, and tetracycline-resistant Shigellaemerged in 1959; erythromycin came on the market in 1953, and erythromycin-resistant strep appeared in 1968. As antibiotics became more affordable and their use increased, bacteria developed defenses more quickly. Methicillin arrived in 1960 and methicillin resistance in 1962; levofloxacin in 1996 and the first resistant cases the same year; linezolid in 2000 and resistance to it in 2001; daptomycin in 2003 and the first signs of resistance in 2004.

Without the protection offered by antibiotics, entire categories of medical practice would be rethought:

  • transplants
  • the use of ventilators, catheters, and ports
  • kidney dialysis
  • Caesarean sections
  • surgery on intestines and the urinary tract
  • bone marrow transplant
  • implantable devices
  • hip replacements
  • botox injections
  • liposuction
  • prostate biopsies
  • open-heart surgery

British health economists with similar concerns recently calculated the costs of antibiotic resistance. To examine how it would affect surgery, they picked hip replacements, a common procedure in once-athletic Baby Boomers. They estimated that without antibiotics, one out of every six recipients of new hip joints would die.

Antibiotics are administered prophylactically before operations as major as open-heart surgery and as routine as Caesarean sections and prostate biopsies. Without the drugs, the risks posed by those operations, and the likelihood that physicians would perform them, will change.

Medical procedures may involve a high risk of infections, but our everyday lives are pretty risky too. One of the first people to receive penicillin experimentally was a British policeman, Albert Alexander. He was so riddled with infection that his scalp oozed pus and one eye had to be removed. The source of his illness: scratching his face on a rosebush. (There was so little penicillin available that, though Alexander rallied at first, the drug ran out, and he died.)

Before antibiotics, five women died out of every 1,000 who gave birth. One out of nine people who got a skin infection died, even from something as simple as a scrape or an insect bite. Three out of ten people who contracted pneumonia died from it. Ear infections caused deafness; sore throats were followed by heart failure.

Bugs Resistant for 30,000 Years!

The thing about antibiotics is that they tend to be sourced from nature, even if indirectly. This means that bugs have already encountered their enemy, and have developed resistance to them, long ago.

With few new wonder drugs in the pipeline, some doctors are warning of a postantibiotic age, in which simple infections will become untreatable again.

Most antibiotics are based on chemicals used by bacteria or fungi to fight other bacteria, and researchers have speculated that antibiotic resistance must have coevolved with these compounds millions of years ago. Some scientists even claimed to have cultured ancient resistant bacteria from frozen Siberian soil in the lab…

Ulitmately the age of resistance is immaterial – solving the problem is tantamount.