In little more than 30 years, antibiotic-resistance may be more deadly than cancer around the globe.
At least 23,000 people in the US die of an antibiotic-resistant infection each year – and some estimates suggest it’s far more.
Superbugs – bacteria that have mutated to be untreateable with antibiotics – are rapidly spreading and becoming a serious threat to public health the world over.
Their growing numbers are fueled by over-prescription, waste from drug manufacturing plants, antibiotic use in animals and even international travel.
One researcher told CBS that his ongoing research suggests one in three international travelers returns home with at least one superbug.
By 2050, some projections suggest that drug resistance in general will claim the lives of 10 million people – more than the 8.2 million that die of cancer worldwide each year.
If we can rein in the practices fueling drug resistance, then death rates may never climb that high.
But doctors are seeing more resistant infections every day, forcing them to resort to more powerful drugs of last resort – or simply to lose patients.
Antibiotic resistant bacteria, like this strain of campylobacter, are spreading rapidly and could kill as many as 10 million people in 2050, some estimates suggest (file)
ANTIBIOTICS CURED SO MANY INFECTIONS THAT THEY STARTED CAUSING NEWER, STRONGER ONES
Antibiotic resistance is fast becoming an issue entangled with countless others.
Environmental waste and destruction helps fuel it, as do practices railed against by animal rights activists, industry lobbies and even the antivaxxer movement.
Penicillin, the first antibiotic, was introduced in 1928. Since, the drug and its successors have saved countless lives from bacterial infections that were once death sentences.
For a few decades, it seemed there was an antibiotic to treat just about every bacterial infections – and some, called broad-spectrum antibiotics, that treated many different infections.
As long as they are bacterial, that is. Antibiotics will have no impact on a virus, which, in most cases, has to just run its course.
But the symptoms of viral and bacterial infections are often difficult to distinguish from one another, and patients – especially the parents of pediatric patients – hate being told to go home empty-handed.
So doctors began to prescribe ‘harmless’ antibiotics to anyone with symptoms like a runny nose, a fever and a headache, which could be caused either by a mild bacterial infection or a viral one like the common cold.
But they didn’t anticipate that bacteria could become immune to the drugs by virtue of coming into contact with them.
MAKING DRUGS, RAISING LIVESTOCK, DIRTY CONDITIONS, AND TRAVEL: THE THINGS HELPING BACTERIA ‘LEARN’ TO BE RESISTANT
Meanwhile, many drug manufacturers’ poor waste and sewage disposal has allowed antibiotics to seep into the soil, making swamps and lakes perfect breeding grounds for antibiotic-resistance.
Plus, farmers have long given their animals antibiotics prophylactically, to keep them from getting sick.
Now, an estimated three-quarters of meat in US supermarkets are thought to carry antibiotic-resistant bacteria, according to federal tests published last summer.
Other countries face even more uphill battles.
In the US, a doctor must at least determine – rightly or wrongly – that a patient needs antibiotics and prescribe them, so there is at least one barrier to overuse.
But in many countries worldwide, including Mexico, Brazil, Spain, India and China antibiotics are widely sold over-the-counter.
‘You can still walk into pharmacies around the world and buy antibiotics, including colistin,’ a powerful broad-spectrum drug with dangerous side effects that is sometimes used to treat resistant infections, says Dr Jason Newland, a Washington University St Louis pediatrician and antimicrobial stewardship specialist.
A graph from an alarming 2014 study shows that by 2050, drug-resistant infections (purple) could be far more deadly than many major diseases, including cancer
‘It’s one of the major drivers [of antibiotic resistance], that if you want an antibiotic, you could go to India right now and buy it and use it inappropriately.’
Antibiotic resistance is exceedingly common among refugee populations, who are often forced to live in crowded and unsanitary conditions.
Every time we travel, especially if it’s to one of these countries, we risk bringing home antibiotic-resistant bacteria.
About one in three international travelers returns home carrying – but not necessarily infected by – according to an ongoing study of travelers and antimicrobial resistance, Dr Edward Ryan, a Massachusetts General infectious disease specialist and study leader, told CBS.
Some of these travelers will shed the resistant bugs after coming home, by way of time and hand-washing. But they’ve still introduced the germ to the environment.
This is how many of the US’s ongoing measles outbreaks began, too (although, notably, measles is a virus). A traveler came to the US, carrying measles, infected one or more unvaccinated person or people, and the illness started spreading like wildfire.
‘These measles outbreaks have an impact on antibiotic stewardship,’ says Dr Newland.
‘They’ll get secondary infections and we’ll have to use antibiotics, or going to walk in [to hospitals and clinics] just looking sick, and someone will give them antibiotics.’
Dr Newland said this further underscores the importance of vaccination.
‘If we immunize people – and we should immunize people – then we won’t have [as much of this problem],’ he said, adding that the same is true for refugee populations.
WE NEED TO USE ANTIBIOTICS LESS SO THEY ARE MORE EFFECTIVE
The fallout of the measles outbreaks and the secondary infections they may bring also drives home a second point that Dr Newland says is often overlooked.
‘People have to realize that these antibiotics are life-saving and we’re not going to quit using them, but unless we stop using them, we’re still going to see resistance happen…even if we use them 100 percent appropriately,’ Dr Newland says.
As for the scary 10 million deaths in 2050 prediction, Dr Newland says we can bring that number down, but haven’t yet made much progress in that direction.
‘There’s some caveats to this estimate,’ he says.
The UK-based research looked at six pathogens, but two of these – malaria and HIV – are viruses, not bacteria, but can still become drug-resistant.
So their inclusion may tack some deaths onto that estimate.
‘That said you could argue that that it probably underestimates the possible impact,’ because it didn’t include some other superbugs, like the bacteria killing scores of infants in India, according to Dr Newland.
On the other hand, he added: ‘Part of that forecasting was assuming that we’re not going to change anything about our antibiotic use and rates are going to stay really high.
‘We’re continuing to see rises [in antibiotic-resistance,’ he says, but adds that efforts and progress are being made to curtail antibiotic use (and therefore resistance) – they just haven’t played out in clinical settings yet.
