Antibiotic Resistance – A New Plague?

Please forgive the melodramatic title.  But trouble is brewing in Lecale, right under our noses.  And indeed inside our noses.  In these divided times, this is a problem that has the potential to unite us all, rich and poor, old and young.  The problem has the rather unsexy name of “Antibiotic Resistance” (AR), but I prefer to think of it more like a plague.  The Oxford English Dictionary defines a plague as “a thing causing infection or trouble”.  AR certainly has the potential to do this.  It is has no respect for age or class, and it is everywhere.

Antibiotics are wonder drugs, discovered in the 20th century, with the ability to kill bacteria without harming us.  Many antibiotics come from the soil, and were discovered by famous scientists such as Flemming, Florey & Chain.  Diseases that once killed millions such as TB and infected cuts soon were brought under control.  In the past you could go for an operation in hospital and have a reasonable expectation that you would not leave due again to post-operative infection.  This was truly a revolution in medicine, and veterinary medicine.  But then things changed.

We started using antibiotics for everything, often without thought as to whether they were always useful.  We also sometimes used antibiotics to make up for poor hygiene in our hospitals and homes.  However, as early as the 1960s we noticed problems.  Bugs that used to be killed by antibiotics were no longer being cured.  What was happening was a phenomenon called “selection pressure”.  You see, bacteria are great at reproducing.  One bacteria can reproduce every 20 mins.  This means in about 7 hours that one “grand-daddy” bacteria can produce 7 million offspring.  These offspring will all be slightly different due to genetic variation – in the same way kids are often different from their parents.  Now, say you use antibiotics to kill lots of bacteria.  Some of the bacteria will be resistant due to genetic variation.  They will survive.  Only now, as the only bugs in the environment, they have free reign to fully populate it.  And they will have made many copies of resistant bacteria against which the antibiotic is useless.  This process happens every time we use antibiotics.  So that now, we have some lethal bugs (superbugs) that can’t be killed by antibiotics.  Today, in hospital wards around the country, people are dying because of these superbugs.

So, what can we do?  There are two courses of action: make new antibiotics, and ensure that the ones we have are not overused to prevent selection pressure.  Antibiotics are not profitable to make – as generally you get better once they are used, so the drugs companies cannot make money from repeat sales.  Therefore the government needs to get involved here for the public good.  The second course of action involves vets as well as doctors.  We should only use antibiotics sparingly, and make sure that we make full use of alternatives, such as vaccination, antiseptics and good hygiene.  Indeed, studies have shown that on our farms, good farming practices and herd health planning can reduce antibiotic use to near zero, saving the farmer money and protecting these valuable drugs.  All of us need to treat these lifesaving drugs with more respect, like the proverbial uisce bheatha that they are.

You may feel that this argument is esoteric and has little to do with you.  But the chances are that you will experience hospital at least once in you life, whether that be birth or even visiting a relative.  You may then be grateful that society has moved on this issue to ensure that there are no superbugs lurking in the corridors.  This is a cause we can, and should, all get behind.