SOME people describe Darwinian evolution as “only a theory”. Try explaining that to the friends and relatives of the 700,000 people killed each year by drug-resistant infections. Resistance to antimicrobial medicines, such as antibiotics and antimalarials, is caused by the survival of the fittest. Unfortunately, fit microbes mean unfit human beings. Drug-resistance is not only one of the clearest examples of evolution in action, it is also the one with the biggest immediate human cost. And it is getting worse.
Stretching today’s trends out to 2050, the 700,000 deaths could reach 10m.
Cynics might be forgiven for thinking that they have heard this argument before. People have fretted about resistance since antibiotics began being used in large quantities during the late 1940s. Their conclusion that bacterial diseases might again become epidemic as a result has proved false and will remain so. That is because the decline of common 19th-century infections such as tuberculosis and cholera was thanks to better housing, drains and clean water, not penicillin.
The real danger is more subtle—but grave nonetheless. The fact that improvements in public health like those the Victorians pioneered should eventually drive down tuberculosis rates in India hardly makes up for the loss of 60,000 newborn children every year to drug-resistant infections. Wherever there is endemic infection, there is resistance to its treatment. This is true in the rich world, too. Drug-resistant versions of organisms such as Staphylococcus aureus are increasing the risk of post-operative infection. The day could come when elective surgery is unwise and organ transplants, which stop rejection with immunosuppression, are downright dangerous. Imagine that everyone in the tropics was vulnerable once again to malaria and that every pin prick could lead to a fatal infection. It is old diseases, not new ones, that need to be feared.
The spread of resistance is an example of the tragedy of the commons; the costs of what is being lost are not seen by the people who are responsible. You keep cattle? Add antibiotics to their feed to enhance growth. The cost in terms of increased resistance is borne by society as a whole. You have a sore throat? Take antibiotics in case it is bacterial. If it is viral, and hence untreatable by drugs, no harm done—except to someone else who later catches a resistant infection.
Learn more: When the drugs don’t work
The Latest on: Antibiotic resistance
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The Latest on: Antibiotic resistance
- Resistance Spreads Even without Antibiotic Useon September 6, 2019 at 6:02 am
Drug resistance in the microbial world is a public health threat that is nearing pandemic proportions globally. While limiting antibiotic use is still seen as one of the best long-term defenses ...
- Scientists Reveal New Mechanism Of Resistance Spread Without Antibiotic Useon September 6, 2019 at 5:24 am
Novel additional, previously unknown mechanism of resistance was revealed in intestinal bacteria that is independent of the use of antibiotics by a team of researchers led by scientists from ETH ...
- Newly discovered resistance-spreading mechanism is independent of the use of antibioticson September 5, 2019 at 8:10 pm
Antibiotic resistance does not spread only where and when antibiotics are used in large quantities, ETH researchers conclude from laboratory experiments. Reducing antibiotic use alone is therefore not ...
- 4 Facts Parents Should Know About Antibiotic Resistanceon September 5, 2019 at 10:00 am
MISSION, Kan., Sept. 5, 2019 /PRNewswire/ -- (Family Features) When administered properly, antibiotics can provide essential, even lifesaving, relief to a sick child. However, antibiotics are not ...
- Resistance can spread even without the use of antibioticson September 5, 2019 at 4:49 am
Antibiotic resistance does not spread only where and when antibiotics are used in large quantities, ETH researchers conclude from laboratory experiments. Reducing antibiotic use alone is therefore ...
- FDA Finds Unexpected Antibiotic Resistance Genes in ‘Gene-Edited’ Dehorned Cattleon September 5, 2019 at 1:49 am
Gene-editing is seen by many as the ultimate in precision breeding. Polled cattle, whose horns have been genetically removed, have been presented as exemplars of this–a socially beneficial use of ...
- Podcast: Persistent antibiotic resistance, and modeling hot citieson September 4, 2019 at 10:05 am
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- Targeting flesh-eating, drug-resistant bacteria, Peninsula company grabs small grant for antibioticon September 3, 2019 at 8:32 am
In the grand scheme of drug development, $1.6 million isn't much, but for a small Peninsula vaccines developer — and people with a common and potentially deadly bacterial infection — it could mean the ...
- Antibiotic resistance 'could wipe out humanity before climate change does'on August 30, 2019 at 5:01 pm
Bugs that are resistant to antibiotics could pose more of a risk to humanity than climate change, England’s chief medical officer has warned. Professor Dame Sally Davies said antimicrobial resistance ...
- Antibiotic resistance could wipe out humanity before climate change does, top medical officer warnson August 29, 2019 at 8:06 pm
Antibiotic resistance has the potential to wipe out humanity "before climate change does", England's chief medical officer has warned. Professor Dame Sally Davies said resistance is a major threat ...
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