Winning the Micro-War: Prevention and New Drugs

Humans are engaged in a “micro-war” with bacteria, and we are losing.  Bacteria represent one of the most adaptable organisms on the planet primarily due to their propensity for adopting genetic mutations.

As with all evolutionary mechanisms, most mutations are either harmful or neutral; they do not provide a comparative advantage to the mutated organism.  Other times, however, a mutation will counteract a new and damaging environmental pressure and the organism will become well-equipped to survive and pass on its genes.

This is precisely the problem with antibiotic resistance in bacteria: human antibiotics present a new environmental pressure to the highly-adaptable micro-organisms, and some develop an ability to survive through mutation.  That threat is magnified by the horizontal spreading of resistance through plasmid transfer and replication (“Extending the Cure”).  To mitigate the threat of antibiotic resistant bacteria, three paths must be pursued: prevention and development of new drugs.
Because antibiotic resistance arises primarily as an evolutionary response to environmental pressure, antibiotic resistance can be avoided by minimizing the introduction of antibiotics and using them only when truly needed.  When antibiotics were first introduced, they were seen as a panacea—and rightly so, as they quickly and effectively treated diseases that had previously been deadly and widespread (Lewis, FDA).
Unfortunately, however, this enthusiastic adoption of antibiotics has led to a dangerous over-reliance on their use.  For example, many dermatologists not only prescribe antibiotics for mild acne, but they also make the mistake of frequently rotating between antibiotic types.  As the data show on the Essential Biology website, rotation does not decrease the prevalence of antibiotic-resistant bacteria (Essential Biology).
  In fact, 10.7% of patients in the resistant group were found to be housing resistant bacteria, as compared to 7.7% in the control group—indicating that antibiotic rotation may actually exacerbate the problem rather than solve it (Essential Biology).  Furthermore, this method may be particularly harmful because it raises the possibility that a colony of bacteria may develop into a so-called “superbug” by gaining resistant properties against multiple antibiotics (“Breeding the Superbug”).
Conversely, reducing the number of antibiotic prescriptions is effective in limiting the number of antibiotic-resistant strains.  Finnish researchers proved this correlation in a study where they tracked the prevalence of antibiotic-resistant bacteria while they reduced their prescriptions of Erythromycin (Essential Biology).
As the data in the bar graphs demonstrate, prevention through reduced prescription of antibiotics seems to stem the tide of resistant bacteria: by prescribing fewer antibiotics, doctors were able to more than have the percentage of resistant colonies from a peak of 19.0% in 1993 to a low 8.6% in 1996—a dramatic reversal (Essential Biology).
However, preventative measures will only slow down the development of resistance and will not in fact solve the larger problem.  To really gain ground in mitigating the effects of antibiotic-resistant bacteria, researchers will continually need to develop new antibiotics that are capable of killing off resistant strains of bacteria.
This is where careful regulation of antibiotics could save lives: if these “last lines of defense” are prescribed for everyday usage, the effectiveness of a doctor’s arsenal will be reduced and modern medicine may be powerless to stop treatable illnesses from becoming killers (“Extending the Cure”).
If, on the other hand, doctors limit the usage of antibiotics to times when they are truly needed and researchers continue to develop new, more effective antibiotics, we will be able to minimize the ill-effects of antibiotic-resistant bacteria and win the “micro-war.”  Our health depends on it.
Works Cited:
“Breeding the Superbug.” Allianz Knowledge Online (Ed. Valdis Wish). Electronic article.
http://knowledge.allianz.com/en/globalissues/safety_security/health_pandemics/hospi
al_infections_mrsa.html. Accessed 3 November 2008.
Essential Biology. “You Decide: What Can We Do About Antibiotic-resistant Bacteria?”
Online interactive lab. Pearson Education.
http://wps.aw.com/bc_campbell_essentials_3/47/12139/3107664.cw/index.html.
Accessed 3-6 November 2008.
“Extending the Cure: Policy Responses to the Growing Threat of Antibiotic Resistance.”
Executive summary. “Extending the Cure” online publication.
http://www.extendingthecure.org/downloads/ETC_EXSUM.pdf. Accessed 5
November 2008.
Lewis, Ricki. “The Rise of Antibiotic Resistant Infections.” Electronic article. United States
Food and Drug Administration. http://www.fda.gov/Fdac/features/795_antibio.html.
Accessed 4 November 2008.