One of the
reasons I chose to do my PhD in microbiology is that I believe a lot of modern
medicine relies on the ability to treat infections. For example, without that
ability, things like surgery, transplants and immune suppression will be too
risky. And the scary truth is that antibiotic resistance is becoming a big
problem. Recently, a review on antimicrobial resistance by Lord O’Neill was
published, and this article summarises the key findings.
With antibiotics, we’re trying to control nature by using chemicals
derived from nature - have a read of this post for more on antibiotic resistance. While bacteria can adapt to this new challenge easily, it
can take a while to adapt the chemicals. This leads to a situation where the
number of antibiotic resistant infections are on the rise, but the number of
agents which are available is not rising at the same rate; it was last year
that a new class of antibiotic was found after almost 30 years.
So what can
be done to make sure that we keep antibiotics effective? Certainly more
awareness and control of its use will be helpful (especially in veterinary medicine),
as will improving hygiene and surveillance – points which the report
highlighted. But I believe focus on research and development is important, not
only to discover new antibiotics but also to create new tests to ensure that appropriate
antibiotics are given – again, highlighted in the report.
While these
above points are important, I also believe that the pharmaceutical industry
need to play a part too – after all, even if discoveries like teixobactin are
made, there are lots of steps before it can become a medicine and I believe
that this will be difficult without the involvement of pharmaceutical
companies. Now, the fact that resistance to antibiotics can occur rapidly means
that it can become ineffective very fast – not great if you are trying to cover
the cost of its production! There have been proposals both from the pharmaceutical industry (see the blog post mentioned above) and in the report of finding alternative ways to fund antibiotic discovery; this
I think will be crucial.
Funding for
research I think is another crucial piece of the puzzle in terms of finding new
antibiotics or new ways of treating infections – that is how teixobactin was
found, and I hope that research like this will be happening long into the
future. As technologies improve, we are able to increase our understanding of
how the infection process works, and who knows, this may lead to a change in
how we approach infection treatment. With genome sequencing improving all the
time, there may come a time where a clinician may be able to sequence a patient
sample quickly, and then work out if antibiotics are necessary or not, and also
work out which antibiotics will be effective/ineffective.
I am hopeful
that with the above report and the Longitude Prize being focused
on antibiotic resistance we will be able to tackle this problem which may
indirectly affect a lot of us.