the superbug is coming! well, maybe. in a way.

Antibiotic resistance is rising and becoming a real threat. But we still have time and methods to fight it.
biohazard aftermath

When a new antibiotic resistant bug rears its ugly head, news sites rush to recycle articles about a future that looks awfully bleak for civilized society, a future in which our mighty arsenal of antibiotics is obsolete and we’ll struggle to control outbreaks of disease caused by mutant bacteria which we created by overusing medicines that were supposed to save us. To some extent, this is a perfectly legitimate concern because overusing our current antibiotic agents forces a new cycle of selection in bacteria and helps breed superbugs which simply don’t respond to standard treatment. But as an article in Foreign Policy points out, the doomsday superbugs we’ve all heard so much about may have a very difficult time appearing, especially if we were to adopt several policies reasonably limiting antibiotic use, and were willing to reuse and update some older treatments.

When it comes to the bacteria that causes diseases and infections in the human body, we need to seriously consider the role evolution plays in medicine. Our bodies can handle a wide host of contagions on their own because we evolved strong immune systems, and the more we hammer bacteria with something that could kill them, the more likely it is that subsequent bacterial generations will be more resistant to whatever agents we use. In organisms with relatively small genomes undergoing constant flux and reproducing within hours, this is a real concern. Today’s use of just about everything coated with antibiotic agents keeps introducing an immense number of microbes to more and more agents to which they can develop a resistance, triggering a cycle of selection with potentially dangerous consequences for us. It’s may be just a matter of time before an enterprising species develops immunity to a class of antibiotics and become very, very difficult to treat. Then, with a flight across an ocean on an unsuspecting host, this species could quickly find new places to infest in very little time, causing seemingly sudden global pandemics. But there are a few effective countermeasures we could take against such outbreaks and even help prevent them.

One way to deal with a new antibiotic resistant bacterium could be to use older antibiotics to which strains of microorganisms haven’t been exposed for decades, eons in bacterial time. There is a greater risk of potential side-effects, but it could stop life threatening infections. Another, and a more effective one over the long term, would be to go easy on how many antibiotics we use. Overprescribing and bad matching have been points of concern for a while, and by restricting the use of antibiotics only to bacterial infections, and carefully matching them to cases in which they could do the most help, will help slow down the evolution of antibiotic resistance. Another thing to keep in mind is that the sudden emergence of a super bacterium would be an extreme rarity, not the typical scenario, since bacteria rely on random mutations to keep evolving, and it’s far more likely that they’ll just be slightly more resistant to current classes of treatments, which would subsequently become less effective when used to treat infections, than suddenly come up with a novel mutations that profoundly changes their reaction to an antibiotic. And even if they do, given enough time, we can simply make new antibiotics and use them as rarely as possible until our current ones cease to be as effective as we need them to be.

So relax, we probably shouldn’t panic about the coming bacterial apocalypse just yet. We still have time to get better at how we use antibiotics, have the opportunity to recycle older classes which the bacteria may find just as deadly as it once did due to its absence from their list of selective pressures, and know that the odds of a powerful, new super-germ are low enough to give us time to come up with brand new antibiotic treatments for the future. Things might look grim in the media, but regardless what reporters say, we still have the ability to fight back when the next powerful microbe attacks, and even more importantly, we can tame it before it starts being a problem if we just follow some medical common sense.

# science // health / medication / medicine / microbiology


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