Apocalypse now: in less than 10 years, antibiotics may be useless

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Apocalypse now: in less than 10 years, antibiotics may be useless

Impending disaster

  • Bacteria are mutating and developing a resistance to antibiotics

  • Very soon, probably within 10 years, antibiotics may lose their life-saving touch

Ominous signs

  • There's a lack of awareness among people about the drugs and their proper use

  • A WHO survey revealed that 64% of people thought antibiotics can cure cold and flu

More in the story

  • What are the reasons for the mutating bacteria

  • How this will impact the world, and India in particular

Imagine this: you are suffering from fever, chronic cough and fatigue. Good old paracetamol is not making the situation any better. You run to the doctor, who diagnoses it as tuberculosis.

And then he or she tells you it is back to being an untreatable disease. The antibiotic used to treat it is no longer effective.

Sounds a bit far-fatched, right? Wrong. This could be a reality for a lot of diseases within the next 10 years.

The post-antibiotic era

Scientists across the globe say we are on the brink of 'the post-antibiotic era', or, more ominously, the 'antibiotic apocalypse'.

Various studies have shown that bacteria are becoming increasingly resistant - in some cases, completely resistant - to drugs used in treatment.

Various studies show that bacteria are becoming increasingly resistant to drugs used in treatment

What's even more worrying is the fact that people across the world are confused, and in a lot of cases, unaware of the threat of antibiotic resistance.

The World Health Organisation conducted a survey with a small sample size of 10,000 people across 12 countries. About 64% of respondents had heard of antibiotic resistance, but didn't know how it would affect them and their families, or what they could do to address this. Interestingly,

Some 64% of respondents also thought antibiotics could treat cold and flu - something they can't do. About 32% also said they stopped taking antibiotics when they felt better, rather than completing the course as advised by a doctor.

Bacteria mutating

A recent Lancet study, published on 18 November, revealed something more alarming.

Colistin, a last-resort drug used to kill various bacteria like Klebsiella pneumoniae (pneumonia) and Pseudomonas aeruginosa (kidney, lung and urinary tract infections), will no longer be effective in parts of China, Malaysia and Laos, due to mutated antibiotic-resistant bacteria.

Scientists from China, who were part of Lancet survey, say they've identified the new mutation of the bacteria. What's worse, this is expected to spread around the world and raise the spectre of untreatable infections.

Also read: Stop Pill: one course of antibiotics can mess with your gut for 12 months

A scientist involved with the research, Prof. Timothy Walsh, warns of a time when this mutation will align itself with other antibiotic resistance diseases, which would mean increasing antibiotic resistance, leading to the impending 'antibiotic apocalypse' . This he says, is inevitable.

In the battle between bacteria and doctors, doctors are clearly losing.

Why the mutation is taking place

So why is it that the bacteria is able to develop resistance to the antibiotic?

The Lancet research shows that this is due to the overuse of the drug among farm animals.

Antibiotic Action is a UK-based campaign group that works towards spreading information about the harmful affects of antibiotics, if not used as per dosage. It has also warned against using the same antibiotics for human and veterinary healthcare.

Reports suggest that the Chinese government has taken heed of the matter, and is also contemplating banning use of colistin for agricultural use.

Many health experts try to allay all these fears by saying a combination of antibiotics may still prove to be effective. But they also agree that the reports are a serious warning bell.

Also read: Ignore the headlines, India won't get a malaria vaccine anytime soon

Why Indians need to worry

According to the WHO survey, 75% of Indian respondents thought, incorrectly, that cold and flu can be treated with antibiotics. Additionally, only 58% of Indians know that they should stop taking antibiotics only when the prescribed course is finished.

What's worse, less than one quarter (22%) of respondents had heard of the term 'antibiotic resistance', the lowest proportion of any country.

One of the prime reasons for bacteria developing resistance is antibiotics given to farm animals

Dr Abdul Ghafur, from the Department of Infectious Diseases at Apollo, Chennai, warns that India has showed very high microbial resistance rates, and there are multiple reasons behind it.

"There is a lack of awareness among patients. There's also the relative lack of engagement between prescribing clinicians and microbiologists, who mostly confine themselves to the laboratory. There's an absence of quality prescriptions, and a lack of desire among clinicians towards the broader public good," Ghafur says.

A recent AIIMS survey reveals gloomier news.

Analysis of water samples from different six different spots on the Yamuna river has shown the presence of three different classes of antibiotics used to treat various diseases, including pneumonia, scarlet fever, rheumatic fever, respiratory and urinary tract infections.

Dr Vel Pandian, professor of pharmacology at AIIMS, who was part of the survey, says these antibiotic-resistant microbes could eventually enter the human body, nullifying the effect of antibiotics.

One of the main reasons why antibiotics get into river water, according to Pandian, is throwing away unused antibiotics.

Dinkar Sahal of the International Centre for Genetic Engineering and Biotechnology was recently awarded by Antibiotic Action for his efforts on spreading awareness on antibiotic-resistant microbes.

Asked about the fallout of the high concentration of antibiotics in water bodies, Sahal says: "This makes rivers a fertile ground for antibiotic-sensitive strains to perish, while the resistant ones become dominant."

Diseases to worry about

What are the diseases we should immediately worry about?

"We ought to worry about water-borne treatable diseases like diarrhoea, dysentery, cholera etc becoming incurable, should resistance to existing antibiotics becomes widespread," Sahal says.

He concludes by saying that antibiotics may be weapons against bacterial infections, but their misuse is rendering them ineffective.

Experts disagree about the time-frame when the antibiotic apocalypse might arrive. But they all agree that it is inevitable, and that human beings will have to look for alternative drugs to save lives.

As the Lancet survey concludes: "The implications of this study are enormous, and unless something significant changes, doctors would face increasing numbers of patients for whom we will need to say, 'Sorry, there is nothing I can do to cure your infection'."

Also read: Bitter pill: why has Delhi HC made drugs costlier for diabetics?

Vishakh Unnikrishnan

Vishakh Unnikrishnan @sparksofvishdom