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.
Common failings
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
- WHO updates list of drug-resistant bacteria most threatening to human healthon May 18, 2024 at 6:32 am
The World Health Organisation (WHO) has updated its list of antibiotic-resistant bacteria that pose the most threat to human health, and have ranked the 15 families of bacteria by grouping them as ...
- Better medical record-keeping needed to fight antibiotic overuseon May 17, 2024 at 5:29 pm
A lack of detailed record-keeping in clinics and emergency departments may be getting in the way of reducing the inappropriate use of antibiotics, a pair of new studies suggests. In one of the studies ...
- After Seven Years, WHO Updates Antibiotic-Resistant Bacteria Liston May 17, 2024 at 10:18 am
After a gap of seven years, the World Health Organization (WHO) on Friday released its updated list of antibiotic-resistant bac ...
- Mystery CRISPR unlocked: A new ally against antibiotic resistance?on May 16, 2024 at 11:54 am
CRISPR-Cas systems have revolutionized biotechnology by offering ways to edit genes like a pair of programmable scissors. In nature, bacteria use these systems to fight off deadly viruses. A recent ...
- William: Urgent action on antibiotics resistance is needed for future generationson May 15, 2024 at 5:00 pm
William: Urgent action on antibiotics resistance is needed for future generations The Prince of Wales has called for “urgent” action to combat antimicrobial resistance (AMR) that risks “jeopardising ...
- Woman becoming resistant to antibiotics after UTIson May 15, 2024 at 2:54 pm
A woman who needs antibiotics almost every other month says her growing resistance to them has caused "stress and suffering". Sian Jones, from Vale of Glamorgan, has spoken about her experience to ...
- Woman's stress as UTI becomes resistant to antibioticson May 15, 2024 at 2:54 pm
A woman who needs antibiotics almost every other month has said her infection's growing resistance to them has caused "stress and suffering". Sian Jones, from Vale of Glamorgan, has spoken about her ...
- Antibiotic resistance in weaned calves a rarityon May 15, 2024 at 8:15 am
Bovine respiratory disease is one of the most important causes of sickness and death loss in beef cattle, both in cow-calf herds and in feedlots.” ...
- New bacteria discovery could tackle antibiotic resistanceon May 14, 2024 at 6:23 am
A Queen’s University Belfast study suggests bacteria with antibiotic resistance are able to pump the medication out of their cells.
- Fears over emergence of new superbugs as antibiotic-resistant genes found in soil samples from across Scotlandon May 14, 2024 at 1:51 am
Organisms with genetic defences against our most commonly used medicines are everywhere in Scotland – not good news for human and animal health ...
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