When Antibiotics Work Against Us

Updated: Jun 27, 2020

By Abby Strong


Graphic by Senching Hsia, Graphics Editor

Methicillin-resistant Staphylococcus aureus, or MRSA, is your worst nightmare.


If you’ve ever had a nasty infection, the first thing your general practitioner will do is prescribe an antibiotic medication. Antimicrobial substances that stop the growth of harmful bacteria, antibiotics have become some of the most common and widely used options for the treatment of infections since the discovery of Penicillium chrysogenum, more commonly known as penicillin, in 1928 by Alexander Fleming. Before this discovery and the introduction of penicillin into the market in the 1940s, common infections like pneumonia, strep throat, and scarlet fever were largely fatal. Between the 1940s and the 1960s, many classes of antibiotics we know today entered the market, kicking off the “golden era” of antimicrobial medicine.


However, the global fight against infection hasn’t been that simple. Let’s step back even farther: to 1908.


Around this time, German immunologist Paul Ehrlich popularized the idea of medical “magic bullets.” Exploring the idea that some substances can target disease-causing organisms, and those organisms exclusively, Ehrlich pioneered a screening technique to uncover a machine-like drug to treat syphilis. The uncovered substance was marketed as Salvarsan, and became one of the most popular treatments to fight syphilis until the introduction of penicillin in the 1940s.


It’s this very idea of “magic bullets,” or highly effective substances that target infection without additional effects, that is partially responsible for the complex 21st century consequence known as antibiotic resistance.


Although they were treated as such in the mid-1900s, antibiotics are not magic; rather, they deal with real, evolving microorganisms. After the popularization of penicillin in post-World War II America, antibiotics were given out like candy, prescribed unnecessarily in excessive amounts. This overuse is partially responsible for the adaptation of many targeted microorganisms to become “tougher” throughout the 20th and 21st centuries. Antibiotic resistance, one of the most critical health crises of our time, has been caused by the survival, reproduction, and exchange of resistant alleles against once-effective drugs. This evolutionary mechanism, known as selective pressure, has been accelerated in some bacteria given the presence of antibiotics worldwide. Essentially, each time we fight infections with drugs, we’re simultaneously breeding highly-advanced, rapidly-developing superbugs.


Methicillin-resistant Staphylococcus aureus is one of these modern monsters. Known as MRSA or just staph, it’s an antimicrobial-resistant pathogen first reported in 1968. Its most common effects are boils/sores, blood infections, and sepsis. According to Harvard Medical School, MRSA can also have lasting impacts on a patient’s immune system, producing toxins that can impair the pumping of lymphatic fluid to lymph nodes.


As a microbe, MRSA is quite advanced; in fact, it’s resistant to an entire class of antibiotics known as beta-lactams, which includes penicillin and amoxicillin. On top of its distinct presence in the public over the past four decades, MRSA is becoming a large problem in 21st century hospitals. Due to the increasing prevalence of invasive operations and immunocompromised patients in modern medical care, a variant known as HA-MRSA (hospital-acquired MRSA) has begun to wreak havoc worldwide.


The growth and spread of antibiotic-resistant bacteria has already cost the world a multitude of lives, years, and dollars. According to the National Institute of Health (NIH), the cost of treating just six hospital-acquired resistant bacteria has added up to at least 1.87 billion dollars. The potential for a “magic bullet” that doctors and scientists once saw in antibiotics is now known to be a myth.


The mitigation of antibiotic-resistant bacteria in the 21st century has largely been focused on the discovery and implementation of new antibiotics. Though other treatments, such as phage therapy, have been explored, it seems that the only comprehensive option to counter microbial evolution is to keep engineering new treatments, which is a slow and irregular process.


So, what can you do?


One thing to keep in mind is that hygienic habits are incredibly underrated. According to the NIH, simple hand-washing remains the single most effective and efficient way to stop the spread of antimicrobial-resistant bacteria. In one study, it was found that more hand washing was directly correlated to decreased rates of MRSA.


One final thing to consider is your own impact on the antibiotic-resistant world. MRSA and other antimicrobial-resistant bacteria have been caused almost exclusively by the excessive and unnecessary prescription of antibiotics. In the future, it is important that we only use antibiotics when we truly need them.


References:

https://www.niaid.nih.gov/research/mrsa-overview

https://www.reactgroup.org/toolbox/understand/antibiotics/development-of-antibiotics-as-medicines/

http://emerald.tufts.edu/med/apua/about_issue/about_antibioticres.shtml

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240113/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109405/

https://hms.harvard.edu/news/lasting-effects

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/

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