I’m sure you have heard about antibiotic resistance, which results when a pathogenic bacteria evolves new mechanisms to deactivate antibiotics. I’ve heard about scientists talking about the issue for decades, but never truly understood how terrifying this issue is for our global healthcare system until recently. If you don’t believe me, check out this map below with the number of deaths that are projected to be attributed to antibiotic resistance in 2050.
I recently submitted a project for my elective class about antibiotic resistance. The goal of the project was to find some sort of solution to a problem. It was a pretty bright idea of mine to make my project some sort of solution to antibiotic resistance. After about a week of fruitless research, it became pretty clear to me that antibiotic resistance will be a pretty daunting problem to solve.
To make my life at least a little easier, I decided to focus on the Beta-Lactam class of antibiotics. Think penicillin, monobactams, carbapenems. This class of drugs is the most prevalent in clinics because it can treat a large spectrum of conditions, have a low cost, and have few side effects (except for people like me who are allergic to it, but that is besides the point). Overall, these drugs are fantastic, but bacteria are becoming immune to their effects. Many bacteria have an arsenal of resistance mechanisms including Beta-Lactamase enzymes that deactivate the antibiotic and efflux pumps that remove the Beta-Lactams from the bacterial cell. Check out these enzymes in action in the gif to the right.
People have tried to solve this issue for decades. Even the big guys like GlaxoSmithKline and AstraZeneca have come up with no new antibiotics after decades of research. People have tried to save the Beta-Lactams I talked about earlier with Beta-Lactamase inhibitors, which deactivate the Beta-Lactamase before it can deactivate the drug product. And surprise, surprise, the bacteria have already begun to evolve to certain inhibitor-antibiotic combinations!
There will probably never be a permanent solution to antibiotic resistance, as bacteria will eventually evolve to become resistant to anything that we throw at it. The only answer so far seems to be what many scientists call synergy. This idea involves treating a single bacterial infection with an army of antibiotics and inhibitors, hopefully leaving no survivors. Unfortunately, each treatment will be limited by cost; it would be impractical to prescribe four different antibiotics to the same person unless it is absolutely necessary. Even more daunting is the fact that the bacteria could just evolve to become resistant to that too!
Overall, I think that antibiotic resistance will be an issue that will always keep the scientific community on its toes. I hate to say it, but I do not see an ideal solution to this issue any time soon.