AN EPISODE FROM THE ANTIBIOTIC ERA
A TIME TO ACT
Umpteen habitats, from the human skin to deep sea volcanos and innumerable shapes and sizes.
Truly varied is the most dominant form of life on earth, with more of them than any other creature.
Well, who is the protagonist? It is none, but bacteria! This single celled organism evolves beyond a
threat, with its ability to produce billions of descendants in the blink of an eye. Since time
immemorial, they have been coexisting in communities and some of them, always at war with
human immunity. From mild infections to deadly diseases, millions of people, the world over,
succumb to this bug every year!
Tidying up a room is nothing special. But it was bliss when Alexander Fleming did so on a September
morning in 1929. Though by serendipity, he had but discovered the wonder drug ‘Penicillin’
restricting the growth of Staphylococcus aureus on uncleansed culture plates in his cluttered
laboratory. This had marked a new beginning, an era of antibiotics and a breakthrough in the field of
Medicine, saving hundreds and thousands of lives thereafter.
Antibiotics have revolutionised medical care in the twentieth century, but in the recent years, the
bugs have been winning the battle against them. Thus, the scenario today is grim; with the
phenomenon of ‘Antibiotic Resistance’ exhibited by these bacteria. It simply means that the bacteria
are no longer vulnerable to these drugs whether bacteriostatic or bactericidal. Hospitals, community
homes and other places which are home to vulnerable groups of people have noted a marked rise in
the number of these drug resistant bugs.
Today, the action of Penicillin, Ampicillin, Amoxicillin and broad spectrum antibiotics is found to be
at stake. The reason for this could be attributed to the long term misuse of these drugs! Who is to be
blamed? Is it the patient who’d pleased to walk out of his physician’s cubicle only if he is prescribed
a bunch of antibiotics or is it the physician who ruthlessly lists down erroneous combinations of
antibiotics even for viral infections or is it the pharmaceutical companies?
According to studies, more number of patients dies of MRSA (Methicillin Resistant Staphylococcus
aureus) infection than HIV/AIDS. Newer drug resistant strains of tuberculosis are causing concern.
However, the most disheartening is the prevalence of VISA (Vancomycin intermediate resistant
Staphylococcus aureus) as Vancomycin is believed to be the most powerful antibiotic in a doctor’s
armoury is also giving way for bacteria!
The emergence of ‘Super bugs’ or bacteria resistant to all antibiotics could herald the end of the
antibiotic era. Microorganisms are getting ahead and therapeutic options are narrowing. Even if
resistance to some antibiotics does not prevent treatment because of the availability of a wide range
of antibiotics, it still costs money. Resistant and multi drug resistant bacterial infections lead to
increased values of health expenditures and are also associated with significant morbidity, longer
hospitalization and mortality. This poses a global problem and is a threat to global security!
The dilemma is whether the antibiotic miracle has now become a crisis? It is time that we wake up
to reality. Reducing the dependence on antimicrobials by increasing man’s immunity, adopting
alternate forms of treatment, educating health professionals and patients, observance of antibiotic
use policies and implementation of simple infection control measures like washing of hands,
screening and isolation could be possible options to resolve the case. Also researches on exploiting
bacteria’s natural enemy, viruses known as bacteriophages which can enter bacteria and kill them
are underway. If it succeeds, then it shall certainly be yet another feather to our golden cap!
The features portrayed in antibiotic resistance are only the tip of an iceberg. If the bugs continue to
proceed unrivalled, then the days are not far when man would find himself back to the age before
the introduction of Penicillin, confronted by a host of diseases caused by bacteria and on a frantic
run unable to cure them!
*HEERA SHAHIR – 2nd year Medical Student, Travancore Medical College, Kollam Kerala India.
THE TOPIC IS CREATED BY HEERA SHAIR A 2ND YEAR MEDICAL STUDENT OF TRAVANCORE
MEDICAL STUDENT, AS PART OF PROGRAMME INITIATED BY DR.T.V.RAO MD PROFESSOR AND
HOD MICROBIOLOGY ON EMPOWERING THE YOUNGER DOCTORS ON RATIONALISM OF
ANTIBIOTIC THERAPY AS WE HAVE FEW OPTIONS IN THE FUTURE TO TREAT OUR PATIETNS.