The coronavirus is nowhere near done with us. The origins of the pandemic remain a mystery, with no
conclusive evidence to put the speculations to rest. But there is still work to be done. Once bit, twice shy as they say. We may not have been able to stop this pandemic in its tracks, but if we are vigilant enough and heed the warning signs, we may be able to arrest the next one. This next one will be different, it will be a biological scourge, alright but one that will be the result of our actions in this pandemic. I am talking about antibiotic resistance, and the horrors it can unleash if it goes unchecked.
Antibiotic resistance is the biological term to define a situation where a species of bacteria becomes immune to a class of antibiotics, making recovery difficult. Developing resistance against antibiotics is a natural process; bacteria gain resistance to antibiotics through mutations or recombination with other resistant bacteria, also known as horizontal gene transfer. Bacteria will try to ensure their survival by developing resistance to different antibiotics. What has accelerated this natural process is human intervention. Antibiotic resistance is not something that we are just learning about. It has been here for a couple of decades and is already a matter of grave concern. But the Covid-19 pandemic has given it new life.
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However, It wasn’t always like this. In 1928, Alexander Fleming made history by discovering the first antibiotic known to modern medicine- Penicillin. A serendipitous discovery, penicillin was the answer to our prayers. Earlier, people died of infections from wounds, something we cannot imagine in our times. Today, wounds are something meant to heal with time, without the worry of secondary infections. This may soon change and we might regress to the old days when an infection was a formidable foe. Penicillin, too, saw its natural death with penicillin-resistant bacteria coming into existence shortly after. This is no trivial issue; increased resistance will lead to a surge in hospital costs and an increase in mortality from diseases that were once vincible.
Let me elucidate the reasons for increasing antibiotic resistance in the past decade. If I were to put it in one word, it would be overuse.
Overuse of antibiotics defeats the purpose; the bacteria learn to evade the antibiotics and the antibiotic becomes useless.
Overuse has led to people requiring stronger doses of existing antibiotics, through injections as oral pills become less effective, or a new type of antibiotic altogether. On the latter front, the well has dried up, so to say. Antibiotic production is an expensive affair. Big pharmaceutical companies shy away from this field, mainly because any new antibiotic they produce will inevitably go out of use due to concomitant newfound resistance, making it a field of short shelf-life. According to the 2020 annual Antibacterial Pipeline Report, around 82% of the recently approved antibiotics are derivatives of the existing class of antibiotics, with known resistance. More to the point, most of them are expected to become ineffective against resistant bacteria. Also, getting regulatory approval is a tedious process, which further repels these companies. In addition, antibiotics are cheap, whereas drugs for diseases like cancer are very expensive, which makes the latter a profitable venture. A primary reason for the overuse of antibiotics is their cheap price and easy availability. Available without prescriptions and at low rates, antibiotics become the prime choice for consumption in case of physiological distress. Another aspect of overuse is over prescription. Medical practices vary among professionals and countries. Some medical professionals, unwittingly, prescribe antibiotics to patients who don’t need any, adding to the problem. Animal husbandry plays a significant role as well; livestock are fed antibiotics pre-emptively to keep them healthy and free of diseases. This is a huge problem, one that needs urgent attention. The livestock passes on these antibiotics to humans when we consume them. There is also the fear of the genesis of superbugs- microorganisms such as viruses, bacteria, and fungi which are resistant to most antimicrobials (Antimicrobials are drugs that kill microbes. In this respect, an antibiotic is a type of antimicrobial). If this comes to pass, we will be helpless to the most common forms of infections. One such superbug, NDM-1, surfaced in our country in 2008 and has since spread around the globe.
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Hopefully, now you understand the connection between overuse and increased resistance. Moving on to the current pandemic, it has stepped on the gas pedal, accelerating an already aggravated issue. One needs to first understand that Covid-19 is caused by a virus and antibiotics are effective only against bacteria, meaning an antibiotic cannot treat Covid-19. Antibiotics are required only in severe cases where a Covid-19 positive person acquires bacterial infections, on account of low immunity. Other than this, antibiotic is not going to do you any good. On the contrary, it will exacerbate the problem of antibiotic resistance. World Health Organization (WHO) advises against using antibiotics for curbing the coronavirus menace. Still to save lives, doctors prescribe antibiotics assuming a bacterial infection might strike during coronavirus infection. The reverse of this is more prudent. Through word of mouth and disinformation, people start self-medicating these antibiotics to protect themselves. These antibiotics have side effects and may cause complications, besides fueling antibiotic resistance, if used without medical supervision.
The best way to break this cycle of resistance is to prevent the incidence of these infections. The way by which this is possible is by following basic healthy practices of washing hands, living in hygienic conditions, and consuming uncontaminated food and water. Maybe the current pandemic will push us in the right direction on this count, with people making an effort to follow these guidelines. Studies suggest the death of 2 million people in India alone due to antimicrobial resistance by 2050; the figure is 10 million globally. Stop the misuse of antibiotics! Become informed and spread awareness on the pros and cons of overuse of antibiotics.
