The Edge of the Antibiotic Abyss

While the world awaits the 2016 Olympics and the potential impact the games will have on Zika virus transmission, there is the growing threat of antibiotic resistance. Lacking the pomp and frill of a new outbreak, this sinister threat doesn’t get the kind of media attention that Ebola garnished, and yet it has the potential to kill millions a year. Many are calling it the antibiotic apocalypse and while that may seem a tad on the dramatic side, the truth is that the days of antibiotic efficacy may be limited.

The Review on Antimicrobial Resistance recently published their report, “Tackling Drug-Resistant Infectious Globally.” Within this report, chaired by economist Jim O’Neill, they estimated that “by 2050, 10 million lives a year and a cumulative 100 trillion USD of economic output are at risk due to the rise of drug-resistant infections if we do not find proactive solutions now to slow down the rise of drug resistance.”

Recommendations to combat the problem include a global public awareness campaign, improving hygiene and sanitation, promotion of new, rapid diagnostics to cut unnecessary use of antibiotics, improving numbers, pay and recognition of people working in infectious disease, establishing a Global Innovation Fund for early-stage and non-commercial research, etc.

While all of this sounds great, what’s the bottom line? Simply put, without effective antibiotics, we’re back in the days of children dying from Scarlet Fever, small percentages of children surviving to adulthood, and “every day” infections as the primary cause of death around the world.

Do you remember the video game, Oregon Trail? A world with limited effective antibiotics means we’re back to the risk of dying from dysentery, typhoid, and cholera.

Sure, there’s a potential promise for treatment of Carbapenem-resistant Enterobacteriaceae (CRE), but the truth is that unless we start taking this threat seriously, the funding and urgency needed to combat it will be too little too late. If that doesn’t worry you, yesterday Department of Defense researchers announced that they had found, for the first time in the US, a patient with a strain of E. coli that is resistant to the drug, Colistin, which is the last line of antibiotic defense. In their report, the discovery of the plasmid-born colistin resistance gene, mcr-1, was found in the urine of a 49 year-old female in Pennsylvania in late April.

Bacteria that is resistant to our last resort drug is officially now on US soil, which means the time to act was yesterday.