There are a number of inventions that have helped make modern life comfortable and relatively safe. But few of them had a bigger direct impact on the average person’s lifespan than the introduction of antibiotics. Beginning with penicillin, scientists have developed a series of antibiotics designed to knock down everything from sinus infections to life-threatening injuries. Looking back, it’s hard to believe there was a time when getting a minor cut could lead to infection and death. But that was the reality 100 years ago.
In the pre-antibiotic era of the early 1900s, 90% of children with bacterial meningitis died. And the majority of the survivors faced severe mental and physical handicaps. Strep throat was often a fatal disease and something as simple as an ear infection could lead to an infection of the brain and death. Modern antibiotics have not only tamed those diseases, but as they were used more widely, they tended to make the remaining bacteria strains less dangerous.
But since the early 1960s, doctors and medical researchers have been concerned that overuse of antibiotics will lead to strains of bacteria that are resistant to modern treatment. Antibiotics are often the first line if defense used by doctors and it’s a treatment that patients often request. More than 150 million prescriptions are written each year in the United States and while most of those are needed, an increasing number fall into the category of “better safe than sorry.”
Prescribing antibiotics when they may not be needed and/or having patients who don’t finish their complete dosages has led to an increase in patients who have developed an immunity to all or most of the antibiotics available to doctors. That resistance not only raises the dangers from existing diseases, it has encouraged the growth of so-called “nightmare” bacteria, who use the immunity to spread among the population.
That danger is the central premise of Hunting the Nightmare Bacteria,” a troubling and frankly scary report from Frontline. It begins with the fact that before 2000, it was extremely rare to find patients who were resistant to carbapenems, a class of powerful, last-resort antibiotics. But the growth of antibiotic-resistant patients has grown to the point that more than 2 million patients in the U.S. last year were resistant to at least some antibiotics. And antibiotic-resistance was the cause of nearly 24,000 deaths in the U.S. last year. Margaret Chan, director general of the World Health Organization, warns that: “A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.”
But as frightening as those statistics might be, what really concerns medical researchers are the growth of “nightmare” bacteria. In March of this year, Thomas Frieden, director of the CDC, warned about the growth a family of germs known as CREs. They can kill up to half the patients who get bloodstream infections from them, resist most or all antibiotics and spread resistance to other strains. Once patient infected with CREs can spread the germs throughout a hospital or medical clinic if doctors and the nursing staff are not careful. And the fear among some researchers is that one of these nightmare bacterias could develop into an epidemic that could kills thousands or even tens of thousands of patients.
While nearly everyone in the medical community understands the dangers, little time, effort or money is being tasked to the problem. Frontline recounts some of the challenges, including the fact that while an interagency task force was created in 1999 to target the problem, it only meets once a year. The federal government also devotes almost no funding to the problem and because antibiotics tend not to be all that expensive, pharmaceutical companies spend most of their research money developing more lucrative medicines targeting chronic diseases.
The result is that at a time when there is an increased need for new antibiotics, the antibiotic research pipeline is essentially empty. That’s a dangerous problem when it can easily take five years or more to bring a new medicine to market. And in the meantime, patients who are resistant to the current regime of antibiotics have limited options.
Like all good episodes of Frontline, Hunting the Nightmare Bacteria will leave you with a combination of dread and outrage. Antibiotics are such a common part of medicine we scarcely think about them.. But the prospect of a future where an infected tooth could lead to death should scare anyone. There don’t appear to be any easy answers to the problem. But based on what you’ll see on Frontline this week, it might be a good time to start putting a lot more money into medical research. In the meantime, I’m going to be a little more careful when I’m around knives and old rusty nails.
Frontline: Hunting the Nightmare Bacteria airs on tpt2 on Tuesday, October 22nd at 9:00 p.m.