Will common infections become incurable? The rise of antibiotic resistance
Antibiotic resistance is a term that captures the attention of the news. Phrases such as ‘last line of defence fails’ and ‘common infection kills’ are typical in these scenarios. But I sometimes feel that the hype and ramifications that are generated around these stories is not fully understood by the public. This could be because the stories are still thankfully pretty uncommon or that there is some confirmation bias. Most people if they are sick, can still go to a doctor and receive antibiotics for their infection. Antibiotics can’t really be failing if I can still get them- can they?
Antibiotics- a simple method for effective cures, image by Carissa Byers from Flickr
Unfortunately the tide of bacteria that are resistant to antibiotics continues to grow. Its no longer just hospitals that are the breeding grounds for resistant bacteria but over the last year there has been a massive rise in drug-resistant sexually transmitted infections.
Just as scientists thought that they had found a very effective drug to prevent HIV transmission with PrEP, old diseases, that used to have quick and easy cures are now re-emerging, in particular syphilis and gonorrhea.
The growth of resistant STIs is not a small and isolated element, but accounts for more than 60% of the total number of drug resistant cases in Australia.
In 2016 there was a threefold increase in the number of people seeking treatment for resistant gonorrhea.
It’s not just in Australia either, with the World Health Organisation providing updated advice on how to treat Chlamydia, Syphilis and Gonorrhea. The prevalence of drug resistance especially with Gonorrhea, is so common that the previous first line treatment, quinolones, is no longer suggested.
Gonorrhoea bacteria, image by plgstd01 from Flickr
So why has there been such a massive rise in drug resistance for these diseases and why is it an issue?
Lets begin with the ramifications of STI drug-resistance. Syphilis, Chlamydia and Gonorrhea have relatively mild immediate symptoms, but if left untreated can lead to severe complications. These complications include infertility, pelvic inflammatory disease and more systemic effects if it spreads to the blood. Infection with Gonorrhea has been associated with an increased risk of contracting HIV. They are diseases that used to be easily treated with antibiotics and were some of the first diseases to be treated on mass with antibiotics. It was during this early period that the advice to not drink alcohol while on antibiotics was first put forth.
Why has drug resistance emerged?
Antibiotic resistance has been observed since the earliest days of antibiotic use, with the first case recorded in 1947 only four years after mass production. Resistance is natural selection in action. If the bacteria are not completely killed by the antibiotic either due to incorrect use or random genetic mutation, surviving bacteria will grow and spread with that inherited resistance. When people do not finish or correctly take antibiotics, then the chance of bacteria developing resistance increases substantially.
Excessive prescription of antibiotics, incorrect use and a fall in use of physical contraception barriers, has all led to increases in exposure of drug resistant STIs such as Gonorrhea.
What can be done?
Until new antibiotics are created that can treat the resistant infections there are a few things that can be done to limit its spread. Sexually active people should be tested regularly so that they can receive appropriate treatment and avoid infecting others. Condoms should also be used to reduce the risk of transmission. Finally all people should ensure that if their doctor prescribes them antibiotics, that they follow medical advice and finish their course. We need to remember antibiotics are an amazing medical tool; we cannot take them for granted.