This isn’t the antibiotic crisis you’re looking for…
So there is a lot of talk going around right now about the antibiotic crisis. And a good bit of it is on HuffPo. No, I won’t link you. You will never find a more wretched hive of anti-vaxers and homeopaths. Suffice to say, Dan Rather, writing on the antibiotic crisis, made the following comment about a week ago:
[…] there isn’t a single known antibiotic to which bacteria have not become resistant.
I think that everyone who is taking the time to read this probably already has a good idea of my attitude towards scientific misinformation. And the above quote is a particularly good one because it manages to pack two mistakes in only thirteen words. What a value! Now, lets be clear about one thing, there is an antibiotic crisis, but the nature of it is subtly and importantly different than the picture many people are trying to paint.
Okay, the first mistake is a high school biology one. And its pedantic of me to even point it out, yet still important to know. Bacteria do not “become” resistant to antibiotics. That’s not how evolution works. A certain small percentage of bacteria already are resistant. In the absence of antibiotics this percentage remains small because antibiotic resistance (like every trait) has a cost, and it is not efficient to have it when there are no antibiotics. When we start using antibiotics, that small percentage grows and while the rest of the bacteria die off. Thus the already pre-existing resistant bacteria replace the vulnerable ones. This was once and for all conclusively demonstrated when we isolated penicillin resistant bacteria from among the gut flora of polar explorers who died and were frozen in permafrost in 1845 (Medical Tribune, December 29, 1988, p. 1, 23.) This one just bugs me.
The second mistake is the big one: “there isn’t a single known antibiotic”. Do you have any idea how many antibiotics we know? Dan Rather certainly doesn’t. I don’t either, so I guess I shouldn’t throw stones. But Mr. Rather seems to think that the number of antibiotics known is somehow equivalent to the number of antibiotics in use. I can guarantee you that he is at least an order of magnitude off. And if he wants to talk about the antibiotics that exist, then he is multiple orders of magnitude off. See, we tend to be anthropocentric, another pet peeve of mine. This means that we naturally want to view the battle against microbes as us vs. them. And that’s not true. We do not make antibiotic agents de novo to wage our war against tiny invaders. Rather, we subvert their own mechanisms (or the mechanisms of other types of life) and use those. As far as I know, there is no wholly synthetic antibiotic compound. No one is going to waste the money making one when they can be plucked from anywhere. These things are literally more numerous than if they grew on trees.
So why the crisis? Why, if there are so many antibiotic compounds known are we running out of ones that are effective to use? Because it is just not profitable. Because there are other, higher profit yield things that the pharmaceutical industry could be doing, and it doesn’t want to waste the time and resources on deriving, testing, and going through all the governmental red tape to get approval for a new antibiotic. Not to mention they have no pressure. In terms of the numbers game, the number of people who are dying from resistant strains is too small to raise a great public outcry. And because of people like Mr. Rather, everyone is going to be too busy pointing the finger at doctors and ag business to ask why the hell the pharmaceutical industry wasn’t prepared.
Should we stop being so careless with our antibiotics? Certainly. But are we going to run out? Well, no. Not unless we sit around twiddling our thumbs and playing the blame game when we could be isolating and testing more.
[featured image source: By Janice Haney Carr, Centers for Disease Control and Prevention (Public domain)]