Why Antibiotic Resistance Is a Worse Crisis Than Climate Change

A couple of weeks ago, a Nature article argued that the antibiotic resistance crisis is on a par with global warming. I think the resistance crisis is worse than the global warming crisis.

Here’s why: if I were appointed El Supremo–which would be a really bad idea by the way–I could get us to 95 percent renewable energy. It wouldn’t be easy, and would require some (or lotsa) fundamental changes, but there is a path to follow. Of course, in the real world, we won’t do this because we’re fucking idiots. Hell, Republicans lose their shit over energy-efficient light bulbs, so good luck saving the planet.

Lo, there are assholes, and they walk among us.

But with antibiotic resistance, the problem is much more difficult. First, some potentially good news. On the diagnostics front, we have made very good progress over the last decade, and I think we’ll only get better. To the extent that we can diagnose infections accurately (as opposed to what we do now in the initial stages, which is make an educated guess), we can use older antibiotics instead of newer drugs when appropriate, and not use antibacterials to treat viral infections.

We are also slowly realizing–or relearning–just how critical infection control and surveillance are (‘Partying like it’s 1899’). With the advent of genomic-based surveillance and the continuing integration of informatics into biology (as ugly and kludgey as that can be), we will only get better at identifying outbreaks and sources of antibiotic resistant organisms and resistance genes. We can prevent or contain the spread of resistance–if we’re smart (though see the “Lo, there are…” bit above).

But these strategies, as important as they are in preserving the power of the antibiotics we currently have, do nothing to expand the arsenal. And here’s where we’re screwed. I don’t think anyone has any idea where the next class of drugs will come from. Yes, there are attempts to enhance the effectiveness of existing antibiotics, such as compounds that dislodge urinary tract infection bacteria from the walls of urinary tract, making them more susceptible to lower concentrations of antibiotics. But very little that I’ve heard of over the last decade has actually panned out. One reason drug companies are pulling out of antibiotics is because they can’t figure out how to do it; for the most part, the large companies still investing in antibiotic research are doing so out of noblesse oblige as much as anything else.

Hopefully, I’m wrong: maybe there’s some company somewhere that’s figured this out, but there doesn’t seem to many or any promising leads on the drug development front. Politics, especially around surveillance and drug use, will be a problem. But nobody seems to have any concrete plans to develop new classes of antibiotics. That’s not politics, but a much more serious problem.

We really don’t want to live in a world where even one to two percent of clinical infections are untreatable or where E. coli and Klebsiella urinary tract infections are the next major sexually transmitted diseases.

If you think global warming is bad, wait until we can’t treat some infections at all. That will be disruptive–in the non-Silicon Valley sense of the word–to say the least.

This entry was posted in Antibiotics, Fucking Morons, Global Warming, Public Health. Bookmark the permalink.

9 Responses to Why Antibiotic Resistance Is a Worse Crisis Than Climate Change

  1. dr24hours says:

    What ever happened to the cockroach-brain antibiotic potential?

  2. Simon says:

    A while ago I watched a BBC documentary about bacteriophage medicine as a replacement for antibiotics. Do you know whether any progress has been made in that field?

    • becca says:

      There is some fabulous exciting fundamental molecular biology coming out on phages (the CRISPR systems for genetic engineering are very cool). And we’re getting better at industrial uses of phages (e.g. to control yogurt culturing processes, which is how some of the CRISPR work got started). But we are not a *lot* closer to phage therapy than we used to be, considering how long the idea has been around. I personally think they’ll be the impetus to research this stuff heavily when the regular antibiotics wash out. The pro of phages is that they can explore the evolutionary space about as quickly as the bacteria. The con is that it will be a never-ending type of pursuit – resistance will evolve readily and perhaps even faster than to pharmaceutical stuff. It’s not a comforting notion, though I think it looks harder up close (climate change looks pretty hard up close too, on a global scale).

  3. dr2chase says:

    Both problems share a common cause, the inability of capitalism to deal with collective welfare. “Can’t figure out how to do it” is a variant on “it’s not profitable”; in the limit, we could even go so far as to consider tweaking the human genome against the baddies (if things go far wrong, it will get tweaked anyhow — the sickle cell anemia gene was good enough for the Intelligent Designer, after all). But how do we monetize that?

  4. One way to fight the spread of antibiotic resistant germs is to use antimicrobial copper for touch surfaces. A few businesses in many countries are switching highly touched surfaces to copper. Restaurants, schools, hospitals bus stations and more are using copper for faucets, countertops, bed rails, doorknobs, etc. I don’t know why this is so slow to catch on; the statistics are clear.

    It is very effective, and not dependent on humans behavior (choosing to wash hands, for example). Whatever germs get left on these surfaces by touch or sneeze or whatever, die within minutes. The next person coming along doesn’t pick up the germs.

    We used that science to make a little fondle-friendly piece of copper that you can carry with you to rub on hands or in nose to kill the same viruses and bacteria where they live. I’m not holding my breath waiting around for new antibiotics.:)

  5. Gingerbaker says:

    Well, global warming is not going to be significantly reduced by a program of improved hand-washing. And it seems pretty likely to kill billions of people, which is several orders of magnitude worse than what might be realistic from antibiotic resistance.GW is, imo, a LOT worse than a microbial resistance scenario.

    • Hmm. Antibiotic resistance could drop average life expectancy back to 40 or so. And that could be a lot sooner (a decade or two) than later. Global warming will only impose minor inconveniences over then next 50 years (it’s only the end of the century that things start going really wrong). By the time it becomes problematic, there may be a lot fewer people to be disrupted by rising sea levels…

      And antibiotic resistance is already here. Hospital-acquired infection killed my father. He was 82, though, so that didn’t do much to life expectancy statistics. I had eye surgery here in Tokyo, and they were very aggressive with the antibiotics; cleared out my gut flora quite thoroughly. I wish I had known that yogurt helps before said surgery. Sheesh.

  6. Pingback: You mean news should be informative rather than just sensationalist? – Bridget Magnus and the World as Seen from 4'11"

  7. Ellie K says:

    This is pathetic, tragic, and true,
    “We are also slowly realizing–or relearning–just how critical infection control and surveillance are…” Relearning, similar to reversing the evils done by anti-vaccination advocates.

    I wish we would spend less money on figuring out how to make one embryo from 3 people, but I’m not in charge. Sadly, I wonder if all the recent genomics pyrotechnics is actually more, not less, tractable a problem than developing new antibiotics (boring as the latter may seem).

Comments are closed.