HEALTH
The Medical Crisis
You Never Knew About
By Farhan Shah
In many parts of Southeast
Asia, out-of-date and
poorly stored drugs, low
dosages, counterfeit
medication and many
other medicinal issues
are fuelling the time bomb
of antibiotic resistance.
Farhan delves into this
rarely talked about
problem and explores a
potential future that could
see your children in the
future passing away from
a simple cut.
In 2008, a 67-year-old man was
admitted to a Manhattan hospital
to undergo the Whipple procedure,
a major surgical operation and one
commonly used to remove pancreatic
cancers. Although the operation
went smoothly, the man picked up an
infection that was surprisingly resistant
to the typical course of antibiotics
used to treat it. Fourteen days later,
the man passed away. The antibiotics
barely made a scratch on the bacteria
responsible for the infection.
The following year, a man named
Richard Armbruster went to a hospital
in St. Louis to go through a routine hip
replacement; his right hip, worn from
78 years of living, had begun bothering
him. A month later, Armbruster was
dead after falling prey to a series of
post-surgical complications. The killing
blow was a bloodstream infection that
resisted all treatment with antibiotics
and put him into shock.
...with today’s antibiotics losing its
effectiveness at such a rapid rate,
the profits, if any at all, that
can be gained from creating new
antibiotics are simply not
enticing enough for the
pharmaceutical giants.
1940
1950
1960
Alarmingly, these cases are becoming more common, so much so that doctors
have come up with a new term – pan-resistant – to describe infections that are
impervious to the array of antibiotics that are currently available. The physicians
who valiantly tried to treat the 67-year-old man in the first case had this to say
while piecing the investigation together. “It is a rarity for a physician in the
developed world to have a patient die of an overwhelming infection for which
there are no therapeutic options.”
Dr Brad Spellberg from UCLA’s David Geffen School of Medicine has even
addressed this emergent problem in a book titled Rising Plague: The Global
Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them in an effort
to galvanise not just the medical community but the whole world to band together
and do something to nip the issue in the bud before it spirals out of control. The
scariest thing, as Dr Spellberg eloquently puts it, is that “this is not cancer; it’s
infection disease that has been treatable for decades, yet you’re sitting with a
family, trying to explain that you have nothing left to treat their dying relative”.
SOUNDING THE WARNING BELLS…SIX DECADES AGO
Yet, the plague of antimicrobial resistance was not something that caught the
scientific community by surprise. Sixty years ago, the founder of penicillin and the
one arguably responsible for kick-starting the antibiotics era that we’re currently
living in, Alexander Fleming, cautioned the audience while accepting the Nobel
Peace Prize for Medicine. He said: “It is not difficult to make microbes resistant
to penicillin in the laboratory by exposing them to concentrations not sufficient
to kill them…there is the danger that the ignorant man may easily under-dose
himself and by exposing his microbes to non-lethal quantities of the drug to make
them resistant.”
Even at that nascent age of medicine, Fleming knew that the bacteria that he
and the scientific community were battling would eventually develop defences to
counter the drugs they’ve produced. It was just the way evolution worked. What
Fleming was worried about, though, was that the misuse of these antibiotics
would hasten the process of evolution.
The passage of time served to prove Fleming correct. Traces of penicillinresistant gram-positive bacteria begin emerging in the 1940s, around the time
when penicillin had only starting being mass-produced. As more and more
antibiotics were created and thus mass produced to be used in treating infection,
the windows of time between a drug’s production and the emergence of bacteria
resistant to it slowly shrunk.
1970
ERYTHROMYCIN
TETRACYCLINE
METHICILLIN
A TIMELINE OF ANTIBIOTIC EVENTS
Family & Life • May 2014
1990
2000
IMIPENEM AND CEFTAZIDIME
PENICILLIN
22
1980
2020
LINEZOLID
VANCOMYCIN
GENTAMICIN
2010
CEFTAROLINE
LEXOFLOXACIN
Antibiotic Introduced
Antibiotic Resistance Identified