In a first-of-its-kind report, World Health Organization (WHO) announced today that bacterial infections that can’t be treated with the antibiotics of last resort have emerged in every part of the world, which means that patients who pick up E. coli, pneumonia or staph infections don’t have an effective way to control their illnesses. In some countries, more than half of people infected with K. pneumonia bacteria won’t respond to carbapenems. A similar percentage of patients with E. coli infections won’t be helped by taking fluoroquinolone antibiotics.
The growth of drug-resistant strains of bacteria means infections are either harder or impossible to control, which could lead to quicker spread of diseases and higher death rates, especially among hospital patients. But even more concerning, say experts like Dr. Martin Blaser, director of the human microbiome program at the New York University Langone Medical Center and author of Missing Microbes, is how these antibiotics are affecting the makeup of both good and bad bacteria that live within us – our microbiome. “The first big cost of antibiotics is resistance,” he says. “But the other side of the coin is [the fact that] antibiotics are extinguishing our microbiome and changing human development.”
By that, Blaser is referring to growing research that shows that the trillions of bacteria that live in and on our bodies play a critical role in our health. Bacteria and microbes aren’t always enemies of a healthy body, but can be allies as well, helping us to digest food, fight off disease-causing bugs, and more. Early studies suggest that different communities of bacteria in the gut, for example, may affect our risk of obesity and of developing certain cancers. Other intriguing work hints that babies born vaginally and are exposed to their mother’s reproductive tract flora, may develop different immune systems that better prepare them to combat allergens compared to those who are born via Cesarean section. But overuse of antibiotics is slowing wiping out the good bacteria with the bad, and that may have serious consequences for public health years from now, warns Blaser.
The WHO report highlights how individual decisions about prescribing antibiotics can have more widespread, even global consequences. “If I prescribe a heart medicine for a patient, that heart medicine is going to affect that patient," says Blaser. "But if I prescribe an antibiotic, that antibiotic will affect the entire community to some degree. And the effect is cumulative.”
The first step in pushing back, public health experts say, is to reduce our over-prescription of antibiotics for minor infections that don’t necessarily require them, and that applies to both people and food-producing animals such as poultry and livestock. Animals can harbor and pass on drug-resistant bacteria as well as people can, and expanded use of antibiotics in agriculture in recent years has contributed to the growth of more aggressive bugs. In the home, people can refrain from using antibacterial soaps, which also push bacteria to become resistant.
“What we urgently need is a solid global plan of action which provides for the rational use of antibiotics so that quality-assured antibiotics reach those who need them, but are not overused or priced beyond reach,” says Dr. Jennifer Cohn, medical director of Doctors Without Borders’ Access Campaign.
That may also help to protect our microbiomes, which in turn could slow the appearance of chronic diseases such as obesity, cancer and allergies. As the WHO findings show, antibiotic resistance is now everyone’s problem.