What would a world without antibiotics be like?
Here’s what David Weiss, Ph.D., director of the Emory Antibiotic Resistance Center, thinks.
“A world without effective antibiotics would be terrible, an 80-year trip backward in time,” he told Healthline.
Weiss notes that many great achievements of modern medicine would be reversed if antibiotics ceased to exist.
“Transplants would no longer be possible, many cancer treatments would be too dangerous, and very premature babies would have greatly reduced survival rates,” Weiss said. “Routine surgeries would carry great risk. Even seemingly harmless cuts and scrapes could prove deadly. The way we go through life would be fundamentally changed.”
Although Weiss notes a world without antibiotics is far from a certainty, and perhaps not even likely, he also suggests that for patients with drug resistant infections, his hypothetical scenario has already become a reality.
That was the case for a woman in Reno, Nev., who died last year from an incurable infection that was resistant to all 26 antibiotics available in the United States.
She had spent a significant amount of time in India, and had contracted a bone infection after breaking her right femur (thigh bone).
When she was hospitalized in Reno last August doctors found she was infected with carbapenem-resistant Enterobacteriaceae (CRE).
CRE are a class of bacteria that are resistant to a number of antibiotics, including carbapenems, drugs that are considered the last resort when all other antibiotics have failed.
Dr. Tom Frieden, the director of the U. S. Centers for Disease Control and Prevention (CDC), has described CREs as “nightmare bacteria” due to their ability to spread their resistance to other bacteria.
Typically, CRE spreads in hospitals and care facilities. It causes an estimated 9,300 infections and 610 deaths in the United States each year.
Spreading more than anticipated
A study published this month from researchers at the Harvard T.H. Chan School of Public Health, and the Broad Institute of MIT and Harvard, found that CRE may be spreading more widely than previously thought.
It may also be passing between people asymptomatically, meaning it does so without showing any obvious symptoms.
“We need to look harder for this unobserved transmission within our communities and healthcare facilities if we want to stamp it out,” William Hanage, Ph.D., associate professor of epidemiology at the Harvard T.H Chan School, and senior author of the study, said in a press release.
Dr. Lee Riley, head of the infectious diseases department at the University of California, Berkeley, says antibiotic resistance poses a significant threat to public health.
“People should recognize that antibiotic-resistant bacterial infections are an epidemic of worldwide proportions, and they kill more people each year than Ebola or Zika virus, which gain more attention in the lay media. This silent epidemic needs to be better recognized,” he told Healthline.
According to the CDC, every year at least 2 million people in the United States become infected with bacteria that are resistant to antibiotics. Of those at least 23,000 die as a result of these infections.
“Many factors led us to this point,” Weiss said.
“Pharmaceutical companies stopped developing new antibiotics in part because they have not been as profitable as other drugs. The use of antibiotics for growth promotion in farming [nonmedical uses] is another factor. Complacency in thinking that things wouldn't get this bad was a big factor as well,” Weiss added.
Riley also emphasizes the need for reducing use of antibiotics in farming, arguing if nothing is done to address this it may be too late to fix.
“At this time, there is very little emphasis on addressing the problem of antibiotic use as a growth promoter in animal husbandry … More than 70 percent of all antimicrobial agents manufactured are used in animal husbandry. This is a huge source of drug-resistant pathogens and needs to be recognized,” he said.
What can be done
Developing new antibiotics and diagnostic tests, using antibiotics more sparingly, and reducing their use in agriculture are some of the ways experts suggest antibiotic resistance could be combatted, but it will require a significant global investment.
However, Weiss says there are ways the general public can do their part to help stop the increase in antibiotic resistance.
“Urge your lawmakers to support increased funding for research and regulations that limit the overuse of antibiotics. Purchase antibiotic-free products [soap, meats, etc.] to incentivize producers to stop using unnecessary antibiotics. If you or your loved ones are in the hospitals, insist that care providers wash their hands each time they enter the room,” he said.
Most importantly, Weiss says, both the medical community and the general public should avoid becoming complacent.
“As we would, bacteria will always try to survive,” he said. “They evolve rapidly, and are under great pressure to find ways to resist antibiotics. They have had decades to become as resistant as they are today. We should not think that if we simply develop new drugs, we will be past this problem. We will also have to remain vigilant and not let our guard down.”