The Antibiotics Problem
by Dr. David L. (“Woody”) Woodland
(as published in the Summit Daily News of November 9, 2014)
The bacterium that causes tuberculosis thrives in the lungs and is spread from person to person
through the air. Many patients’ immune systems are able to wall off the pathogen, effectively
halting the infection. But in others, fortunately a minority, the bacteria manage to replicate
extensively, causing irreparable damage to the lungs and eventually death. The lucky patients
who are able to wall off the bacteria are not cured, since live bacteria persist in a dormant form
and can subsequently re-emerge from their prison to cause disease, especially later in life when
the lung’s immune defenses decline. It may be hard to believe, but approximately one-third of
the world’s entire human population, over two billion people, is infected with TB bacteria and
harbors these bugs in this inert form.
Antibiotics (anti-bacterial drugs) have been the main line of defense in the global control of TB.
But in recent years, strains of TB bacteria have emerged that are increasingly resistant to even
the most powerful antibiotics available. The end-result will be a strain of TB simply not controlled
by modern drugs, taking us back to the early 20th century when TB was a feared disease across
the globe. Surprisingly, relatively little emphasis has been placed on developing new types of
antibiotics, primarily due to the lack of sufficient financial incentives for pharmaceutical and
biotech companies.
TB is not the only disease for which the decreasing efficacy of antibiotics is a problem. Recent
years have seen the emergence of a several antibiotic resistant pathogens, such as Methicillinresistant Staphylococcus aureus (MRSA), which causes a range of illnesses. Of particular
concern is Klebsiella pneumonia, which can live in the intestines and has developed strains that
are resistant to essentially all antibiotics available. The World Health Organization has warned
of the significant threat posed by the spread of these antibiotic-resistant diseases. And in the
United States, the Centers for Disease Control have recently estimated that over two million
people are infected with antibiotic-resistant bacteria every year, resulting in 23,000 deaths. It
appears that we are entering a new phase of medicine characterized by our inability to control
many common bacterial infections, not dissimilar to the state of medicine in the last century.
Moreover, this is a problem that transcends borders and impacts both rich and poor countries
alike.
As pharmaceutical companies and researchers ponder the antibiotics problem, it is worth noting
that the Centers for Disease Control have reported that about half of all human antibiotic use is
unnecessary. For example, the inclusion of antibiotics in soaps and wipes is completely
unnecessary, and its use in various ointments is questionable. The failure of patients to
completely finish a course of antibiotics once they start to feel better is an also a significant
problem. Furthermore, antibiotics are extensively used in the livestock industry to enhance food
production; much of this use is considered unnecessary. This general overuse of antibiotics is
almost certainly increasing the rate at which bacteria acquire resistance.
The solution to the antibiotic problem lies in the development of brand new classes of
antibiotics. This requires a different mindset from the past where antibiotic development focused
primarily on the modification of existing drugs to improve their efficacy. In fact, there has not
been a truly new antibiotic (with a new mode of action) for over 25 years.
So where will we find truly novel antibiotics? In a recent issue of the Petri Dish, I mentioned the
possibility that a type of bacteria referred to as archaebacteria might be a valuable source of
new antibiotics with novel modes of action. Another source of novel antibiotics may be our own
bodies. A recent article in The New York Times highlighted findings by scientists studying the
microbes that live in our guts, referred to as the microbiome. They identified genes for more
than 3,000 unidentified molecules, many of which may be the basis of new drugs. It turns out
that the microbes that live in our guts are constantly competing for space and essentially wage
war against each other by secreting powerful drugs that kill competing bacteria.
While health authorities confront the problem, we can all make an impact by demanding that the
food industry stop using antibiotics unnecessarily and by avoiding antibiotic-laced over-thecounter products. We can also make sure that we always finish any courses of antibiotics
prescribed! All of this will help prevent our descent back into the infectious disease challenges
of the past, including the reemergence of tuberculosis.
David L. “Woody” Woodland, Ph.D. is the Chief Scientific Officer of Silverthorne-based Keystone
Symposia on Molecular and Cellular Biology, a nonprofit dedicated to accelerating life science discovery
by convening internationally renowned research conferences in Summit County and worldwide. Woody
can be reached at 970-262-1230 ext. 131 or woody@keystonesymposia.org.
For more (Petri) Dish columns, visit www.keystonesymposia.org.