The Antibiotics Crisis

On the evening of 20 April 2016 RSC Belgium members and friends welcomed Dr. Laura Bowater from the University of East Anglia's Medical School to the Universite Catholique de Louvain (UCL) campus in Woluwe Saint Lambert. Dr Bowater talked about a very hot topic: the growing resistance of bacteria to today’s antibiotics.

Laura's lecture looked at the latest research in this area and how this impending crisis in modern medical treatment may be averted. Laura took us through a potted history of antibiotics from the serendipitous discovery of Penicillin by Alexander Fleming (pictured below) in 1928. In 1941 the microbiologist Selman Waksman used the term ‘antibiotic’ for the first time to describe small molecules that inhibit the growth of microbes and can be used clinically to treat a plethora of bacterial and fungal infections. Between the 1940s and the 1960s was the so-called 'Golden Age of Drug Discovery' with many new and effective drugs being developed.

However as early as December 1945 Fleming had sounded a note of warning in his Nobel Prize acceptance speech saying: “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them […]. The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant."

He was right. Over the last eighty years bacterial pathogens have developed resistance to almost all of the known antibiotics. Laura explained how bacteria carry the information required for antibiotic resistance in their DNA and some bacterial species are resistant to certain antibiotics as a direct result of their genetic make-up, metabolism and cellular structure, while other bacteria develop resistance to antibiotics through either spontaneous mutation in their DNA or directly acquiring resistance from DNA that is transferred from a resistant bacterium. 

Education is key

The more we use antibiotics the more resistant bacteria are becoming. It is less than a hundred years since Fleming ‘discovered’ Penicillin and our reliance on antibiotics to treat life-threatening infections and prevent post surgery infections is at grave risk if we continue to use them inappropriately and with such casual abandon. Antibiotic use in modern agricultural practice and animal husbandry has increased dramatically and an increase in antimicrobial resistance has followed. Antibiotics are not effective against viruses yet antibiotics continue to be prescribed for viral infections and in some countries it is easy to purchase antibiotics without a prescription.

And, unfortunately the Golden Age of antibiotic discovery is long gone; most commonly found antibiotics have been discovered and the discovery of a novel antimicrobial with a clinical impact is now rare. Pharmaceutical companies are reluctant to invest in a drug that is at best prescribed for a short period of time, and at worst kept on a shelf as a ‘reserve antibiotic’ to be used only when all other treatments have been exhausted and ineffective.

Laura believes that effective education, communication, and engagement lie at the heart of any solution to the antibiotics crisis. Thankfully this approach appears to be working on a global basis and resources are being invested to examine the challenges and present potential solutions to the crisis and financial and regulatory incentives are available to initiate research for new antibiotics.

Dr Laura Bowater (picture above right with RSC Belgium Chairman Tim Reynolds) is a Senior Lecturer at the Norwich Medical School in the University of East Anglia and is a Microbiologist with a research interest in the growing problem of Antibiotic Resistance and the role of education in addressing this global concern.