By CBC Docs  

Since penicillin was discovered by Alexander Fleming in 1928, antibiotics have saved more than 100 million lives according to The Truth About Antibiotics, a documentary from The Passionate Eye.

But pharmaceutical companies have not developed new families of antibiotics since the mid-1980s — more than thirty years ago. And during that time, bacteria have been developing resistance to antibiotics, which means that the medicines we use today are becoming less effective.

A resistance test from Harvard University demonstrates exactly how resistant some E. coli bacteria have become.

Sally Davies, chief medical officer for England, believes that we’re on the verge of an apocalypse, where millions of people may die from resistant bacterial infections: “Asia’s on the brink, so they’ve got what, perhaps 10 years? Maybe that gives us another five, 10 at maximum.”

Even now, the bacteria are winning. A 2014 report from the U.K.’s Review on Antimicrobial Resistance noted that at least 50,000 people a year die across Europe and the U.S. from drug-resistant infections. It also suggested that, if nothing is done, 10 million people could die annually by 2050.

The Truth About Antibiotics looks at ways doctors and research scientists are fighting back.

A quick test for bacterial infections

A recent study found that between 2000 and 2015, global antibiotic use went up by a staggering 65 per cent, and this overuse has real consequences.

According to the film, patients in the U.K. often ask their general practitioner for antibiotics, complaining of respiratory symptoms, while their doctor has no way of knowing definitively if an infection is caused by bacteria or a virus. Antibiotics are not effective in fighting viruses and taking them when they’re not necessary increases the risk of bacterial resistance.

“Our number one rule in medicine is to do no harm, and, at the moment, by issuing antibiotics inappropriately, we could potentially be doing harm for future generations,” says Dr. Aggy York, a general practitioner from England interviewed for The Truth About Antibiotics.

To make prescribing antibiotics more precise, scientists have developed a simple, three-minute finger-prick test that measures a patient’s blood sample for the C-reactive protein, also known as CRP.

CRP levels give information about the body’s response to infection: a high level indicates a bacterial infection, whereas a low level means you’re probably suffering from a virus. A 2016 study suggested that this type of point-of-care test reduced antibiotic use for patients with acute respiratory tract infections.

Narrow-spectrum antibiotics

Doctors often prescribe broad-spectrum antibiotics, which are effective against a large number of bacteria. But this kind of sweeping antibiotic also gets rid of everything in its path. Narrow-spectrum antibiotics have now been developed for specific bacteria to target treatments more effectively.

As shown in The Truth About Antibiotics, Tina Joshi, a researcher and lecturer at the University of Plymouth, is developing a small, handheld device that will analyze a bacteria’s DNA so doctors can identify one strain from another and get a diagnosis in minutes.

“It will be like a traffic light system,” says Joshi. “In the time frame of a five-minute doctor’s appointment, the GP can say, ‘Ah, I’m going to prescribe you this narrow-spectrum antibiotic that’s actually going to treat you.’ And it should really, really assist the clinician in appropriate prescribing.”

New antibiotics

The discovery of penicillin was a happy accident that started when Fleming found mould on an uncovered petri dish that had seemed to have killed bacteria. Right now, scientists are looking everywhere bacteria thrive in search of organisms that could become new antibiotics.

Mark Merchant, a professor of biochemistry at McNeese State University, is studying alligators in the swamplands on the Texas-Louisiana border. “If I get a little scratch on my arm in that water, it gets red and puffy and highly infected,” he says. “There must be something amazing about immune systems of these animals.”

By studying their blood, Merchant has identified two small proteins that could someday become a new antibiotic. But scientists like Merchant have to work fast because new medicines can take years to develop and millions of dollars to bring to market.

Phages: Viruses that kill bacteria

Bacteriophages, also known as phages, are spider-like viruses that reproduce by killing bacteria. They were discovered before antibiotics, but now scientists are studying them with renewed interest. Phages are very specific in the bacteria they attack, so to work as an antibacterial medicine, you need a perfect match between the two.

Ben Chan, a research scientist at Yale University, is looking in all kinds of places, including his local sewage plant to collect and study new phages. “In a single millilitre of seawater, there’s maybe a billion phages in it. So they’re everywhere,” he says.

According to the documentary, the science of phages was developed in Eastern Europe as early as the 1950s, but phage treatments haven’t gone through the necessary trials to be available in the Western world yet.

Good hygiene

Susan Lea, a researcher from the Sir William Dunn School of Pathology at the University of Oxford, says that there’s one thing everyone can do to help fight antibiotic resistance now: wash your hands for twenty seconds after using the bathroom. Bacteria don’t like water — or soap — and this one simple act can reduce the spread of infection, and the need for antibiotics, considerably.

Derek Butler, who helps run the charity MRSA Action UK, has worked on initiatives in hospitals to improve hygiene and screening. Along with government campaigns, these initiatives have reduced deaths in the U.K. from MRSA — a particularly nasty superbug that is resistant to several antibiotics — by 80 per cent from their peak in 2006.

“It’s self-help for ourselves, it’s help for our families, and it’s help for our community … and it’s simple,” Lea says.

Watch The Truth About Antibiotics on The Passionate Eye.