Are antibiotics going out of fashion?

Antibiotics have been the most successful treatment for a whole array of infectious diseases and are vital in almost all areas of modern medicine. However, Bill Gates is claiming that this success has lead to complacency in their use, leading to a rise in microbial resistance. It is estimated that more than 700,000 people die each year from drug-resistant infections, with this number only expected to rise going forward. In order to try and subdue this threat, research is being done to not only develop novel last-line antibiotics (drugs kept in reserve for use against pathogens that have proved resistant to all other antibiotics) but also to create new treatments for infectious disease that work in alternative ways.

Researchers in Oxford have been working on a number of innovative antibiotics and as part of a European project called ENABLE. Chris Schofield is looking into the biosynthetic pathways to clavams and carbapenems (two types of antibiotic) with the aim of improving their production and availability. Mark Moloney and his group are working on novel antibiotics compounds, such as oxazolomycin and lemonomycin, which have, until now, remained untested. Both are exhibiting promising biological activity.

Other scientists have moved away from antibiotics and targeted other differences between bacterial and human cells. In 2014, Erin K Sully and a team of researchers at the University of New Mexico investigated a virulence factor that enables bacteria to recognize when they have entered the body and therefore when to begin replicating. They identified an inhibitor for this factor, now named Savirin, which has been found to disrupt staphylococcus epidermidis’ capacity to replicate and worked to cure mice of its infection altogether.

Another promising treatment is the prevention of biofilm formation. Biofilms are often formed by particularly resistant bacteria and can increase the concentration of antibiotics needed to eradicate them a thousand fold. Stopping them from forming should therefore be very useful in supporting the action of antibiotics. In 2015, Adamson et al. evaluated the efficacy of a combination treatment of a drug targeting this system and an antibiotic. Results showed that the addition of this drug visibly enhanced the therapeutic benefits of the antibiotics for clearing p. aeruginosa compared to simply administering the antibiotics alone.

As well as all of this promising research, there are ways in which we can all help prevent the development of drug resistance and diminish the emergence of multi-resistant bacteria such as MRSA. It is vital when taking a course of antibiotics to finish the course as stopping early can result in the survival of mutated bacteria that can then multiply and infect other individuals. Furthermore, antibiotics shouldn’t be taken without a doctor’s prescription. Antibiotics are only effective against bacteria and will have no effect on viral infections. Carelessly taking them might expose susceptible bacteria to small doses of them and thus help development of drug resistance.

Although there is much uncertainty about the future of our commonly used antibiotics, there is promising research into novel compounds that may prove vital for our treatment of multi-resistant bacteria in years to come.

(featured image courtesy of NIAID on Flickr)