Since penicillin was discovered, antibiotic testing and development had rapidly escalated to a dizzying pace and eventually, the world’s largest pharmaceutical companies were discovering, testing, and developing antibiotics as a lucrative business. However, the evolution of strains of bacteria that are resistant to antibiotics also has escalated and does so at an alarmingly high rate. The race for pharmaceutical companies to catch up with this evolution of strains became nothing short of exhausting. Since the year 2000, only twelve new antibiotics have been approved.
Five major big pharma firms have recently pulled the plug on developing new antibiotics, which would target the influx of various deadly “superbugs” that are developing – superbugs that are antibiotic-resistant. Novartis, Sanofi, Allergan, and AstraZeneca, and The Medicines Co. are the five companies that have shut down their antibiotics research programs. Most of these companies are instead now focusing on the development of drugs for diabetes, cardiovascular disease, and cancer. GlaxoSmithKline, Roche, Merck, and Pfizer do still have active antibiotic research programs so far.
In 2018, FDA Commissioner Scott Gottlieb expressed concern over the growing epidemic of superbugs and antimicrobial resistance; in the United States alone, more than 2 million people fall ill with conditions stemming from antibiotic-resistant bacteria. 23,000 of those people die as a result. It is estimated that these antibiotic-resistant strains could kill 10 million people each year by 2050 if nothing is done.
With this impending superbug threat growing, why are pharmaceutical companies abandoning their antibiotics research programs? In part, it is because of the chronic over-prescribing and overuse of antibiotic products that have contributed to the problem. Many argue that in order to slow down the growth of antibiotic-resistant strains, products deemed “antibacterial” must be used less often and people’s immune systems must be left to do its job and fight the strains effectively without these products. Antibacterial products like soap, as well as antibiotic medicines, often kill off only the weakest and most sensitive bacteria, leaving the strongest bacteria to adapt, evolve, and resist treatment.
The Superbug Crisis
In addition to current superbugs, there is the threat of new ones that emerge over time. To illustrate, doctors warn that a newly emerging sexually transmitted condition could become antibiotic-resistant, in turn leading to infertility and pelvic inflammatory disease in women. In 2017, a woman died from contracting a bug that was resistant to every single antibiotic available in the United States – 26 different antibiotics.
Lifestyle factors and the overuse of antibiotic drugs in people as well as in agriculture are the two main causes of resistance. Many people also believe climate change is contributing to the crisis, as well. Using hand sanitizer, antiseptics, and antimicrobial chemicals in household products decreases the body’s microbial diversity and its ability to fight infections on its own. In addition, antibiotic drugs also kill off good bacteria in the body, and with fewer good bacteria to act as a defense, the body becomes more likely to fall victim to the resistant, bad bacteria.
What Can We Do?
Alternatives are being researched when it comes to the antimicrobial chemicals in soaps, cleaners, and agricultural products; these include organic acids, probiotics, bacteriophages, phytogenic feed additives, nanoparticles, essential oils, and more. People are actively beginning to turn away from products like antibacterial soaps in favor of more natural ones.
To combat the costly development of new drugs, the FDA is considering a reimbursement for new antibiotic agents that are able to target dangerous resistant infections. The National Institute of Allergy and Infectious Diseases and the CDC have developed initiatives to fight antimicrobial resistance as well, in part due to increased funding to the CDC to do so in 2018 from Congress.
In addition to the development of alternative therapeutic treatments, there is also research continuing that is dedicated to understanding the mechanics of resistance, like how it initially happens and how it spreads. Phage therapy is a 100-year old treatment method that, after being put on hold once antibiotics were invented, is resurfacing as a possible option to combat the growing superbug threat. Phage therapy uses viruses that infect bacteria and destroy it; work involves matching up phages with resistant bacteria and injecting them into a person’s bloodstream. It’s currently being tested in mice and also in bacteria extracted from people.
Just one person taking antibiotics can affect every person on the planet – it’s not the person who becomes immune to the drug, it’s the bacteria that does. Eventually, all antibiotics will be ineffective because bacteria are excellent at evolving to defeat them. While the threat of antimicrobial resistance and superbugs is real, and is a massive looming crisis, the good news is that research on alternatives is well-established and looks promising.