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Importance of Antibiotics

How different would a world without antibiotics be?

A world without antibiotics, a simple scrape or cut could become life threatening, childbirth would be dangerous for both child as well as a mother, tuberculosis could be returned the old way where only a dose of fresh air works. If we are not able to control our antibiotics resistance all this could turn into reality. A world without antibiotics could become a dark place indeed. Around 2,00,000 years ago homo sapiens originated in Africa and antibiotics have been introduced only 70 years before, in between many of multitudes have been killed and our relation with bacteria has changed. Between 14th and 15th century European population suffered from epidemics of typhus, small pox, and plague which was also termed as the black death (Sansom 2017). The UK also suffered from streptococci, which were the leading cause of maternal mortality in 18th, 19th and early 20th centuries, in the year 1812 Napoleon Bonaparte’s 665,000 army men reduced to only 93000 because of the bacterial infection typhus. A century ago in US three major cause of death were identified tuberculosis, pneumonia and gastrointestinal infection. Later in 1942 when there was an invention of antibiotic named penicillin G the bacterial infections became easy to treat it was also known as Golden Era in the history of antibiotics (Sansom 2017).

The antibiotics which we use today to fight infections are a life saving drug for diseases like heart attack, cancer. Mostly people have not grown up with the idea that a simple fever could also turn into life threatening disease, now if we have throat pain we take antibiotics, have skin infection we go for topical treatment earlier when we didn’t have antibiotics a simple fever could turn into heart problems, surgeries could lead to deadly infections (Sansom 2017). Today’s generation is totally dependent on antibiotics for a simple cough and cold they know that taking medicine for a week and they are done or for a disease like high BP they take medicines every week they don’t worry if they miss any dose. This shows how important these medicines have become in our day to day routine no one can imagine a world without antibiotics (Sansom 2017). But unfortunately, the era of antibiotics is almost coming to an end in just a few more generation what we call today the wonder medicines would no longer be effective on the bacteria they were designed to chuck out. 

Major Consequences of Living Without Antibiotics

Antibiotics are such few medicines which are used in the care of the patients individually and effect the community health and also the subsequent generations directly. Presently almost 7000 Australians are dying every year because of the bacteremia or untreatable sepsi (Jacobson 2006).  The adolescent,  children, adults, and the aged dies as a result of the bacterial pneumonia, poly-microbial infections, wounds, bacteremia and sepsis in huge numbers which resulted the health care to be overloaded with the patients (Jacobson 2006). Private clinic, clinicians and nurses  will face issue related to the decisionsin maintain the duty of care, the infected tissue if possible to ablate, or moving the  patient towards the analgesic care in segregation for minimizing the risk of spreading the infection of superbug towards the other patients available in the clinics.  Operations which involve the persistent procedure from uncomplicated cannulas and catheters, to hip substitution, to heart surgery results into the death risk as a result of the bacterial infection that are drug-resistant (Jacobson 2006).  Intervention like the chemotherapy and organ transplant which is compromised of immunity required to be carried with the high level bio security facilities.

The answer to this question is clearly no, in today’s world to treat infections antibiotics are critical, indeed there are only a few compounds therapeutic which are able to modulate inflammatory burst at the time of severe sepsis. Although anti toxin therapy could represent components of antibiotics in future it is too early to rely on this solution (Llor 2015). 65 years ago a lady died during her operation of removing the appendix, but it was not the surgery due to which she died it was the serious infection which had no cure without antibiotics. Welcome to the future which is showing that era of antibiotics is coming to an end. Doctors and scientists have discovered a gene called NDM-1 and as per them, there are no antibiotics in the pipeline that have resistance against NDM- A bleak window, maybe 10 years what we have to use antibiotics very wisely and to accept the reality that afterwards we do not have anything to treat the infections (Llor 2015)


Without antibiotics lot of modern medicines would come to an end. Organ transplants would become impossible to do as antibiotics play a major role in the surgery while planting a new organ in the body there are high chances the patient is affected by infections. These medicines are vital for abdominal surgeries where the patient is safeguarded with the bacteria leaking in the body. And if we lose our ability to treat these infections many people would die due to peritonitis (Llor 2015). Minor surgeries would also become risky and life threatening, a lot more people will die of things which are currently of no importance, a stab cut by rose bush and you are dead within a week, cold which is peanuts now days without antibiotics people will die within a month due to pneumonia. Surgeries would be last option left, people will avoid cosmetic surgeries, no elective surgeries, and people can take the risk of appendices but will not go for surgery not even hip replacement (Llor 2015). AIDS patients will die even if they are taking their regular medicines, lot more funerals, widowers, widow.

Alternative Treatments

As per government perspective, if we had no antibiotics, the government would have opted for other ways like spending more money on public health infrastructure, putting more resources on R&D and vaccines and would have got much more serious about the infections in the hospitals, more conservative in doing surgeries which are not life threatening. (Peplow 2004) The real threat would be from a new virus if it comes which is both highly deadly and transmissible. Quarantine measures would be the only way to control such threats. Diseases like the simple flu could ruin the entire economy and then the loose effectiveness of antibiotics would truly be catastrophic and would become one of the chain reasons that wipe out modern civilization (Peplow 2004).

But running out with the situation is not the solution, scientists and doctors are finding antibiotics that effective on some of the serious infections caused (Parish 2006). Many pharmaceutical companies also have put in money to find out alternatives to antibiotics but it is like putting a finger in a hole only to find water surges out somewhere else (Peplow 2004). Bacteria’s are great survivors but the biggest threat scientists have is from multi-drug resistant gram-negative bacteria such as NDM-1 which produces an enzyme called KPC and it is quiet active in the US. It also gives bacteria resistance to the carbapenems, the most powerful group of antibiotics we once had. So now the concern is to keep bacteria at bay and for this hygiene is a most important weapon (Peplow 2004).


Proper cleaning, washing hands often and regular warnings to hospital staff and the general public has helped in reducing infection in hospitals. But as per prof. Richard James bugs do not exist in hospitals and the main threat is once these are out in the society it would be difficult to control the situation without antibiotics then there will be probably a need to educate the public about the infection. In early times students were taught that they should wash their hands before every meal and after using the washroom, but most of this has gone (Parish 2006). There are some innovative ideas for teaching students in school about hygiene and women about hygiene at their home and specially kitchen. Beyond all these measures, there is a severe need of preserving the antibiotics which we have (Peplow 2004).  Like people plan to save their taxes they should also take measures to prevent the antibiotics. It is also important for doctors to prescribe antibiotics only when it is much needed and pharmaceutical companies must find out ways to substitute these antibiotics. So together they all three must really get their acts together.

Preserving Antibiotics

Another concern is what will happen when drugs stop working after antibiotics; transplant surgeries will become impossible, organ recipients have to take drugs which support immune suppressing lifetime so that new organs does not stop functioning, they will have to take precautions from life threatening infections. Removing appendix will become almost a life threatening surgery because these patients are dependent on antibiotics so that they do not catch any infection, but if the bacterium enters into bloodstream then their life are in danger (Carlet et al. 2012). Pneumonia will become a mass killer disease particularly among old and infants because their immune system is a week and in infants, it is still developing. Gonorrhea would become impossible to treat and without treatment, the sexually transmitted disease will cause pelvic infections causing infertility or ectopic pregnancies (Carlet et al. 2012).

TB will become incurable because it needs at least six months regular course of antibiotics and patients currently are not doing a full course which has led to spread of resistance. Resistance to antibiotics has increased drastically over the past few years causing a problem for future patients. Microorganisms have become super resistant to these drugs moreover in few countries they have become resistant to carbapenoms leading to susceptibility only to Colistin and Tigecycline (Carlet et al. 2012). The Gram- Negative bacteria which are active in public places and are transmissible from one person to other can be cured only with antibiotics and unfortunately there are only a few new antibiotics left for the cure of this bacterium. It is very hard to believe but it is true that after sometime it would be impossible for doctors to cure certain types of infections. The situation will become as deadly as it was in the Era of 1930’s and early 1940’s (Chapman and Kongnakorn 2015). We cannot look at this pandemic and evolving threat and lose one of our most important threats which were discovered in previous ages, we have to act now because silence is not the answer.

Conclusion 

We have abused and overused antibiotics both in animals as well as humans and the result are today most of the bacteria are are resistant to these medicines and we are not able to do anything. The current resistance level has reached to a pace where human life is in real danger and it requires immediate actions and measures worldwide to protect the erosion of existing antibiotics and identifying the appearances of new and potential antibiotics which are acting against the bacteria lie Gram-Negative (Chapman and Kongnakorn 2015). This will need a profound way of diagnosing infections by doctors and prescribing antibiotics only when it is actually needed. Awareness programs must be organized by the hospitals and government to educate people on how to maintain hygiene at the workplace and their homes so that prevention of infections can be done. Many countries have together formed a committee and organized a program in which line of actions have been defined stating that various awareness camps must be organized, diagnostic techniques must be improved, vaccine development programs must be accelerated (Chapman and Kongnakorn 2015).

Effective infection control programs must be organized worldwide where people must be given awareness on how to control the infections from spreading in public places and at their homes. Children must be educated by schools. Another measure is active protection of antibiotics which are the natural gift for human beings, there is a program called antibiotics stewardship which is implemented worldwide under which doctors have been trained to diagnose infection with a controlled approach which means that antibiotics which are being prescribed must be used in a planned way because as per survey was done by WHO it has been observed that many doctors prescribe antibiotics without mentioning the reason and it is causing increased resistance power of these drugs (Boseley 2017). Diagnosing bacterial infection using test should be urgently developed among doctors so that they can be aware of the infection causing disease and should not rely on just a fever because it can occur due to non-bacterial infection also. Development of new tools must be encouraged so that patients are not treated with the antibiotics when it is not needed.

Organizations like WHO and TATFAR are focusing on identifying new antibiotics which are non-resistant to the bacteria. These drugs should be urgently identified and must be protected so that we don’t have to face the situation which was there a few centuries back. A strong educational program must be organized for consumers as well as physicians on negative impacts of overusing antibiotics. The understanding among these two groups is the key to success of such programs (Boseley 2017). It is strongly believed that if this two group works together for improving the future of antibiotics then there is a possibility that we will be protected from such life threatening infections and we will understand the importance of such drugs in our life and without antibiotics lot of modern medicines would come to an end. Life will be nothing without antibiotics and every second will be breadth taking. 

References

Boseley, Sarah. 2017. "Are You Ready For A World Without Antibiotics?". The Guardian. https://www.theguardian.com/society/2010/aug/12/the-end-of-antibiotics-health-infections.

Carlet, Jean, Vincent Jarlier, Stephan Harbarth, Andreas Voss, Herman Goossens, and Didier Pittet. 2012. "Ready For A World Without Antibiotics? The Pensières Antibiotic Resistance Call To Action". Antimicrobial Resistance And Infection Control 1 (1): 11. doi:10.1186/2047-2994-1-11.

Chapman, R, and T Kongnakorn. 2015. "Challenges In Economic Evaluation Of Antibiotics In Health-Care Acquired Infections: A Targeted Review". Value In Health 18 (7): A580. doi:10.1016/j.jval.2015.09.1937.

Jacobson, Bernard. 2006. "Worry Of A Future World Without Antibiotics". Nursing Standard 20 (17): 39-39. doi:10.7748/ns.20.17.39.s52.

Llor, Carl. 2015. "Antibiotics Without Prescription: More Cons Than Pros". BMJ, h4202. doi:10.1136/bmj.h4202.

Parish, Colin. 2006. "WHO Expert Warns Of A World Without Antibiotics In 30 Years". Nursing Standard 20 (16): 10-10. doi:10.7748/ns.20.16.10.s15.

Peplow, Mark. 2004. "Antibiotics Get New Lease Of Life". News@Nature. doi:10.1038/news041115-6.

Sansom, Clare. 2017. "An Intimate Family Story In A World Without Antibiotics". The Lancet Infectious Diseases 17 (3): 274. doi:10.1016/s1473-3099(17)30067-1.

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