Antibiotic Resistance: A Return to the Medical Dark Ages?

What images spring to mind when you consider healthcare in the middle ages?

23 October 2017

scientists working at the laboratory

By Louise Tibbetts, Innovation Funding Consultant & Quality Assurance

What images spring to mind when you consider healthcare in the middle ages? A world of pestilence and plague? Where illnesses were treated with superstition and old wives tales, rather than antibiotics and clinically proven drugs? Recently, Prime Minister David Cameron has stated that we could soon be “cast back into the dark ages of medicine” as a result of the increasing threat of antibiotic resistance.

Can you comprehend a world without antibiotics? Back in the middle ages rates of mortality were high from illnesses readily treatable in today’s world with a dose of antibiotics. Even something as simple as a cut finger could end in an untimely death.

Antibiotics are medicines that inhibit growth or kill microorganisms that can cause all sorts of nasty infections and diseases. In 1928 Ayrshire born Alexander Fleming discovered penicillin: this marked the start of modern antibiotics. Healthcare was revolutionised: less women died from infections following child birth; soldiers injured in warfare were less likely to die from infection; life threatening diseases such as tuberculosis, pneumonia and sexually transmitted diseases could be managed by antibiotics.

However, this miracle cure soon resulted in the widespread overuse and misuse of antibiotics, which lead to a far more alarming problem, which is now a major threat to public health: antibiotic resistance. In layman’s terms, this is when bacteria no longer respond to antibiotics. Bacteria are pretty crafty, failure to complete a course of antibiotics may leave a few tougher bacteria to survive and multiply; in other cases bacteria undergo genetic mutations which makes the drug non-longer effective.

Lots of diseases that we thought we had mastered are now on the rise, only this time a little bit more scary. Meticillin-resistant staphylococcus aureus (MRSA) is a type of bacterial infection resistant to many widely used antibiotics. It is increasingly prevalent in hospitals: without antibiotics major surgical procedures as knee replacements, organ transplants to complications in childbirth would carry a greater risk.

We all know from reading Victorian fiction that a cough is never just a cough… Tuberculosis was the killer of many, rich or poor. In 1815 it claimed the lives of one in four in England. Improvements in public health and the development of the antibiotic Streptomycin in 1946 made it possible to treat and cure TB. That is, until now. Since the 1980s there has been a resurgence of tuberculosis due to the rise in multi-drug-resistant TB.

But before you get frightened by the thought of an untimely paper cut bring about your demise, let’s consider the cutting edge science that is being carried out by lots of clever people. Researchers all over the world are developing new technology and innovations including: genetically modifying current antibiotics; developing drugs to target the bacteria’s protective cell wall; and targeting the mechanisms by which bacteria form biofilms, a critical phenomenon which protects the interior cells in the film from antibiotic attack.

Antibiotic resistance is a global concern: this week The White House unveiled a new plan to accelerate the research and development of new antibiotics by 2020 and introduce tighter regulations on the use of current drugs. With a global effort to control the increase in antibiotic resistance instead of being “cast back into the dark ages of medicine”, we’ll be propelled to the future where once a disease is tackled it stays that way.