Losing war on bacteria

The war between antibiotics and the bacteria they kill is taking a turn for the worse, says Dr. Ligia Pic-Aluas of the Washington Hospital Center.

Dr. Pic-Aluas, an epidemiologist with the District hospital, echoes the concerns of some in her field that more bacteria are becoming resistant to our best medicines.

These “superbugs” won’t be fooled by the same old antibiotics, in part because for years doctors overprescribed existing antibiotics and, in turn, patients clamored for the drugs even when they weren’t needed.

The U.S. Food and Drug Administration reports that diseases such as gonorrhea, malaria, tuberculosis and childhood ear infections all are becoming harder to treat because of increasing levels of antibiotic resistance.

Doctors often are required to use a potent antibiotic to treat sick patients, when in the past, a mild medication would do. That threatens to make the stronger medication more open to resistance in the future, which one day could rob physicians of a vital weapon against disease.

Doctors already have changed some of their attitudes toward dispensing antibiotics, and patients, too, are beginning to use them more rationally. It still may take some time, however, before the war shifts back to favor science.

The more we use antibiotics, Dr. Pic-Aluas says, the more we “select out the organisms resistant to it. We’ve exacerbated the problem by using more and more antibiotics.”

Part of the problem is that in an increasingly mobile society, bacteria can travel from one coast to the other in the time it takes to fly cross-country.

“Once it shows up in one place, it takes no time for it to show up in another place,” she says.

Dr. Pic-Aluas says researchers once were able to create new antibiotic drugs to counter many resistant bacteria. Today, few new medicines are being counted on to stave off tomorrow’s bacteria. The process, alas, isn’t quick or inexpensive.

“Creating one takes 10 years to bring to the market,” she says. “The problem with antibiotics is they have a short life.”

Worse, she says, drug companies don’t have as much incentive to create them because they require plenty of funding and can be made obsolete, in some cases within a short time frame.

A bacteria like streptococcus, also known as strep, never became resistant to penicillin, the first antibiotic, she says. Staphylococcus, however, became resistant to it in a short period of time and then, one by one, it became resistant to other drugs, so it’s never certain when a bacteria strain will become resistant to a particular drug.

“There’s a lot of genetic change required [for bacteria] to become resistant,” she says.

Plus, a potentially helpful new drug may have side effects that make it impractical to administer.

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