Why the 'war' against bacteria is the wrong strategy

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Increasing numbers of antibiotic resistant bacterial infections in South Africa and across the world are everybody’s problem.

The loss of working antibiotics affects how we may need to treat you for what used to be straightforward everyday infections, how we prevent you getting infected when you need treatment for cancer, transplantation, HIV and other immune suppressing illnesses.

It also threatens your chances of having a successful surgery if more wounds become infected and can’t be treated.

The dramatic global increase in antibiotic resistant bacterial infections has led to rallying cries to ‘fight’ back and wage ‘war’ against antibiotic resistant bacteria. But fighting bacteria is definitely the wrong strategy.

Here’s why:

Bacteria and other microorganisms comprise the earliest life on Earth, found as microfossils in Australian rocks dating back 3.5 billion years.

Bacteria (and fungi) in soil produce antibiotics, chemicals that give bacteria a competitive advantage for the resources they need by killing off the competition. Soil bacteria and fungi are the origins of most antibiotics we manufacture today.

READ | There’s another pandemic we should be focused on: Antibiotic-resistant infections

The upshot of all of this is that the more antibiotics we use, the more antibiotic resistant bacteria will gain the advantage and cause infections that are harder to treat. But then again, we have to use antibiotics to treat infections.

Antibiotics should only be used for infections caused by bacteria - such as bacterial pneumonia, urinary tract infections and bacterial meningitis.

The sad truth is that we have been using and abusing antibiotics to treat any number of non-specific symptoms and non-bacterial infections – viruses such as the common cold and most diarrhoeal illnesses are just two examples – against which antibiotics are about as useless as a 3-pin plug for a 2-pin socket. All they do is create more antibiotic resistant bacteria and cause unwanted side effects in those taking them.

Moreover, what happens in humans happens in animals. We have abused antibiotics in food production systems to get animals to market quicker, generating antibiotic resistant bacteria in animals that can enter humans via the food chain.

Also, antibiotic manufacturing plants have been pumping waste containing antibiotics and their products into the environment, increasing the cycle of resistance build up in the soil and waterways.

This in turn can affect food production animals and humans. In the next article in this series, we will explore the ‘One Health’ (human, animal, and environmental) aspects of antibiotic resistant bacteria, and how when you misuse antibiotics, it can affect others.

But for now, know that: the ‘war’ or ‘fight’ is not against bacteria, but against humans who misuse and abuse antibiotics to an extent that 1.3 million people died due to antibiotic resistant bacterial infections in 2019.

We are killing ourselves because of our own folly. If we are to limit this in the future, we are going to have to radically change the status quo.

Marc Mendelson is Professor of Infectious Diseases and Head of the Division of Infectious Diseases and HIV Medicine at Groote Schuur Hospital, University of Cape Town.

Read the original on GroundUp here.
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