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MEDICINE Germ warfare threatens defenceless humanity

Antibiotics, once the saviours of humans and animals, are no longer providing protection and cure as overuse has lead to germs developing resistance. What’s to be done? asks PETER FROST

Antibiotic materials and substances have been used for centuries to treat infections, although we didn’t know that many infections were caused by bacteria.

Until the 20th century, bacterial infections that we now consider straightforward to treat like pneumonia were the largest cause of human death.

Various natural materials including honey, moulds and plant extracts had long been used to treat infections by some of the earliest civilisations . The ancient Egyptians, for example, used mouldy bread applied to infected wounds.

Mainstream medicine still uses honey to pack and dress ulcers and other open wounds. It still has remarkable curative powers.

In the Champagne caves of France workers never seemed to suffer from as many common coughs and sneezes as other folk. We now know that the cotton-wool-like fungus that lined the roofs and walls of the caves was, in fact, wild penicillin.   

It wasn’t until the late 19th century that scientists began to observe and understand antibacterial chemicals in action.

In 1909, German physician Paul Ehrlich discovered that a chemical called arsphenamine was an effective treatment for syphilis.

The word antibiotic would not arrive for another 30 years. It was coined by Ukrainian-American inventor and microbiologist Selman Waksman who discovered a score or more antibiotics.

Alexander Fleming is more usually put forward as the father of modern antibiotics — his discovery of penicillin is put down almost to an accident.

Upon returning to his lab at a Paddington hospital from a holiday in Suffolk in 1928, Fleming noticed that a fungus, Penicillium notatum, had contaminated a culture plate of Staphylococcus bacteria he had accidentally left uncovered. The fungus had killed the bacteria on the plate.

Fleming may have kept an untidy lab, but he was a good enough scientist to realise he was onto something important. He grew more of the penicillin mould in his Petri dishes and found it proved extremely effective at killing germs even at very low concentrations. It prevented Staphylococcus growth even when diluted 800 times.

Just as important it was less toxic than the coarse often coal tar-based disinfectants used at the time.

After early trials major pharmaceutical companies started mass production of penicillin. Treatment with what was soon called a wonder drug started to become hugely successful.

By D-Day in 1944, penicillin was being widely used to treat troops for infections both in the field and in hospitals throughout Europe and, by the end of WWII, penicillin had saved many lives.

The sale of post war black-market penicillin in war-torn Europe became such a scandal that Orson Welles made it the subject of his film masterpiece The Third Man.

Oxford scientists Howard Florey and Ernest Chain shared the 1945 Nobel Prize in medicine with Alexander Fleming for their role in creating the first mass-produced antibiotic.

Medical science is desperate today to find the next great anti-bacterial medicine, a new and effective antibiotic or some other way of killing infections.

The World Health Organisation (WHO) is warning that too few antibiotics are in the pipeline to tackle the growing global crisis of drug resistance.

There is a frightening increase in almost untreatable infections around the world, with a quarter of a million deaths every year from drug-resistant tuberculosis alone.  

Only half of TB patients globally are successfully treated, mainly using the only two new antibiotics for the disease that have reached the market in the last 70 years.

Now our own NHS is using newspaper and television advertising to encourage patients not to demand antibiotics as a first and every time solution to simple health problems.

New drugs are being researched and developed but nowhere near enough. We are relying on one of these drugs currently in development being able to treat the diseases caused by what are becoming drug-resistant germs.

Even when we discover new antibiotics and prove they work, it still takes a long time to get the new drugs approved and onto the market.

One major problem is that we are using the antibiotics we have far too widely. The spread of internet drug trading means it is easy to buy all types of antibiotics — even ones being reserved to treat rare and difficult infections — without medical supervision. If you have the money, you can get the drugs.

Unprincipled farmers, particularly in the US, are still using unregulated antibiotics for quick fattening of all kinds of meat with no thought for the disastrous long term effects that will have on future antibiotic use in fighting disease.

The drugs the farmers use are often the same ones used to treat human infections. For example, in the US more than 70 per cent of antibiotics that are medically important for humans are also used in animals.

This form of antimicrobial usage is likely to rise.

Properly used, antibiotics are essential for treating infections in animals, but excessive and inappropriate use of the drugs is wrong.

Worse, many antibiotics are used in healthy animals to both prevent infection and speed up their growth. This is particularly the case in intensive farming, where animals are kept in confined and potentially unhealthy conditions.

Some last-resort antibiotics for humans are being used extensively in animals and there are no replacements currently on the way.

What is to be done? We need to establish a global target to reduce or completely end antibiotic use in food production.

We need keep a careful eye on pollution in antibiotic manufacturing. Far too much waste is released into the environment.

Most importantly, we need to keep our present antibiotics to do important work in keeping humans healthy and not as a get-rich-quick scam for those seeking bigger profits from the beef inside the next burger.

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