Just 70 years after the introduction of antibiotics, a 20th-century gift to humanity that can cure many would-be killer diseases, the world is now facing a new problem: antibiotic resistance.
Antimicrobial drugs, known as antibiotics, are medicines that fight bacteria by killing or stopping their growth. Before the discovery of penicillin in 1928, people all over the world had been waging a losing battle against bacterial diseases such as meningitis, pneumonia or post-operative infection.
According to a 2016 study by the U.S. National Center for Biotechnology Information (NCBI), before the 20th century, the average life expectancy at birth was 47 years, even in industrialized countries. But soon after the advent of antibiotics, that figure rose to nearly 80 years. With the use of antibiotics, the leading causes of death switched from communicable diseases to non-communicable ones such as cardiovascular disorders, cancer and strokes.
No antibiotic is a cure-all
"Antibiotics aren't painkillers or antipyretics. Due to widespread misconceptions, people tend to use antibiotics to fight the cold and flu," says Yeliz Demirci, a physician specializing in family care in Aksaray, central Turkey.
"Infections such as influenza and cold aren't caused by bacterial infections, but rather by viruses, so using antibiotics to treat these won't help, as they have no effect on viruses," she added.
Demirci admits that while antibiotics are life-savers, they must be used to combat the right disease, at the right time, and for the right duration. "No antibiotic can cure all diseases. Each antibiotic acts on a different bacterium. The area upon which each antibiotic is effective is limited. In other words, antibiotics used to treat throat and lung infections can't be used for urinary tract infections, as they have no effect there. Not all antibiotics can be used to fight all diseases," she explained.
The groundbreaking discovery of antibiotics, unfortunately, has led to a major health threat due to improper use, and thus, bacteria that was once susceptible has since become resistant to antibiotics; like an enemy that knows your next moves beforehand.
Demirci claims that the unnecessary or incorrect use of antibiotics can cause bacteria to develop resistance to subsequent drug treatments.
"This condition, known as 'antibiotics resistance', refers to the event by which bacteria with heightened abilities, or superbugs, grow and infect despite the presence of antibiotics," she said.
Superbugs' resistance to antibiotics poses a danger not only to the person improperly using the antibiotics, but to anyone at risk of subsequently being exposed to the resistant bacteria.
"With this resistance, antibiotics can be rendered completely ineffective, infectious diseases can't be cured, and even a simple infected wound can result in death. Unnecessary and incorrect use of the antibiotics may have serious consequences in the future," Demirci said.
The World Health Organization (WHO) has warned that antibiotic resistance is rising to dangerously high levels in all parts of the world.
"New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases," said the U.N. agency. "A growing list of infections, such as pneumonia, tuberculosis, blood poisoning, gonorrhea and food-borne diseases, are becoming harder, and sometimes impossible, to treat as antibiotics become less effective."
Furthermore, while antibiotics are effective in curing a number of diseases by killing harmful bacteria, Demirci said beneficial bacteria in our bodies that defend our intestines, skin, genitalia, and other systems can also be killed in the process.
"The killing of beneficial bacteria in our body through antibiotics means that we lack the support we receive from these beneficial bacteria, which, unfortunately, paves the way for the growth of other harmful bacteria," she said, adding: "This leads to opportunistic infections, such as diarrhea and fungal infections. The healing of these disorders also has adverse affects on the individual, depending on their immune system."
Demirci said antibiotics should only be used when prescribed by a physician and at the right time and in the right way. "Only in this way can disease-causing bacteria be destroyed and resistance development prevented," she said.
"Bacteria gain resistance to antibiotics that they encounter a lot, or encounter at an inadequate time and dose. This is a change in the genes of the bacteria. This resistance is transmitted from bacteria to bacteria through genes, but it occurs between bacteria. There is no transfer from parent to offspring. If people encounter these resistant bacteria, an antibiotic that was once effective will no longer work due to increased resistance," she says.
Although inappropriate use of antibiotics is a global problem, the reasons for higher or lower resistance rates differ according to the amount of use, underlying diseases, quality of hospital care, immunization rates, and social factors.
Although people in developing countries are still dying due to lacking the required antibiotic treatment, on every continent there is concern about resistance arising from improper use.
According to a 2018 Organization for Economic Co-operation and Development (OECD) report, "Stemming the Superbug Tide," around 2.4 million people could die in Europe, North America and Australia by 2050, due to infections caused by superbugs unless more is done to stem antibiotic resistance.
The study states that three out of four deaths from superbug infections could be avoided by spending only $2.58 per person a year on steps as basic as hand-washing and administering antibiotics more prudently. According to 2015 OECD data, Turkey ranks seventh in resistance proportions for eight priority antibiotic-bacterium pairs, at 38.8%, following India, China, Russia, Romania, Indonesia and Peru. The situation is much more dire in India, with 57.1% of people already having developed resistance to eight major antibiotics.