For a few days this August, much of the news media in the West became convinced that we were headed back to the 1800s, medically speaking. A study in the September 2010 issue of British medical journal the Lancet argued that bacteria carrying genes for NDM-1, a gene that imparts resistance to a key family of antibiotics, had made their way through India and Pakistan into Britain and were now threatening to derail medical treatment across the developed world. Linked with the always shady-sounding concept of "medical tourism" -- the practice of traveling to other countries for budget surgery -- the so-called "superbug," able to breed vicious and deadly infections, became an instant media panic during a slow news month. The Drudge Report and Andrew Breitbart's news website both featured it. A Guardian science columnist wrote, "Now, the post-antibiotic apocalypse is in sight."
Er, not so much. As with most August stories, the reality of superbugs is a bit more complex than the media has portrayed it. Yes, antibiotic-resistant bacteria are a threat, as this week's news of an outbreak among premature infants in London reminds us. But no one yet knows how bad NDM-1-related infections could be. Not only is it far too early to say we're headed for apocalypse, we've also got a lot to learn from superbugs -- namely, how our own over-use of antibiotics is making it more likely that a superbug of the future could live up to this summer's hype.
Alexander Fleming discovered the first antibiotic by accident in 1928, when he left out a bacterial culture for a month while on vacation and came back to find that some of the bacteria had been killed by a fungus named Penicillium. By the early 1940s, a commercial product, penicillin, was mass-produced to cure bacterial infections in humans, and medical practice hasn't been the same since.
These days, antibiotics are a major weapon in medicine's war on disease, used to treat everything from life-threatening infections like meningitis to more run-of-the-mill ear infections. For more advanced medical technologies, like chemotherapy or organ transplantation, antibiotics are needed to prevent and treat infections while patients heal. Neither treatment would be possible without antibiotics.
At this point, in fact, antibiotics are suffering from their own success. They are so engrained in the medical and social culture that over-prescription is a major problem. Recent surveys have found that 70 to 80 percent of doctors' visits for sinus infections result in an antibiotic prescription. But most sinus infections are caused by viruses, and antibiotics don't cure viral infections.
The medical sin of antibiotic overuse goes beyond mere ineffectiveness -- it actually can be harmful. Here's how it works: Bacteria are everywhere on our bodies, even when we are not sick. When we take antibiotics for a bacterial infection, they only kill certain bacteria (usually the ones making us sick). Then, as the body gets better, the surviving bacteria multiply and take over. Now and then a few remaining bacteria carry special resistance to antibiotics -- which is what kept them alive in the first place. With the other bacteria out of the way, the resistant bacteria (i.e., the superbug) can multiply and sometimes cause problems. For example, if one of those superbugs causes an infection, some antibiotics won't work anymore, and then you have an infection that is more difficult to treat.