Dear antibiotic pill popper,
How have you been?
A few weeks have passed since our last encounter, and yet, I have to admit, that day still lingers in my mind. The way your eyebrows furrowed as you ranted about how the Dutch under-prescribe medication. How you bragged about a doctor from back home giving you all sorts of antibiotics for you to bring back. And how kindly you offered to share them in case I ever felt burdened with a simple common cold; Ah, what a day!
I must confess that the motive behind this letter is not purely to reminisce; I am also writing to deliver some good and bad news. Maybe I’ll start with the bad: you will be dead by 2050. At least most likely. The cause? Antibiotic resistance.
I hope you know this isn’t just me being macabre for shock value; I would never dare be so careless with your health. I’m telling you this because you’re part of the problem.
If you’ve scrolled through news sites in the last few months, you’ll have seen talks of drug resistance, superbugs, and the “silent pandemic” killing millions.
Last December, a World Health Organization (WHO) report indicated global “high levels of resistance in bacteria”. Such resistance has increased the complications of bloodstream infections as well as very common E. coli-related infections, like urinary tract infections.
And just last month, at a media briefing, the WHO’s Director-General, Dr. Tedros Ghebreyesus, stated that “antimicrobial resistance threatens to unwind a century of medical progress.”
I know what you’re going to say: But I have such a great stash of antibiotics. Surely one of them should work? Well, it turns out modern medicine is not so simple.
Bacterial infections are treated with antibiotics, which can kill or inhibit bacterial growth. The bacteria with better mechanisms to defend themselves will be more likely to resist antibiotics, and thus be able to continue to grow or spread. Survival of the fittest, if you want to get Darwinian about it.
A significant cause of this increase in antibiotic-resistant bacteria is the overuse or misuse of antibiotics. Like when a doctor you know from back home prescribes antibiotics for you to bring back to the Netherlands when the “overly-cautious” doctors here deny any antibiotic treatment. Ring any bells?
If I may be so bold, let me anticipate what you’re thinking again: Why not just make new antibiotics? Genius! But again, not so simple.
It takes about a decade on average for new antibiotics to move past the preclinical stage. On top of that, only a few of the antibiotics that are in development during that time actually succeed in being approved for use. And even when they finally hit the market, bacterial resistance is usually reported within 2 to 3 years. Let’s just say that the lengthy procedure and the low success rates don’t make the production of new antibiotics the most economically appealing.
However, I have to acknowledge that you did get one thing right: Dutch doctors are very resistant to prescribing antibiotics. In fact, in the past, the Dutch were even ranked lowest in antibiotic use within Europe. But this is precisely one of the strategies that have made antibiotic-resistance a not-so-severe issue in the country, according to the Institute for Public Health (RIVM).
The problem with antibiotic-resistant bacteria is that it doesn’t stop at borders, and simply being more cautious about their prescription is not enough.
I hope you don’t see this letter as a simple memento mori. After all, as promised, there is some good news. Multiple national and international organizations are already set in place to try to address the issue and with a bit more financial commitment to antimicrobial resistance research, including antibiotic resistance, they might just put a stop to this doomsday clock.
Oh, and let us not forget, that even if you are one of the victims of antimicrobial resistance, you won’t be alone! Back in February, the UN estimated that by 2050, up to 10 million people will die annually due to antimicrobial resistance. Of these 10 million, many will be part of more vulnerable groups, including diabetics like me.
But hey, at least you didn’t have to suffer from a little cold right?