I’ve written in previous blogs (here, here and here) about the increasing danger of drug resistant bacteria—that one day we may find that certain bacteria have evolved to be resistant to ALL known antibiotics and that the so-called “Golden Age of Antibiotics” may be coming to an end.

Medical experts are increasingly concerned that today’s most powerful and most often used antibiotics are sometimes not effective against common infections of the urinary and respiratory tracts. They suggest that at some point people may die from these common ailments, just as it was in the early 1900s. Minor infections may become life-threatening crises, and pneumonia and TB may be much more difficult to treat.

Drugs develop resistance to antibiotics in two simple ways: 1) mutations happen in the bacteria genomes to allow them to withstand antibiotic attacks, and 2) bacteria become infected with small pieces of foreign DNA that carries a gene for antibiotic resistance (sort of like jumping from one bug to another).

Much of the drug resistant bacteria studies indicate that overuse of antibiotics in common products such as household cleaners and hand sanitizers can lead to mutations that make bacteria resistant to antimicrobial therapies. Other studies indicate that antibiotics used to wash produce and those used at animal farms are overused and can lead to drug resistant strains of bacteria.

The end result is that bacteria present in our environment eventually become resistant to some of our commonly-used antibiotics. The antibiotics that are used to grow our food and those added to cleaning products eventually lose their effectiveness when prescribed to treat serious infections.

In recent years, drug resistance has increased at a greater rate than the development of new antibiotics to treat these drug-resistant microbes. In situations where commonly-used antibiotics are no longer effective, healthcare providers are turning to some older antibiotics to treat these super bugs.

One such older drug that’s getting a second look is colistin (polymyxin E).  It was first developed in Japan in 1949 and became available for clinical use in 1959, primarily for the treatment of gram-negative infections (E. coli, salmonella, pseudomonas, helicobacter, legionella, and a few others bacteria). Although colistin is an effective antimicrobial agent against these stubborn bugs, colistin fell out of favor when newer, more effective drugs with less side effects became available.

These newer, safer and more effective replacements for colistin, however, are presently used to prevent such contamination in food products and to sanitize kitchen and bathroom surfaces, as well as being used in hand sanitizers. The abundant use of these once-effective antibiotics have allowed certain bacteria to develop resistance through mutations and DNA transference.

Therefore, medical professionals are beginning to use older drugs, like colistin, to effectively treat drug resistant infections such as CRE, a super bug that is reported to kill up to 50% of infected patients.

The news regarding the successful use of colistin is not all rosy, however. The very first case of a colistin-resistant bacterial infection has reached the United States. A 49-year-old women in Pennsylvania has contracted a colistin-resistant urinary tract infection. Fortunately, her doctors were able to treat her with other antibiotics and she will survive.

The battle to keep an arsenal of effective antibiotics available is rapidly losing ground to evermore drug-resistant bacterial strains. I sometimes wonder who will win the battle!

Thoughts? Comments? I’d love to hear them!