Evolution is racing, or why antibiotics stop working

Antibiotics stop working? Since the discovery of penicillin, humanity has been constantly conducting a kind of “arms race” with the world of bacteria, which have learned to adapt quickly after the advent of new antibiotics. And, alas, today in this race we have gradually begun to lag behind the opponent. In the face of the threat of being left helpless when new, “bulletproof” infections appear, scientists are stocking up on their trump cards up their sleeve. The problem is extremely acute – either to have time to find the optimal replacement for antibiotics in the next decade, or to plunge into the new Middle Ages, risking dying from the smallest scratch every day.

Fame and world recognition in science is a capricious and unpredictable thing. Many have heard the story of Alexander Fleming’s discovery of the first of antibiotics – penicillin – in which, it would seem, a trifling accident played a key role. In 1928, a mold fungus of the genus Penicillium accidentally got into a bacterial culture cup that was forgotten on the table in his laboratory, and Fleming noticed that the microbe colonies were dying (lysing) next to the mold plaque.

By the way, quite a lot of Nobel laureates, including Fleming, worked in the scientific departments of pharmaceutical companies

However, not everyone knows that penicillin was discovered several more times before Fleming, although with less success. 60 years before the events described, the English physiologist and part-time medical service officer Baronet Sir John Bardon Sanderson, in his report to the Cabinet of Ministers of Great Britain, mentioned a fungal mold that suppressed the spread of “microzymes” (as he called bacteria) in the tissues and fluids of living organisms. But a report is not at all the same as a publication in a scientific journal. Therefore, the data obtained by him did not become available to the general public.

A year later, inspired by the success of his colleague, Joseph Lister-professor of clinical surgery at the University of Edinburgh — thought that Penicillium glaucum (the same blue mold that is well known to cheese lovers) could serve him well as an antiseptic during operations. And I even tried it on a patient; then the questions of the ethics of such things were looked at somewhat more simply. The patient survived, but for some reason Lister also did not bother to publish the results of his experiment, and the scientific world did not know anything about it.

Since then, penicillium has repeatedly come to the attention of scientists who have systematically observed and described its ability to inhibit the growth of bacteria. Nevertheless, it was Fleming with his perseverance who managed to bring the matter to an end.

Since the mid-twentieth century, new antibiotics began to appear one after another, and at first they had high hopes. However, after some time it became clear that antibiotics stop working and a quick and final victory over infectious diseases with their help, most likely, should not be expected.

The world is on the threshold of a post-antibiotic era

As a result, after the launch of any antibiotic on the market, its effectiveness begins to decrease over time, tending to zero. Some bacteria today does not take almost anything. In the English-language press, the term “superbugs” was even coined to refer to strains resistant to several antibiotics at once. So, according to the results of a study published in January 2014, up to half of the cases of tuberculosis bacillus infection are accounted for by them.

antibiotics stop working

Once starting a large-scale use of antibiotics in clinical practice, humanity entered into an arms race with the world of prokaryotes, and continues to lead it to this day. Microbiologists, chemists engaged in organic synthesis, and pharmacologists have to constantly look for new molecules with stronger bactericidal properties or change something in the structure of existing ones. Of course, the methods of molecular design allow you to choose a molecule that will be longer or shorter than the original one, change its spatial structure and the number of possible conformations, increase or decrease the hydrophobicity and total charge, collapse into a ring or just randomly shuffle the structural blocks. With the help of computer modeling or artificial model systems, you can even try to calculate its behavior when interacting with the bacterial membrane and predict in which direction you should look. However, the human imagination is far from limitless, and it is already difficult for the opponent to keep up with updates in time. It will only become more difficult, and at some point the development of new antibiotics will simply end in an innovation crisis (some data, however, suggest that it has already come – antibiotics stop working).

Antibiotics stop working?

Can we win this race, in which bacteria have such a clear advantage? In fact, there are alternatives to antibiotics. Some of these drugs are at the stage of study, others are at the stage of clinical trials. Still others do not require medical intervention at all and are based solely on common sense.

Surprisingly, the epic battle of bacteria and antibiotics with an unclear ending was predicted by Fleming himself, speaking with the Nobel speech in 1945. He is also credited with a rather philosophical phrase that ” penicillin, of course, helps, but wine makes you happier.” And I must say, in some ways he is subtly right here.

Evolution is racing, or why antibiotics stop working

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