GUT REACTION: How the most powerful treatment against bacterial infection is becoming obsolete

stew of bacteria constantly sloshes around in our guts. Most of it is supposed to be there, helping to digest food and absorb nutrients.

There are harmful bacteria as well that can cause infections, in the gut and all over the body. Before the use of antibiotics became widespread in the 1940s, maladies such as a sore throat or even a small cut that became infected could wind up causing death.

Antibiotics were (and still are) miracle drugs, but biology adapts, and in the 87 years since Alexander Fleming discovered penicillin, bacteria have continuously evolved, developing new defenses against attack. In fact, by 1946, 18 years after Fleming’s discovery, an estimated 14 percent of one particular bacterial strain was already resistant to penicillin. Since then, the dance has continued: scientists identified more antibiotics, and bacteria continued to evolve. But now, thanks to what some experts call unethical use of antibiotics in humans and animals, the multitude of varieties of bacteria may be outpacing our efforts to control them. Time may be running out for the world’s defenses against bacterial infections.

In 2014, the World Health Organization released its first report on the worldwide threat of antibiotic-resistant bacteria, saying that without a coordinated plan of action, we are headed for a post-antibiotic era.

For some people, that era is already here, says Dr. Guy Palmer, Regents Professor of Pathology and Infectious Diseases and the Senior Director of Global Health at Washington State University. According to a 2013 report from the Centers for Disease Control, 2 million people become infected with antibiotic-resistant bacteria every year, and at least 23,000 die from the infections.

“Antibiotics are an amazing part of medical history,” Palmer says. “But resistance to them by bacteria is also a fact. It’s inevitable, but the speed with which it occurs could be preventable.”

Consider the impact of a “post-antibiotic era” on health care as we know it: Procedures that define the heights of medical advances — such as bone-marrow transplants, cardiac bypasses and joint replacements — will become much riskier, possibly too risky to attempt; chemotherapy will become a challenge, as patients with weakened immune systems won’t be able to count on protection against infection; and people with common illnesses ranging from strep throat to gonorrhea to a urinary tract infection may no longer be able to go to the doctor, get a prescription and walk out confidently, assuming their symptoms will soon be gone. . .  reader_3