Antibiotics – the molecular atom bombs
When Alexander Fleming discovered the antibiotic in 1928, he did not yet know that he had scientifically implemented what the ancient Egyptians, Chinese and Indians had already known long before him. The healing effect of molds had already been known to them and they had used it to rub wounds to make them heal. Alexander Fleming had discovered the bactericidal power of the mold Penicillium notatum and, after some initial difficulties, antibiotics began their triumphal march around the world.
With antibiotics, it became possible for the first time to specifically fight the major epidemics of our time: all bacteria-based diseases suddenly lost their sinister horror. Whether cholera, plague or leprosy – infections that had been fatal for thousands of years could suddenly be cured.
The mechanism of antibiotics
The action of antibiotics is based on one of three mechanisms in each case:
A. Antibiotics interfere with the cell wall synthesis of bacteria and thus suppress their growth.
B. Antibiotics can affect the protein synthesis of bacteria and prevent the production of enzymes and cell components needed for growth and cell division.
C. Antibiotics interfere directly with the cell division of bacteria.
Modifications of antibiotics became necessary
Today’s antibiotics are usually no longer purely natural products, but have artificial added chemical modifications. Many antibiotics are now even purely synthetic products and, according to the original definition, are no longer antibiotics at all. What they have in common, however, is their antibacterial effect.
The modifications became necessary in order to be able to survive as long as possible in the race against the bacteria. Where there is an antibiotic, there will also be resistance. Due to the short generation times of the bacteria, i.e. the time a bacterium needs to duplicate itself, which in the shortest case can be 15-20 min, there is a good chance that a mutation will be introduced that will give the bacterium an advantage in the face of antibiotic selection pressure. It can continue to multiply despite the antibiotic and is now the carrier of resistance. When a bacterium is resistant, it is the carrier of genetic information that codes for a protein that makes the microorganism no longer vulnerable to that antibiotic.
In the case of treatment, this can lead to massive problems. In many cases, an acquired infection can no longer be treated with antibiotics due to resistance. In addition, an infection with antibiotic-resistant germs acquired primarily in hospitals can lead to serious problems. Methicillin-resistant Staphylococcus aureus bacteria (MRSA) are an example of this. In many cases, an infection with these resistant microorganisms can no longer be treated successfully and leads to death through multiple organ failure. A harmless knee and hip operation can then quickly lead to the grave – without there having been a dangerous indication originally.
Antibiotic resistance on the rise worldwide
These resistances, which are either anchored directly in the bacterial chromosome or on a plasmid, i.e. a genetic element that is not part of the actual bacterial chromosome, can be multiplied and also passed on. If the bacterium grows and divides, one cell carrying the resistance gene can very quickly become millions or even billions of cells. If the single bacterium with the resistance gene could not cause any damage, millions or even billions of bacteria may well do so. If this resistance is found on a pathogenic, i.e. disease-causing, bacterium, the bacterium can spread during an infection without being able to be fought by the corresponding antibiotic. Resistance is a real problem that is continuously increasing worldwide.
What are the reasons for the resistances?
There are three main reasons for the global increase in resistance:
1. Increasing use of antibiotics in symptomatic treatment.
Antibiotics are used far too quickly in the care and treatment of patients today. There are two main reasons for this.
First, the physician, in the short time available for treatment, wants to take the least risk and ensure the highest success for the patient . Delayed antibiotic therapy, first relying on conventional reduction of infection, is usually associated with prolonged therapy for the patient. At the same time, the risk for the physician to receive complaints from the patient or even lawsuits is lowest when antibiotics are used-if their use is indicated.
Secondly, very few patients are willing to rely on conventional remedies. In many cases of infection, conventional “home remedies” can be used to control the infection. However, the patient wants “immediate” help to reduce pain and shorten the length of treatment. There is also the psychological moment: the patient wants to have the “good feeling” that the doctor has done something for him. He has that when he leaves the practice with a prescription for medication. If, however, the doctor were to explain to him that he should treat his infection and its future prevention by means of conventional home remedies such as inhalation, bed rest or even a change in diet and exercise, the patient would in most cases see another doctor.
2. Use of broad-spectrum antibiotics
Broad-spectrum antibiotics are antibiotics that act against a huge group of bacteria. Their advantage is that they can be used even if the pathogen is not precisely known. This is especially important when it is a matter of life and death and there is no time for a specific diagnosis. However, this is rarely the case. Ideally, the specific germ would be analyzed precisely and then, an antibiotic developed precisely for that purpose would be used. The problem here, however, is detection. In many cases, the pathogens cannot be analyzed using conventional methods such as cultivation; instead, molecular methods such as gene probe technology or PCR must be used. However, these are only paid for by health insurance in exceptional cases. In addition, doctors and patients usually do not want to wait, but want the “quick” solution. The risk of selecting the wrong antibiotic is also massively reduced, since broad-spectrum antibiotics cover a large group of pathogens. For the pharmaceutical industry, broad-spectrum antibiotics are again of great advantage. While the development of a specific antibiotic is very costly and perhaps only several thousand packages could be sold per year, the market for broad-spectrum antibiotics is immeasurably larger. Instead of developing 20 different specific antibiotics and marketing each to a small target group, an unspecific broad-spectrum antibiotic is developed and sold to hundreds of millions of patients.
3. Use of antibiotics in animal production
But the use of antibiotics for human patients is only of secondary importance for the pharmaceutical industry. Approximately 70 – 80 % of all antibiotics are sold to the animal industry. Whether cattle or chickens – everywhere many animals are confined in the smallest space to increase margins. Diseases or death of the animals can be reduced to a considerable extent by the continuous administration of antibiotics. Furthermore, the feeding of antibiotics in subtherapeutic amounts leads to an increase in the live weight of the animals by 10-15%. The “yield” for the same amount of feed is thus higher. It is true that the use of antibiotics to increase liveweight is now banned in many states. However, cost pressure and profit optimization lead many farms to continue using these methods.
The mass use of antibiotics in turn leads to a further increase in resistance. Through the animals, not only the antibiotics reach the consumer’s plate but also the resistant bacteria. A study in the USA, for example, showed that more than half of all meat samples collected in supermarkets contained antibiotic-resistant germs. The antibiotics themselves also reach the consumer through the animal industry via the meat and water, leading to a further increase in resistance. Even if consumers claim never to have taken an antibiotic in their entire lives, the likelihood is very high that they have already ingested antibiotics in significant amounts via the factors mentioned above. In the U.S., children and adolescents receive an average of 17 antibiotics by the time they are 20 years old. By the time they reach the age of 40, they receive an average of another 13 antibiotics, so that the average 40-year-old American has already consumed 40 packages of antibiotics. And that’s without any other effects from the animal industry. Given these facts, the threatening global increase in antibiotic resistance is anything but surprising.
The genie from the bottle
However, research over the past 1-2 decades indicates that perhaps the increase in resistance is the smaller problem caused by antibiotics.
Our microbiome, the totality of all bacteria that live in and on us, is massively affected by antibiotic treatment. The reason lies primarily in the use of broad-spectrum antibiotics as described above. These not only eliminate the harmful bacteria that caused the infection, but also destroy to a large extent the beneficial bacteria that perform essential functions in our body.
The beneficial bacteria in our microbiome affect our bodies in a variety of ways:
1. They break down substances that humans cannot break down and make this energy partially available to them
2. They produce substances that are used in the human organism
3. They are part of various regulatory circuits in the human body
4. They suppress the growth of harmful bacteria
This is explicitly not only about the bacteria in the intestine, the intestinal flora, but about all bacteria in humans. If the microorganisms are partially killed by antibiotics as collateral damage, this has dramatic effects on the body. Nowadays, it is assumed that modern civilization diseases such as diabetes in children, obesity, asthma, food allergies, reflux, autism, cancer and many more are triggered by a microbiome altered by antibiotics.
The genie, the antibiotics, were let out of the bottle. And it will be very difficult to catch him again.
The molecular atom bomb
Today’s findings show that in many cases an antibiotic does not completely eradicate the harmful bacterium, but that it is suppressed below the detection limits. Here it then leads a more or less miserable existence. Bacteria must multiply in order to cause damage in the human organism. The healthy microbiome flora, e.g. in the intestine, prevents this. Humans harbor a multitude of pathogenic microorganisms. The notion that all infection is external, i.e., “becoming infected” with a pathogenic agent, is outdated. Instead, we carry a variety of pathogens within us that can only achieve vigorous growth when the immune defenses are weakened and, as the new findings show, the microbiome, e.g., the intestinal flora, is de-stabilized. This then leads to the bacteria themselves then causing damage in the human organism or via their toxins.
An antibiotic can be compared to an atomic bomb that leaves tremendous damage in our microbiome. By weakening the “good” intestinal flora or other places that are part of the human microbiome, “bad” bacteria can take control and lead to serious diseases. Even if the microbiome tries to return to its original state, in some cases it is difficult or impossible to do so.
A frightening example is Clostridium difficile. This anaerobic bacterium waits patiently for its chance in the intestines of a good third of people. If there is a massive impairment of the microbiome, C. difficile seizes its chance in a blink of an eye and multiplies to such an extent that it can no longer be pushed back by the other bacteria of the intestinal flora. In severe cases, its toxins perforate the intestinal wall and the patient dies.
A change in thinking is needed
In order to address the problem of resistance, a change in thinking must be required. Antibiotics must no longer be used en masse in animal production. Patients must no longer be prescribed antibiotics for infections based on viruses. Unfortunately, this is still the case for preventive reasons, the keyword being secondary infections. Antibiotics should not be used as a precautionary and preventive measure, but only after careful consideration of the advantages and disadvantages. Otherwise, resistant bacteria will remain an increasing threat and antibiotics can no longer be used for truly life-threatening diseases due to the multitude of resistances.
The multitude of civilization diseases caused by a destruction of our microbiome, and especially our natural intestinal flora, by antibiotics, must be brought more into the public focus. We must recognize that the serious diseases are not only triggered by an unhealthy fat and far too carbohydrate-rich diet, but are supported or even caused by a change in our microbiome. We must be willing to acknowledge and address this as a real problem. Otherwise, the new diseases will continue to grow and threaten humanity at an increasing rate. (JS)
Martin J. Blaser, Missing Microbes; How the overuse of antibiotics is fueling our modern plagues, Henry Holt and Company, New York.
Header: Peter Jurik – stock.adobe.com