The 'return of our old enemies in an untreatable form'

Mellon said the general public has a mistaken sense that there will always be options when an infectious disease does not initially respond to treatments — that doctors will somehow just raise the level of drugs, switch to a different drug, or try a combination of drugs if one doesn’t work. But the classes of antibiotics are limited, and new classes aren’t being developed. (Beyond the scientific difficulties, two hurdles are frequently cited: pharmaceutical companies not interested in the relatively low profits yielded by new antibiotics, and idiosyncrasies in the FDA drug-approval process as applied to antibiotics, see box).

“We’re scrambling,” Mellon said. “In some cases enough antibiotics don’t work that you can get to a point where there’s nothing left on the shelf.”

Antibiotic resistance, she continued, “will be a gradually accumulating kind of weight on our medical system that will increase costs, increase suffering, and decrease the tools we have, and finally that weight will get us.”

“People will die of these infectious and we won’t be able to treat them at all,” Spellberg said, adding that infectious disease will “drag down the average lifespan and result in a lower quality of life.”

The “return of our old enemies in an untreatable form”

Ellen Silbergeld, professor of environmental health sciences and epidemiology at Johns Hopkins University’s Bloomberg School of Public Health, said the majority of new infectious diseases that have emerged in the last 40 years are caused by drug-resistant bacteria.

“E. coli is not new, salmonella is not new, staph is not new,” Silbergeld said. “But what is new are strains of these old pathogens that are now resistant to almost all classes of drugs that we can throw at them. It’s a return of our old enemies in an untreatable form.”

Alexander Fleming, who won the Nobel Prize in 1945 for his discovery of penicillin, warned in his acceptance speech of the danger of antibiotic resistance and the need to safeguard the drugs, Silbergeld said.

“Instead we did the opposite,” Silbergeld said. “Having been warned, having this knowledge, how could we permit the enormous range of unnecessary uses of antibiotics that we’ve done?”