'We use antibiotics to treat colds and runny noses! COVID-19 has relaxed us'

By 2050, humanity may be left without antimicrobials at all, because bacteria will become resistant to them

'We use antibiotics to treat colds and runny noses! COVID-19 has relaxed us'
Photo: Maksim Platonov

Antibiotics are a powerful weapon in the fight against infections, but with frequent and improper use it loses its effectiveness. At the press conference dedicated to the World Week of Proper Use of Antimicrobial Drugs, experts told about the main mistakes in the treatment of antibiotics and that very soon this type of drugs may disappear. Read the details in the material of Realnoe Vremya.

What antibiotics, nuclear energy and space have in common

Doctor of Medical Sciences, Professor, Rector of Smolensk State Medical University Roman Kozlov reminded that antimicrobials were discovered relatively recently and their use has significantly reduced mortality:

“Antimicrobials are one of the youngest classes of medicines... Penicillin, from the point of view of clinical pharmacology, was used incorrectly, in small doses. But it has already increased the survival rate of patients with pneumonia by nine times. Think about it, nine out of ten patients with pneumonia died! And the chance of a woman in labour dying during childbirth in the pre-antibiotic era was 20%. This is a brilliant discovery of humanity.”

According to Sergey Yakovlev, MD, Professor, President of the Alliance of Clinical Chemotherapists and Microbiologists, the discovery of antibiotics is one of the main achievements in the science of the 20th century:

“The first use of antibiotics began in the 1940s. This is one of the most significant events in the 20th century, and not only in medicine. I put it on the same level as nuclear fission and flight to space. The average life expectancy of a person on the globe has increased by an average of ten years — this is the merit of antibiotics and vaccines.”

Why are antibiotics losing their effectiveness?

However, experts note that microorganisms are able to adapt to the means of combating them. Over time, antibiotics become less effective, scientists have to improve them and try to create new ones.

“Bacteria evolve, their resistance evolves. From monoresistance to one class of drugs to polyresistance — resistance to three or more classes of antimicrobial drugs. And, finally, to pan-resistance — resistance to almost all drugs available in our arsenal," Roman Kozlov states.

Vladimir Kulabukhov, a leading researcher at the Sklifosovsky Institute, also focuses on the ability of microorganisms to adapt quickly. Because of this, there are doubts about whether it is possible to completely defeat infections.

“Microorganisms, being more plastic, came into the world much earlier than us. They have acquired the property of antibiotic resistance. The first drug-resistant microorganisms appeared quite quickly after the start of their use, and we began to produce drugs of other classes to which there was no resistance yet. But very little time has passed, and new enzymes appear that inactivate them as well. Antibacterial therapy is a life-saving technology, but it is a very dangerous technology in its consequences, in the consequences of the formation of resistance in microorganisms," Kulabukhov warns.

Scientists are concerned, because the consequences of microbial resistance threaten the achievements of modern medicine. If the effectiveness of antibiotics decreases, any surgical operation can be fatal.

“There are fewer and fewer new drugs, there was a period when there were no new antibiotics at all, while the old ones lost their effectiveness. The rate of emergence of new drugs is much lower than the rate of how we lost them in terms of clinical use. Without a doubt, medicine has stepped far ahead, new technologies have appeared, minimally invasive surgery, there are practically no contraindications to surgical operations. But antibiotic resistance is, perhaps, the most important obstacle that can slow down, or even throw back all these achievements. By 2050, if nothing is done, resistance will become the main threat, and the main lethality will be due to this very resistance. But this period may come much earlier," says Vladimir Kulabukhov.

“You can't take antibiotics as vitamins”

One of the reasons for the decrease in the effectiveness of antibiotics, doctors call their incorrect use. Experts assure that it is necessary to resort to treatment with these drugs only as prescribed by a doctor.

“Covid-19 happened two years ago. And a huge number of antibacterial drugs began to be used without indications. The WHO suggests a number of ways to contain resistance. First of all, these are outreach programmes for the population. People should understand that they shouldn't take antibiotics as vitamins. One shouldn't “finish” antibiotics for someone, you can not give them to your neighbours! It is necessary to observe hand hygiene, cooking, water safety and so on," says Vladimir Kulabukhov.

It is necessary to use antibiotics with great caution, and do it only when necessary, experts emphasise. But the population ignores these simple rules. Professor Sergey Yakovlev recalls that back in 2012, the World Health Organisation predicted a possible onset of the “post-antibiotic era” when bacteria will gain full resistance to all drugs.

“We use antibiotics to treat colds and runny noses! We still sell them in pharmacies without a prescription. Since 2019, over-the-counter control has been tightened, but COVID-19 has relaxed us again. Go to any pharmacy and you can buy any antibiotic. We do not fulfill doctor's appointments, forget to take medicine on time, sometimes we miss a dose, we decide when to finish taking it ourselves, we give harmful advice to our relatives and friends. And finally, we do not like to get vaccinated, and some are even active opponents of vaccinations. And who is to blame? We are all to blame!” said Professor Sergey Yakovlev.

Scientists note that the acquisition of resistance is a normal biological phenomenon, but the unreasonable and uncontrolled use of antibiotics accelerates this process so that manufacturers do not have time to create new effective drugs. Thus, the salvation of antibacterial therapy as a phenomenon depends on every inhabitant of the Earth.

Emil Ziyangirov
Analytics