What would the world be like without antibiotics? | BBC Ideas

Our entire medical system really relies on antibiotics. This would be the biggest health crisis that we’ve experienced this century. We don’t hear about it. But it’s already here. Nobody is safe, until we’re all safe. What would a world without antibiotics look like? Well, I think it would look a lot like the past, where a lot of people would die younger than they do now. Just think about war – more people died of infections and their wounds, than died actually on the battlefield. The discovery of various classes of antibiotics in the 20th Century had a profound impact on health care. So treatment of infection suddenly became very straightforward, and it’s something that we benefit a lot from today. Antibiotics protect people during operative surgery – Caesarean sections, replacement joints, let alone cancer treatments. Antibiotics added, on average, 20 years life to everyone. We went to the hospital, the emergency room. They said they gave him a broad spectrum antibiotic. And then they took me to another room and they’re like, “Your son has an infection. We don’t know the source.” We were in the ICU with like 10 doctors, and they said he wasn’t really going to make it. At that point, I knew that he was dead. I could feel it. And that’s when we learned that Simon had contracted an antibiotic resistant bacterium, a superbug. And I had never heard of any of this. Alexander Fleming’s discovery of penicillin was immense. Noticing that in a petri dish where bacteria were growing, there were white areas where the bacteria were not growing. And he realised that something had happened. He looked and found the fungus, penicillin – our first effective antibiotic that saved masses of lives. Most antibiotics come from soil and fungi. When I expose bacteria to antibiotics, they’re going to become resistant, which is very bad because we haven’t discovered a new antibiotic in the last 30 years. Growing up back in Mexico, you didn’t need a prescription to get an antibiotic. You had a little bit of a sore throat, you go to the pharmacy and get an antibiotic. And that only gives more and more chances to these bugs to acquire mutations to become resistant. The situation today is more serious than people realise. It’s actually the first real study looking at all the data – 494 million patient records – to model what is happening. It is predicted that by 2050, 10 million people are going to die every year from complications with superbugs or resistant microbes. So we really have to find alternative strategies to fight against these bugs. A world without antibiotics – I sometimes call it “the post-antibiotic apocalypse” – would impact on our food chain too, because animals would get ill, plants would get ill and die. We would really be in the most dreadful mess. As an individual, I think one of the most important things is don’t ask for antibiotics if they are not offered to you. If you are prescribed antibiotics, then make sure you finish the course of antibiotics that you’re given. Because if you don’t finish the course, even if you’re feeling better, there might be some residual infection that could become resistant. We have probably found the easy-to-find antibiotics. But that doesn’t mean there are not many more to be found. If we keep recycling the same old treatments, then the problem is just going to exacerbate. One of the main bottlenecks with antibiotic research is that the easiest thing to do is to look at the structures of existing antibiotics, and modify those slightly to try to overcome the resistance. It’s much more challenging to find a completely new class of antibiotics. So we have to fund quite widely in order to be able to identify those strategies that are going to work best. I think if there were more awareness then there would be more general pressure from society on governments and on companies to fund more research into targeting this problem. We should be anticipating problems, and doing something about them before they become enormous global crises.

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