Maryn McKenna – one of the better science journalists out there – is the culprit this time.
One might argue in her defense that she is simply relaying the views of a top expert, in this case Kevin Outterson of CARB-X who said “…every antibiotic we count on now will be destroyed…antibiotics will be crushed.”
But Outterson is hardly a disinterested expert. He runs an organization dedicated to developing the tools – new drugs, vaccines and diagnostics – to combat the very real problems caused by antibiotic resistance. It is funded by both governments and NGOs, and it is part of Outterson’s job to keep the funds flowing. Saying “It’s not a problem that can be solved but is one that can be managed” is not how you do a job like that.
Nor, of course, is that how you generate clicks (and thus revenue) for your articles.
I’ve argued (here, here and here) that antibiotic resistance is not an apocalypse but a problem to be managed.
The first step in managing the problem is to change its framing, or paradigm, if you will. Much of the medical community, and nearly all of the journalists who report on this issue, take it for granted that the only way we can use antibiotics is the way that we have always used them. That is, to prescribe broad-spectrum antibiotics on the basis of signs and symptoms alone, with no microbiology data, and then expect them to work all the time. Anything other than that is a crisis.
But those days are gone and they are not coming back, not ever.
Narrow-spectrum antibiotics and the rapid diagnostics required to use them are the future of effective antibiotic use. CARB-X knows this, as they are funding a number of projects in both of these areas.
Narrow-spectrum antibiotics will allow us to treat infections effectively without disrupting our microbiomes and suffering collateral damage to our health. Dificid for the treatment of recurrent C. difficile diarrhea, is an early example.
Antibiotic usage, particularly in infancy, has been linked to increased risk of a host of metabolic and autoimmune disorders. If this linkage turns out to be real, then the transition to smart prescribing of narrow-spectrum antibiotics might well result in a significant improvement in overall health: even a few percent reduction in obesity rates would drastically reduce the toll from diabetes, colon cancer and cardiovascular disease. These diseases kill far more people than antibiotics save (vaccines and clean water are much more important in preventing infectious disease deaths).
We would never make this transition absent the threat of rising rates of antibiotic resistance. In the end, perverse as it sounds, antibiotic resistance might actually improve public health.
That’s a story that I would click on.