Saturday, August 29, 2009

rising plague

The Scientist | How do you look the family members of a critically ill patient in the eyes and tell them that their loved one is going to die because there are no drugs left to treat their illness? I'm an infectious diseases specialist. I'm not supposed to have to bear such bad news to patients or their families. I expect to cure my patients' infections, and their families and friends hope that I can. It's been that way ever since the 1940s, when penicillin burst onto the scene. But this is the 21st century, and things are different now.

The discovery of antibiotics in the mid 20th century was nothing less than a revolution in public health and medicine. It was a revolution as significant to human civilization as the discoveries of Isaac Newton or Thomas Edison's first light bulb. Physicians trained in the era immediately preceding the dawn of antibiotics learned how to resign themselves to the fact that they could not change the course of their patients' illnesses in most cases. Their job was largely to make an accurate diagnosis so they could relate the unalterable prognosis to the patient. In an instant, antibiotics changed all that by empowering physicians to eradicate diseases with aplomb. What a stunning power to acquire!

How ghastly then, having acquired this brilliant power, to watch helplessly as it shrinks back into history, leaving us once again at the mercy of even the most mundane microbes. That's the reality that we're facing now. Rising Plague is a fervent plea -- in the words of the poet -- that we not let antibiotics "go gentle into that good night."

In my latest book I describe how the relentless escalation of antibiotic resistance has created a critical need for new antibiotics. Just when we need it most, the discovery and development of new antibiotics is dying. I share with you real patient stories to underscore that the loss of effective antibiotics is not a hypothetical problem. Antibiotic resistance is killing thousands of people every year, and devastating their families. I know this because I have seen it first-hand.

The antibiotic problem didn't take shape overnight. And one can't blame physician misuse of antibiotics for all of our problems. Despite how widespread that belief is, it does not reflect reality, and it serves as a poor foundation for effective response planning.

We instead must alter our worldview of antibiotics and bacteria. Bacteria have been creating and defeating antibiotics for 20 million times longer than humans have known of the chemicals' existence. We will never stop antibiotic resistance from occurring.

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