It’s no secret that the world is facing an antibiotics apocalypse; a world in which these lifesaving antibacterial medicines no longer work.

For too many years, we've overused antibiotics. It's been going on everywhere: in agriculture, because, among other things, they help us breed bigger animals; in medicine, to treat infections that may have cleared up on their own; or for viral infections, such as colds and flus, that antibiotics don’t help with at all.

The result has been a sort of antimicrobial resistance movement, culminating in the emergence of drug-resistant bacteria strong enough to kill.

Other issues, too, have contributed to the rise of antibiotic-resistant bugs. Poor hygiene in hospitals, for instance, help to spread infections, and a lack of new types of antibiotics has left us helpless in the face of resistant bacteria.

 Causes of antibiotic resistance
Image: World Health Organization

A world without antibiotics

Without antibiotics, we could be transported back almost a hundred years, to a time before the world’s first antibiotic – penicillin – was invented. Back then, even a tiny cut on your finger could lead to death. Things that we consider fairly routine today – major surgery, childbirth, cancer treatments – would be much more dangerous without the use of effective antibiotics.

A report published last year, the Review on Antimicrobial Resistance, estimated that by 2050, infections that are untreatable with antibiotics will kill 10 million people a year. And that doesn’t take into account the economic cost of people spending more time in hospital. The report, sponsored by the Wellcome Trust and the UK Department of Health in the United Kingdom, says it could cost the global economy $100 trillion by 2050.

 Total GDP loss
Image: AMR Review

But some UK scientists think they might have hit on an answer.

A new discovery

A team of researchers from Imperial College London and Nottingham University may have discovered a new weapon in the fight against drug-resistant bacteria.

Writing in Current Biology, the scientists recounted how they injected a bacteria called bdellovibrio bacteriovorus into zebrafish larvae that had been infected with an antibiotic-resistant strain of the shigella flexneri. Shigella is a bacteria which causes severe diarrhoea in humans, and is responsible for more than 160 million illnesses and over a million deaths every year. They found that the infection was greatly reduced, thanks to the bdellovibrio bacteriovorus having eaten the shigella bacteria.

"It may be unusual to use a bacterium to get rid of another, but in the light of the looming threat from drug-resistant infections the potential of beneficial bacteria-animal interactions should not be overlooked. We are increasingly relying on last-line antibiotics, and this innovative study demonstrates how predatory bacteria could be an important additional tool to drugs in the fight against resistance," says a press release by the Wellcome Trust.

"It’s an important milestone in research into the use of a living antibiotic that could be used in animals and humans."

What else can we do?

In the summer of 2016 the Review on Antimicrobial Resistance, jointly supported by the UK government and Wellcome Trust, highlighted four key recommendations for the fight against microbial resistance. Firstly, we needed a global public awareness campaign to educate people on the problem of drug resistance. Secondly, we had to create new drugs that could replace the ones that the bacteria had become immune to (we have developed no new classes of antibiotics for 25 years). Thirdly, we had to use antibiotics more sparingly in humans and animals, and a big part of this meant improving how we diagnose illness and prescribe the right antibiotic; and, fourthly, we had to reduce the extensive and unnecessary use of antibiotics in agriculture.

 Tackling antimicrobial resistance
Image: Review on Antimicrobial Resistance

A prize launched at Davos

At a panel event about diagnostics and global antimicrobial resistance (AMR), which took place at the World Economic Forum’s Annual Meeting in Davos in January, the UK’s chief medical officer, Professor Dame Sally Davies, announced a new £250,000 seed funding to drive innovation in rapid tests to help reduce antibiotic resistance.

The challenge is to create a cost-effective, accurate, rapid and easy-to-use test to diagnose bacterial infections so that the right antibiotics can be administered at the right time, she explained.

This comes a year after a declaration, at Davos 2016, by the pharmaceutical, biotechnology and diagnostics industries that they would combat antimicrobial resistance. Eighty-five companies and nine industry associations made a joint call on governments to work with them to develop new and alternative market structures that would provide more dependable and sustainable market models for antibiotics, and to commit the funds needed to implement them.