It’s a nightmarish scenario. If our antibiotic wonder drugs lost their effectiveness against infections, health care would be cast back to where medicine was before Howard Florey discovered a way to mass manufacture penicillin towards the end of World War Two.

Rising public health standards and public awareness of the need for clean food and water in the United States saw a decline in the death rate attributed to disease from 800 per 100,000 head of population in 1900 to 150 in 1940.

Today’s Situation

Today’s figure hovers around 60 800 per 100,000 population and much of the credit for the sharp increase in public health is attributable as much to the level of public awareness as it is to our new and better antibiotic. Based on that model, the worst-case apocalypse is the death rate from infectious diseases might revert to its pre- antibiotic level of around 100 per 100,000 head of population.

While that would be grim, on a community level the Centers for Disease Control estimate that approximately 23,000 Americans are killed by antibiotic-resistant infections each year. Death s due to antibiotic-resistant infections is particularly prevalent amongst the elderly and those already in poor health. If that figure were to spike by a factor of 10, it would place infection related deaths on par with those caused by lung cancer and use of oxygen concentrator for therapy. That would be desperately unfortunate but falls well short of the definition of an apocalypse.

Simple Preventative Measures

Although it seems some level of antibiotic resistance is going to be with us for the foreseeable future, there are some simple public health steps we can adopt to limit its potential impact. These are:

• Cease adding antibiotics to livestock feed immediately
• Halt the prescription of antibiotics for diseases such as colds, which are almost always viral and unaffected by antibiotics
• Introduce a premium-pricing scheme for antibiotics to incentivise the pharmaceutical firms to develop new forms of antibiotics
• Replace the current physician model of writing prescriptions based on educated guesses with a regime of low cost, rapid testing kits to identify different forms of bacteria and establish their susceptibility to antibiotics

In themselves, these measures are unlikely to return us to the 1950-1990 pre-superbug ‘Golden Era’. However, they might just wind back the accelerating levels of antibiotic resistance amongst bacteria with its subsequent impact on the effectiveness of our health system and the human and financial costs associated with countering infections.

All that is required it seems is the will power and political support to implement them.oxygen concentrator for therapy

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