Two years ago, Bobbie Mackeon got a paper cut. She thought it was no big deal.
But it got infected. Bobbie, a nurse practitioner, spoke with the doctors at her hospital, and they all figured an antibiotic would take care of it.
It didn’t. Nor did the next two antibiotics she tried. “The bug that was in there was eating these antibiotics for breakfast,” she says.
With her infection still raging, Bobbie turned to an intravenous antibiotic, which finally did help. But complications then led to potentially fatal blood clots. “The blood clot was about four inches across and it had little bubbles around it, which told us it was infected,” she says.
The clots were so severe that her life now depends on high doses of blood thinners, which created new problems. Any injury can now be life threatening, because it is difficult to stop her body from bleeding. Now, instead of running as she used to, she works out, carefully, in her garage.
That a tiny infection could spiral into a life-threatening condition doesn’t surprise Michael Shnayerson or Mark Plotkin. In their new book, “The Killers Within,” they explore why antibiotics don’t work the way they used to. Susan Spencer reports.
“The bad news is the bad bugs are getting badder faster. They’re getting stronger faster,” says Plotkin.
“We no longer live in a time when antibiotics work 100 percent of the time and in fact there are some bugs resistant to all the antibiotics used against them. And people are dying,” says Shnayerson. Even common staph infections, once easily cured, now can kill. The superbugs, which first showed up in hospitals, are everywhere.
The culprit: overuse of antibiotics. Like all living things, bacteria adapt to the environment. Faced with an antibiotic, a few hearty bugs survive. Those superbugs then multiply, creating a new strain that the old antibiotic can’t touch.
The more antibiotics used, the more the bacteria evolve. After five decades, Americans have been using and now overusing these "wonder drugs."
“Too many doctors still feel that antibiotics basically do no harm. And that i'ts better to give them than not,” says Shnayerson.
Patients demand them even for colds - viral infections against which antibiotics are useless. Adding to overuse is agriculture. Farmers use antibiotics in feed, mostly to make the animals grow a little faster. According to Plotkin, a recent study estimates that farms use 70 percent of all antibiotics in the U.S.
“I think were looking at the end of the antibiotic era if we don’t start changing our behavior,” says Mackeon’s colleague, Dr. David Witt, an infectious disease specialist at Kaiser Permanente in California.
Most chilling, Witt says, is the rising rate of resistance in one very common bug, pneumococcus, which causes most cases of pneumonia, ear infection, and sinusitis. “Everybody gets them. All of your kids have had them,” Witt says.
When Gail Mullin’s 3-week-old daughter, Hollie, got her first ear infection, Gail, like many mothers, asked for antibiotics. But more infections followed. And the antibiotics kept coming: amoxicillin, augmentin, zithromax, receptin - 17 different courses in one year. By the time Hollie was 18 months old, she contracted a bacteria that was resistant to every oral antibiotic available.
Her only hope was a drug called vancomycin, a potent antibiotic given intravenously. The doctor told her it was the last option.
Hollie was lucky. Vancomycin did work. Her parents learned a lesson. “By giving Holllie as many antibiotics as we did by the time she was a year old we created a superbug,” says her mother.
Vancomycin saved Mackeon as well. But now she struggles with the blood clots. Despite efforts to regain her health, Bobbie has been unable to work for much of the past two years.
“Bobbie is a good example of the worst-case scenario,” says Witt. He expects to see many more such cases, which is why he carefully checks and rechecks every antibiotic ordered at the hospital.
“I don’t want to give you the wrong impression. I love antibiotics. They are life-saving, they are miracles. And I want to save them for when we need them,” he says.
There is some good news. A new study finds that doctors are ordering fewer antibiotics for children. But experts estimate that there’s still are tens of millions of unnecessary prescriptions being written each year.
Now even Vancomycin is losing its punch. This prospect is “chilling,” Witt says.
But could there be alternatives to antibiotics? Old technology from the former Soviet Union may hold a surprising answer.