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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

The antibiotic resistance conundrum: Bugs already resistant to drugs that have not been invented

Continuing to expose the environment to mass quantities of antibiotics in agriculture and health care creates selective pressure to kill off susceptible microbes in favor of those naturally resistant to the drugs being used. And it’s not like the diverse dominion of bacteria need any help. Consider their overwhelming advantage expressed in sheer numbers.

“We are never going to defeat organisms that outnumber us by a factor of 1022, outweigh us by a 100-million fold, can replicate 500,000 times faster than we can, and have been doing this for 10,000 times longer than our species has existed,” said Brad Spellberg, MD, an infectious disease physician at Harbor-UCLA Medical Center in Los Angeles.

Spellberg is not a defeatist, but he can read the writing on the cave wall — microbes have ruled the earth for millennia while the antibiotic era is less than a century old. Indeed, he emphasized in a paper published earlier this year that microbes found in ancient underground caves were naturally resistant to antibiotics they could not have possibly been exposed to — synthetic drugs developed in the 20th century. “These results underscore a critical reality: antibiotic resistance already exists, widely disseminated in nature, to drugs we have not yet invented,” he noted.1


1. Spellberg B, Bartlett JG, Gilbert DN. The Future of Antibiotics and Resistance N Engl J Med 2013;368:299-302

For more on this story seen the November 2013 issue of Hospital Infection Control & Prevention.