What would a world without life-saving antibiotics look like?

These days we don’t think much about the possibility of having access to antibiotic treatment to prevent infection. But this has not always been the case: antibiotics have been available for less than a century.

Before that, patients died from relatively insignificant infections that became more serious. Some serious infections, such as those involving the heart valves, have been inevitably fatal.

Other serious infections, such as tuberculosis, were not always fatal. Up to one half people died within a year with the most severe forms, but some people recovered without treatment and the rest suffered from a persistent chronic infection that slowly ate away at the body for many years.

Once we had antibiotics, the outcomes of these infections were much better.

Life (and death) before antibiotics

You’ve probably heard of Alexander Fleming’s accidental accident discovery of penicillinwhen fungal spores landed on a plate containing bacteria over a long weekend in 1928.

But the first patient Receiving penicillin is an instructive example of the impact of treatment. In 1941, Officer Albert Alexander had a scratch on his face that became infected.

He was hospitalized but despite various treatments, the infection progressed to reach his head. This required removing one of his eyes.

Howard Florey, the Australian pharmacologist then working at Oxford, feared that penicillin was toxic to humans. Therefore, he felt it was ethical to give this new drug to a patient in desperate condition.

Agent Alexander received the available dose of penicillin. From the first day, his condition began to improve.

But at the time, penicillin was difficult to produce. One way to expand the limited supply was to “recycle” the penicillin excreted in the patient’s urine. Despite this, supplies ran out on the fifth day of Alexander’s treatment.

Without further treatment, the infection returned. Constable Alexander ultimately died a month later.

We now face a world in which we risk running out of antibiotics, not because of manufacturing difficulties, but because they are losing their effectiveness.

What are antibiotics used for?

We currently use antibiotics in humans and animals for a variety of reasons. Antibiotics reduce the duration of illness and the risk of death from infection. They also prevent infections in people at high risk, such as patients undergoing surgery and those with weakened immune systems.

But antibiotics are not always used appropriately. Studies consistently show that a dose or two will adequately prevent infections after surgery, but antibiotics are often continued for several days unnecessarily. And sometimes we use the wrong type of antibiotic.

Investigations found that 22 percent of antimicrobial use in hospitals is inappropriate.

In some situations this is understandable. Infections in different parts of the body are usually caused by different types of bacteria. When the diagnosis is not certain, we be mistaken exercise caution in administering broad-spectrum antibiotics to ensure we have active treatments for all possible infections until more information is available.

In other situations, there is some inertia. If the patient’s condition improves, doctors tend to simply continue the same treatment rather than switching to a more appropriate choice.