Antibiotic resistance – an impending pandemic
Antibiotics are substances that kill or inhibit the growth of bacteria. Most are produced by microorganisms such as fungi and even other bacteria.
In medicine, they are used to combat bacterial infections, which used to be the most common cause of death.
It is important to note that antibiotics are only useful against bacteria and not against viruses, so diseases caused by viruses, such as influenza or colds, are not only not treatable with antibiotics, but counterproductive.
The first antibiotic discovered was penicillin, and this and other antibiotics that followed have saved countless lives. But when they are used carelessly and abusively, bacteria manage to survive them through sheer evolution by becoming resistant to their effects.
This means that bacteria that were once sensitive to a particular antibiotic become less so by developing mechanisms that allow them to survive the antibiotic attack.
Today, there are countless bacteria that are resistant to not one, but several antibiotics and are called multi-resistant bacteria. Even more alarming, there are bacteria that are resistant to all available antibiotics and for which there is no treatment. These are the pan-resistant bacteria, or superbugs, and they are the ones that will cause the great pandemic of this century if we do not take action.


Bacteria have powerful adaptive strategies against antibiotics:
- Vertical gene transfer from parent bacteria to daughter bacteria.
- Horizontal gene transfer, in which two unrelated bacteria transfer genetic material to each other, allowing them to rapidly acquire antibiotic resistance genes. They do this in several ways:
- Transformation: taking the genes that allow them to survive directly from the environment.
- Transduction: Where phages or viruses that infect bacteria can act as vehicles for antibiotic resistance genes.
- Conjugation: In which a plasmid or circular DNA molecule transfers antibiotic resistance genes between contacting bacteria.
- Integron: When attacked by an antibiotic, the integron is activated and rearranges the genes to find the antibiotic resistance gene needed for survival.
It is estimated that by 2050, antibiotic-resistant bacteria will cause more than 10 million deaths per year worldwide.
We are fast approaching a scenario in which the antibiotics we know today will be less and less effective in fighting infections, and the consequences could be on a scale we have not yet imagined. We would be talking about a world where a knee injury could be fatal. Surgery or a transplant would be mission impossible. Fighting pneumonia would be a losing battle.
This problem has been brewing for years and is currently responsible for more than 33,000 deaths per year in Europe alone, costing the healthcare system around 1.5 billion euros.
According to the World Health Organization, there is an urgent need to change the way antibiotics are prescribed and used, because even if new drugs are developed, bacterial resistance to antibiotics will continue to pose a serious threat to the entire world if current behaviors are not changed.
These changes in behavior must include measures to reduce the spread of infections through vaccination campaigns, hand washing, safe sex, and good food hygiene.
We must always remember that antibiotics are restricted drugs and must be prescribed by the treating physician. They have side effects that can cause serious health problems for those who deliberately take them, not to mention bacterial resistance to antibiotics, which creates so-called superbugs that become immune to treatment, allowing diseases that cannot be controlled and can lead to death.
The deliberate, excessive, and inappropriate use of antibiotics is one of the main causes of this resistance problem, for which we all share responsibility. The solution is in everyone’s hands.