In The Age of Antibiotics
In The Age of Antibiotics
In The Age of Antibiotics
Thesis statement: Throughout its age, the antibiotic, if understood and used properly, can continue
to aid man’s health and attest to the wonderful world in which he lives.
2. Production of penicillin
3. Extraction of streptomycin
A. The definition
1. Detection of target
a. Cell wall
b. Cell membrane
a. Ribosomes
b. Nucleic acids
c. Proteins
A. According to source
1. Natural
2. Semisynthetic
3. Synthetic
1. Bacteriostatic
2. Bacteriolytic
1. Broad-spectrum
2. Narrow-spectrum
C. Superinfections
1. Bacterial resistance
2. Microbiome upheaval
D. Supergerms, or superbugs
E. Limited targets
1. Following prescription
a. Right schedule
b. Right dosage
3. Preventing diseases
1. Culturing
2. Extracting
3. Processing
1. New kinds
2. New sources
1. Probable successors
a. Probiotics
b. Bacteriophages
Humans inhabit a world of infinite wonders. Indubitably, they tread on a raw and priceless
gem that awaits its coarse conundrum surfaces to be unraveled and its brilliant beauty unveiled.
However, the tools of mankind were proven to have only merely scratched the surface of this
globular jewel, for, not more than a century ago, a “surface wonder” was discovered. It was the
wonder drug now known as antibiotic. Contained by humble, microscopic mold spores already
drifting in the air humans themselves breathe, the antibiotic has unquestionably testified to more
mysteries left unearthed in this awesome world and altered the shape of medicine into an
unparalleled, more lustrous fashion. Its wonder is affirmed, even before the age of antibiotics.
The antibiotic finds its precursors in the ancient ways of treating infections dating back to
1500 B.C. The Chinese and Egyptians during this time used moldy and fermented products to treat
wound infections. For so long they would have dressed with bread molds infected wounds, which
would sometimes heal, sometimes not.1 Because ancient people believed that diseases were caused
by bodily dysfunctions and demonic curses, early doctors and tribal societies interchanged magic
and medicine. Thus, treatment of infections also included herbal medicines, rituals, and sorcery.2
However, on the brink of the Middle Ages, Christian influence on medicine established a more
human body, as well as treatment of infections and diseases. During this time the nature of
pathogens began to unfold and apprehension of it drastically improved.4 In the late 17th century,
man gained a wide scale of understanding of bacterial infections when the great French chemist
Louis Pasteur first discovered what he called bacteria. He also devised theories and made effective,
Lemuel Angelo M. Rayel, 2
helpful techniques and treatments out of this discovery.5 Since then, early modern science and
medicine have never been the same, and both turned the majority of their attention towards fighting
Scientists who succeeded Pasteur developed hundreds of drugs that successfully killed
harmful pathogens, yet they faced a rather disturbing and dangerous dilemma—substances of such
ability would have also proven fatal to the infected patient. Because of the need for drugs that
would be selectively toxic, the German bacteriologist Paul Ehrlich developed a theory about a
“magic bullet” and worked on it. In 1909 his works and experiments led him to develop
arsphenamine (which he called Salvarsan), the first cure specifically designed for a disease, which
is the deadly syphilis.6 Although Salvarsan, being arsenic-based, proved too toxic for widespread
use, the pioneering work of Paul Ehrlich aroused the interests of other scientists to search for that
magic bullet.7
In the fall of 1928, a Scottish bacteriologist named Alexander Fleming indeed accidentally
found a magic bullet—marking the dawn of the antibiotic age. For study purposes Fleming was
culturing colonies of the disease-causing bacteria Staphylococcus aureus on Petri dishes filled with
a medium (gelatinlike food for cultures) when one day a green mold grew in one of the dishes.
Instead of deeming it a ruined science experiment, he examined the phenomenon and noticed a
halo around the mold where no bacteria grew. He soon discovered that a chemical produced by
the mold had killed the bacteria and could also kill many other types of bacteria. He then injected
the substance in mice, and to his astonishment, they showed no signs of harm or hurt. Fleming
called this same chemical, which was derived from the molds of Penicillium genus, penicillin, the
This extraordinary breakthrough gradually led to the debut of the antibiotic as a medical
“superweapon”. In 1934 Gerhard Domagk, a German physician, synthesized the first sulfa drug,
or sulfonamide, that was used to treat streptococcal diseases.9 As for the premier antibiotic,
although Sir Alexander Fleming in 1928 proved that penicillin killed harmful bacteria without
harming the infected, it was not yet proven that it could actually treat diseases because of the
difficulty in extracting it in large amounts—until 1941.10 13 years after penicillin was discovered,
the team headed by Howard Florey and Ernst Chain mass-extracted it and also proved its efficacy
even when diluted a million parts to one.11 Then in 1943 Russian-born American microbiologist
Selman Waksman isolated another potent antibiotic called streptomycin from a fungus of
Streptomyces genus and developed a cure for tuberculosis.12 Waksman was also the one who
This term, “antibiotic,” comes from two Greek words that mean “against life.”14 This is
actually quite befitting as antibiotics are substances derived from microbes that hinder the spread
of or decimate bacteria, fungi, and other microbes that harm the body.15 Antibiotics differ from
antimicrobials in that the latter are laboratory-synthesized substances based on the by-products of
certain microorganisms. Both are now used interchangeably to mean any substance that fights
infectious microbes.16 In addition, medicines such as sulfa drugs, popularly called “antibiotics,”
are really “antibacterial agents,” which is the technical term for drugs that are completely
synthetic.17
The mechanism of action of antibiotics begins with the detection of their target. Antibiotics
are able to target both prokaryotic (without nucleus; e.g. bacteria) and eukaryotic (with nucleus;
e.g. fungi, yeasts) cells.18 Because prokaryotic cells also contain cell walls, and most of today’s
antibiotics focus their offenses on these cells, the bacterium will be used as an example. However,
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the process is almost identical to the eukaryotic cells. Antibiotics selectively attack bacteria by
being drawn to a substance or process in that bacteria that is absent in human cells. Thus, they
greatly harm the invaders, but should deal very little damage to the host.19
After antibiotics lock their target, they stop them in two ways. They destroy the bacteria
from the outside or inside. From the outside antibiotics detect the unique chemicals and molecular
composition in the bacteria’s cell walls. Then they prevent the construction of those walls so that
they die from the harsh environment.20 They can also cause leaks in the bacterial cell membrane,
Furthermore, antibiotics attack from inside by entering bacterial cells and disrupting their
chemical processes. They can bind to and attack the bacteria’s protein factories, ribosomes, which
are also chemically unique from human ribosomes. They can trap the bacteria’s nucleic acids, stop
the retrieval and duplication of their genetic information, and disable their ability to reproduce.
Also, some antibiotics, such as sulfa drugs, imitate the building blocks used by bacteria to generate
necessary substances, such as folic acid, for its basic processes. The bacterial cells make a mistake
into choosing the sulfa drug, folic acid cannot be made, and the bacteria soon die from the
abnormal chemical process.22 After they finish their job, antibiotics are filtered from the blood by
the kidneys and liver and then expelled from the body through urine and feces excretion.23
The attack method of each antibiotic may widely differ, but they can still be classified in
three ways—the first being apropos to the source of antibiotics. Those that are purely produced
from natural sources, such as penicillin, are called natural antibiotics.24 When these natural
antibiotics are chemically altered, semisynthetic antibiotics are produced. These partly nature-
made, partly man-made drugs can be easier to intake or have more lasting effects in the body.
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They, too, such as ampicillin, (a more powerful derivative of penicillin), can fight wider ranges of
bacteria.25 Finally, as scientists learned that some antibiotics have very simple chemical structures
and can be produced more easily by using laboratory chemicals than by isolation from microbes,
How antibiotics counter microbial infections is another way to classify them. Antibiotics
could be bacteriostatic, meaning they impede bacterial growth long enough for the body’s immune
system to build its offenses and fight off the infection.27 Examples of these are chloramphenicol,
also called bacteriolytic antibiotics,29 actually kill the bacteria.30 They include neomycin,
Antibiotics can finally be classified according to their range of activity, that is, their
effectiveness against two different types of bacteria: gram-negative and gram-positive bacteria.
These two divisions concern the chemical composition of bacterial cell walls. Broad-spectrum
antibiotics, such as ampicillin and tetracycline, affect both types of bacteria.32 Contrary to this,
narrow-spectrum antibiotics are those that affect only gram-negative bacteria, like gentamicin, or
The efflorescence of these “wonder drugs” seemed inevitable. Their budding stage finally
over, antibiotics of all kinds were soon ensconced in every medical cabinet. The gift of nature
enhanced by man’s scientific and technological intervention has certainly saved millions of lives
since then. However, although antibiotics were created not to affect humans in any negative way,
they do have limitations and adverse effects induced by nature and by man as well.
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One natural aftereffect of antibiotics in some people is allergic reactions. These occur when
the body overreacts at a certain allergen that has entered the body—in this case, an antibiotic or a
substance formed by the chemical reaction of a blood protein and the antibiotic. The overreaction
is translated in the body as production of too much histamine into the bloodstream. In normal
amounts, histamine is produced by the body to counter or regulate an allergen. However, the
Reactions include skin rash, asthmatic symptoms, shock, other typical allergic reactions,
or worse, death. One to ten people out of a hundred who take penicillin suffer allergies. In addition,
according to the National Institute of Health in the United States, 90% of drug allergic reactions
are caused by only three drugs, two of which are antibiotics.35 Thankfully, although all antibiotics
can cause allergic reactions, only a few people are susceptible to these.36
Antibiotics can also cause damage to human tissues and organs. Although they are selective
in attacking only bacterial cells, their chemicals could still react with those of the body’s, causing
unwanted side effects. Antibiotics, especially in pill form, may induce upset stomach or diarrhea
a few days after they have been taken. They can also damage the kidneys and liver where they are
filtered. Damages to these organs may be slight, and tissues can easily be repaired. These are,
Of course, neither antibiotics, nor natural bodily defenses are the only ones to blame for
health mishaps on antibiotic intake. The abusive human consumers also perform a huge role in a
tragic pogrom play called superinfection. Superinfections occur when antibiotics, especially the
broad-spectrum ones, kill too many bacteria, including commensals, which are bacteria that are
beneficial to the body. After this “holocaust,” thousands of unaffected, dormant bacterial spores
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would hatch or a few malignant survivors would multiply in enormous numbers, yet only a few
commensals would be able to limit this cataclysmal growth.38 Apparently, these virulent
superinfections are harder to control and cure, seeing they involve stronger bacteria that are more
drug-resistant.39
the gut where humans’ “fellow roommates” mainly thrive, the sudden demise of commensals will
cause abnormal effects in the body. Two related effects are weight gain and obesity. This antibiotic
aftereffect is taken advantage of by farmers who raise livestock and by pediatricians whose infant
patients are underweight. In fact, an experiment conducted in 1954 by Naval Medical Research
Unit on marine recruits showed that those who took placebos (pharmacologically inert drugs)
gained 2.7 kilograms, but all those who took antibiotics gained up to 4.8 kilograms!40
The theoretical reasons behind these results are astonishing as the results themselves. One
assumption is the extermination of the bacteria Helicobacter pylori in the gut. Now H.pylori causes
serious gastric and duodenal ulcers in abnormally large populations in the body, but when
regulated, they hamper the production of ghrelin, a hunger-inducing hormone. However, since the
advent of antibiotics, the bacteria have never been detected in more than 90% of children in most
Another theory is the overgrowth of other bacteria, after their competitors were
bacteria overgrowing in the gut may increase an inflammatory response in adipose tissue, ramping
up fat storage and weight gain.”42 These reasons contribute to the increasing health cases of people
cardiovascular diseases.43 Superinfections are truly threatening phenomena inside the human body,
Sad to say, infections do not need to enter the “super” stage for bacteria to become resistant.
They can be resistant, not only through overuse, but also through the simple continuous exposure
to antibiotics.44 Resistant bacteria return to war armed with newly developed defenses and
equipped with substances that can by-pass attack systems and subdue those that men call
“champions.” The results would render the antibiotic outnumbered, impotent, and down on its
Resistant bacteria began to drastically increase in 1940’s when antibiotic popularity and
human ignorance led to the use of antibiotics on diseases that those drugs could not cure. One such
example of sheer folly is using antibiotics for the common cold and sore throat, which are viral
infections! Then, in the 60’s and 70’s, it was accidentally discovered that little quantities of
antibiotics added to animal feeds improved animal health, growth, and mass. Today, animals raised
for human consumption consume almost half of all the produced antibiotics in the United States
alone! Resistant bacteria that result from the said practice could be transferred to other animals
Bacteria become resistant by undergoing micro-evolution. This means that they adapt to
antibiotic offenses—practically similar to what happens when people are vaccinated. Resistant
bacteria can then impart and spread their newly acquired ability by exchanging plasmids (a type
of DNA) with others, by collecting DNA pieces from dead bacteria, and by simply bequeathing
their traits to their progeny.47 Because of these and the smaller world in which everyone is
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somehow interconnected, it is not far-off that bacteria that are resistant to multiple antibiotics,
In reality, in 2015, one of the most shocking news from China pervaded the medical world
that day: resistance has already developed against Colistin. Colistin is a powerful antibiotic—
powerful as there was virtually no resistance against it. This was because it was very seldom used,
being potentially harmful to the liver. Notwithstanding, it was a perfect last-resort drug and bane
for resistant bacteria—but not anymore, and the feeding of Colistin to Chinese livestock for many
antimicrobial resistance has already killed 23,000 people in 2017 in the United States alone.50
What’s more horrifying is that according to scientific studies, superbugs could kill more people in
Superbugs and other resistant bacteria can change the composition of their cell walls so
that antibiotics who should invade them could not get in. They can pump out and “vomit” the
drugs. They can confuse the antibiotics and switch the molecules that allow then to be located as
targets. They can even retaliate by producing substances that will destroy the drug before it
destroys them.52
The very first antibiotic, which erstwhile held the names “magic bullet” and “wonder
drug,” can already be neutralized by several bacteria that produce penicillinase,53 a type of beta-
lactamase enzyme.54 β-lactamase disables certain antibiotics that carry the integral molecule, β-
lactam, by dismantling that same compound through hydrolysis.55 In fact, the first bacteria to fall
under antibiotic might, Staphylococcus aureus, can already resist the penicillinase-insensitive
methicillin, giving rise to the term “methicillin-resistant Staphylococcus aureus” (MRSA). Now
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MRSA refers to S. aureus bacteria that are immune to all kinds of penicillin—the same bacteria
that cause tens of thousands of people across the world each year to ruefully bite the dust.56
The limitations of antibiotics do not end there, for another serious quagmire arises. The
targets of antibiotics are very mostly limited only to bacteria. This is because the cellular structures
of other microbes, such as fungi and parasites, are very similar to those of humans. Also, on the
case of viruses, they attack the body by invading and taking over human cells, so killing them may
also involve damaging human cells.57 There is some glint of light here, in that some antibiotics,
such as erythromycin and tetracycline, can fight large viruses or cure virus-caused inflammations.
Furthermore, a few antibiotics, such as metronidazole, can treat parasitic and protozoal
infections.58
Scientists and health officials have laboriously addressed to these progressing problems by
devising solutions that all people need only follow, for the safety and potency of antibiotics are at
stake. Following prescription is crucial in assuring the treatment AND safety of the patient. If the
medication is too financially hurting, one can find generic equivalents of the drug.59 Sticking also
to the treatment duration and dosage is important. Helen Signy, a writer for the magazine Reader’s
Digest Asia, explained, “Feeling better does not mean that all the bacteria have been killed or that
an infection has been totally eradicated.”60 Partially treated infections such as streptococcal ones
Talking to the doctor is a must. The patient should tell him about other medicines he is
taking, whether they are simple food supplements, prescription drugs, or over-the-counter drugs.
A doctor must be informed of any allergic reactions, health history and status, and troubles in
medicinal intake (e.g., trouble in swallowing or remembering to take medicine).62 This is important
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because antibiotic chemicals can interact with other chemicals in drugs, food, and blood, causing
side effects or allergic reactions.63 Doctors will then change or stop the prescription, if this is so,
to prevent further adverse repercussions. Of course, if one really wishes a virtually drug-free life
and escape these dreadful impediments, he must practice healthy lifestyle and abstain from
prevent unnecessary drug intake, milk and food supplies should constantly be monitored for
antibiotic content.66 Doctors should avoid overprescription of antibiotics, especially on mild cases
of infections. In addition, the American Medical Association suggests that using normal cleansers,
such as alcohol, and soap may be better than using antibacterial handsoaps and wipes, especially
those which have no credible names. Because the latter two may not be potent enough or are not
left on the skin long enough, they tend to leave a residue that would only kill the weaker bacteria,
but leave the stronger ones to grow and even resist therapeutic antibiotics.67
The resistant microbial strains should be eliminated at once to stop its spread. The instant
that a resistant microbe is detected, health officials should alert health providers and doctors so
that they can control its spread and, if possible, terminate its existence. 68 Another method in
controlling bacterial resistance is to combine two or more different antibiotics. Doing this would
make it harder for the resistant bacteria to avoid the dual offenses of the drugs, lessen the chance
of side effects because of the decreased dosage of each individual drug, and reduce the likelihood
Cooperation and coordination with the doctor must be observed ritually. If one complied
with the schedule and dosage of treatment, bacteria would be “properly” eliminated and not
provided the help they need to drastically spread and adapt.70 On the other hand, in cases of
diagnoses of viral infections such as bronchitis, stomach flu, or common cold, one should early
ask his physician of the possibility of a non-antibiotic prescription.71 Thus, superinfection and drug
Most of the time, however, these devised solutions are not completely promulgated and
followed, due both to ignorance and obstinacy. Because of these the number of cases of resistant
bacteria has never been so high. Right now, even more digits are constantly being added to the
present figure. This fearsome, yet true fact does propel scientists to continue and intensify both
After the ushering of the antibiotic age through Sir Fleming’s work, the limitations of
antibiotics subsequently became apparent, instigating worldwide expeditions for new antibiotics
and widespread endeavors to produce more refined kinds of these drugs. As was noted before,
penicillin was not readily usable for more than a decade after its discovery in 1928. Since England
was at war with Germany, factories were not available for mass extraction and production of
penicillin. So, Florey and Chain, along with other English scientists, asked the United States to
lend a hand. Soon, it was discovered that the penicillium mold can grow on and inside the
medium.73
Combining efforts, resources, and intellect, the two powers catalyzed the inception of
produce large amounts of pure penicillin—up to more than 6,000 kilograms at that time. It certainly
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was an opportune moment in 1945, when antibiotic treatment was a tremendous need and lifesaver
for the soldiers and other affected people during the Second World War.74 Later penicillin
production boomed further and its availability to consumers skyrocketed to great heights when
scientists isolated the drug from a high-yielding penicillin mold.75 As a result of these series of
technique in culturing microbes. Breeding is done in large culturing vats, called fermenters, which
stir the medium so that the mold can multiply in it.76 After a strain has been cultured, the substance
produced by billions of microbes is extracted.77 Of course, synthetic drugs do not follow this
fermenting procedure; they are, on the contrary, synthesized in laboratories.78 After the isolation
stage, the extracted substance can be processed to improve and develop its chemical composition.79
The succeeding stage involves the testing and production standardization processes. All
quality maintenance, etc.—should undergo thorough technician examinations. These should also
pass through government standardizations, though the methods may vary in each country.80 This
being done, the pharmaceutical company will package the produced antibiotics, which may be in
In a rather special event of a discovery of a new antibiotic, scientists and/or health officials
will first test it on experimental organisms such as rodents to ensure its safety and efficacy.82 After
animal tests they will test the new drug on humans. In the United States, this testing consists of
three phases. In the first phase, the drug is tested on 20-80 people. Results from this phase
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determine the toxicity of the drug in humans, the reaction of the body to the drug, and the dosage
The second phase involves 100-200 people, each with the same particular disease. This
phase measures and deems the effectivity of the antibiotic in favor of the patients’ conditions and
against the disease. In the third phase, the new antibiotic is tested on thousands of patients. This
final stage seeks to further establish the safety, effectiveness, and dosage of the antibiotic when
used on a wide scale. After the results of these three phases is tabulated and considered, drug
authorities, based on their findings, would decide whether to permit the production of the new
drug, or not.84 In summary the development and tests combined would take about 10 years for the
Other testing methods commonly used on already known antibiotics can also be added to
the tests done on newly discovered drugs. One called the sensitivity test determines the diseases
an antibiotic can cure or the antibiotics that are effective against a disease. For the former purpose,
the new antibiotic is placed on different dishes containing different types of cultured pathogenic
microbes. Obviously, the prize is marked when a certain type of bacteria does not grow around the
antibiotic.86 A modified technique, employed for the purpose of measuring an antibiotic’s degree
Given that the new antibiotic was approved by drug administration, the maker or head of
the pharmaceutical firm is granted a permit and patent. Only then can he claim special
manufacturer’s rights and proceed to commercially and exclusively produce, market, and sell the
drug.88 A drug patent usually lasts for 17 years, giving the maker about 7 years to be the only
producer of the drug (minus the 10-year worth of drug developing and testing). After his patent
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expires, generic forms of the drug can be made.89 These generic antibiotic versions contain
technically the same ingredients as the branded ones, but are cheaper due to improved
An antibiotic patent has kept money flowing in the manufacturer’s pocket for 7 years; its
infection-fighting properties has kept bodies functioning well for about 70 years; yet just its
research has already kept scientists’ mind boggled and busy for over 100 years since the concept
of a magic bullet entered Paul Ehrlich’s mind around the year 1900. Advancements from over a
Commonly prescribed antibiotics can be grouped into six divisions according to their chemical
compositions. These groups are the penicillin group (e.g. amoxicillin, ampicillin), cephalosporins
miscellaneous antibiotics (e.g. metronidazole, trimethoprim). Most, if not all, of these antibiotics
are not proprietary drugs and can only be obtained from a pharmacist through a physician’s
prescription.91
Through antibiotics mankind has long since been able to vanquish numerous fearsome
diseases known. Now antibiotics can cure pneumonia, tetanus, tonsillitis, tuberculosis, diphtheria,
otitis, plague, cholera, meningitis, and many more. These truly puissant drugs can fight infections
such as streptococcal, staphylococcal, pneumococcal, fungal, and chest, intestinal and urinary tract
infections. They can subdue venereal diseases, rheumatic fever, typhoid fever, and some viruses.92
Some can also even slow down cancer growth!93 Thanks to antibiotics, scientific studies, and, of
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course, the Great Physician, the diseases that pose dangerous threats to each living individual can
now be controlled.
Again, this assuring fact does not halt further research, nor does it tempt and compel
scientists to spare efforts in searching for “new news” that concern antibiotics. Scientists are able
to create new antibiotics and see its effectiveness on microbes using computers and virtual reality
devices.94 They are now diligently perusing and thumbing through the taxonomic pages for
organisms other than microbes that are potentially capable of producing antibiotics. Sharks and
frogs, which produce protein molecules called defensins, are being examined and tested and are
Furthermore, new molecules that stop infections by preventing them from breeding and
attaching to cells are being analyzed and experimented upon.96 Scientists continue to further their
understanding of the properties of antibiotics, bacteria, and human bodies, and their interactions
and influences on each other.97 They dig tirelessly for clues and answers to the anomalies and
mysteries that these three parties currently exhibit. In addition to this, scientists, along with
national governments and the general populace around the globe, have their eyes open and are
eagerly looking forward to new advancements in science and technology that will create an
“These drugs [antibiotics]…have such dramatic effects that they have often been called
wonder drugs.”99
No more could history books emphasize the enormous impact antibiotics have entrenched
in the society in each passing decade. No greater praise for these drugs could be given anymore by
hundreds of encyclopedias that are yet to be published. To say that these antibiotic superweapons
have pros equally heavy with its cons is an objectionable understatement; that they have done more
harm on humanity than good an utter fallacy. Really, antibiotics are a powerful and wonderful gift
Yet still, antibiotics are inexorably not without harm. Their most menacing drawback now
is that they are somewhat like “red carpets” for the glorious entrée of superbugs in the world. This
sure fact has caused scientists not only to develop better antibiotics, but also to find other
substances that would meet or beat the disease-fighting attributes of antibiotics while, at the same
time, eliminate the danger of superbug emergence and the superbugs themselves.
currently treated as just supplements, studies show that they are vital in maintaining the
microbiome. Admittedly, microbiome study is just in its infancy. But it is better born than not, for
scientists have just lately found out and understood how these gut “micro-amigos” do a capital job
They can signal the immune system whenever, for instance, gut commensals feel
threatened by flu virus, initiating volleys of immune and inflammatory responses to fight the
infection.103 They can also protect us from certain harmful invaders by releasing their very own
antibiotics called bacteriocins. The offenses of the bacteria species Lactobacillus salivarius in the
saliva and Staphylococcus epidermis on the skin are two illustrations of this fact.104 Moreover, as
was mentioned before, they deliver protection through colonization resistance. Their sheer
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numbers in the gut leave practically no more space for foreign bacteria to colonize, suppressing
the growth of even resistant bacteria, which still have to compete with the good bacteria colony in
Probiotics have already been proven to treat infections, especially those in gut. In
November 2010, the not-so-understood bacteria Clostridium difficile plagued a man. He was given
many doses of the powerful antibiotic vancomycin and had had almost all the bacteria inside him
decimated. Despite the efforts the plague kept recurring during his breaks from antibiotics. His
doctor suspected the cause and, so, he needed probiotics that would not come only billions in pills
but rather trillions—from another’s gut.106 This procedure is called fecal transplant, inoffensively
known as human probiotic infusion.107 Surprisingly, after just two transplants, the patient had
Currently, probiotic research is still energetically ongoing. They are actually being tested
to fight STD’s, or sexually transmitted diseases. Some medical schools are now offering fecal
banking programs for those whose microbiome need refreshing after invasive therapies such as
chemotherapy and radiotherapy. Scientists also search for new, less difficult methods of fecal
transplants, like, for instance, taking them in lozenges. The once dreary future for probiotics as
Aside from probiotics, another contender—equally prospective than the former—is the
bacteriophage. The bacteriophage is a virus which hunts and preys only on bacteria. The reason
for “phages’” impending succession of antibiotics is that they may be very effective in killing only
hazardous bacteria and not the good ones.110 This promising attribute of phages would theoretically
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eliminate the dangers of allergic reaction, organ damage, superinfection, microbiome upheaval,
In a nutshell, each species of phages attacks only one kind of bacteria, although sometimes,
they may also attack bacteria related to the original one. This means that no good bacteria can be
harmed, no body cells would be destroyed, and, theoretically, no side effects would be induced.
To add to their list of advantages, phages are very numerous and common—their numbers in the
whole world would exceed the number of other organisms on earth combined!111 Phages, if one
day used for medical purposes, may be far cheaper than antibiotics.
Their most striking asset versus antibiotics is that, unlike the latter, phages are not
chemicals. They are, behaviorally speaking, living things. In an invasion of phages, a slight chance
can occur that some bacteria will survive their attack. So, if ever phages invade again and their
DNA was detected, these bacteria may evolve and become resistant to phages by immediately
If phage resistance does occur, phages would in turn evolve ways to by-pass this resistance
and be able to vanquish bacteria once more, as what they have been doing for millennia.113 At this
point good tidings will greet antibiotics, for they still may be able to catch up and play a role in
the “bacteriophage era” (if it ever arrives). By becoming resistant to phages, bacteria need to lose
their antibiotic resistance, so bacterial resistance to antibiotics OR phages won’t really be a grave
problem.114 To note phage treatment is just in experimental phase and needs further study and
Like the trial of human probiotic infusion, phage-cum-antibiotic treatments have been
successfully performed and are being researched upon. For example, a man was infected with the
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advanced, multi-antibiotic resistant bacteria Pseudomonas aeruginosa in his chest cavity. These
seemingly invincible bacteria are very hard to kill and can even survive long periods of exposure
to outside environment and even alcoholic hand gels. Desperate, with their patient on the brink of
death, his physicians decided to inject tens of hundreds of phages, along with antibiotics the
formidable pathogens were resistant to, inside their patient’s chest. Amazingly, the man recovered
completely only a few weeks after the said therapy.115 Presently, phage treatment, especially in P.
aeruginosa infections, is slowly gaining recognition, phage research is intensifying, and just in
Indeed, it can never be said that the wonderful era of antibiotics is still far from its sunset
stage.
Since the dawn of civilization, humans have already been waging their first wars, not on
their own kind, but on something probably far deadlier than them—pathogens. These microscopic
assassins had from time to time snuffed away the lives of millions of people and erased a
substantial portion of the world population. Then, just a century ago came into existence the
antibiotics, a wondrous substance that had put these deadly diseases in their rightful place, the
history books. Now another battle has emerged; it is now humans against antibiotics, particularly
on their baleful shortcomings. A new age of medical weapon already might be dawning and the
age of antibiotics might be drawing to a close. May the human race, as it delves deeper into the
earth’s infinite wonders, bid the latter age farewell with bodies hale and without ail.
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ENDNOTES
4
Raju, p. 208a-208b
5
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