'Magic Bullet' Antibiotics Missing Target

Almost every school kid learns the story of how a moldy orange provided the first source of penicillin. The reality is far less glamorous, but the results were no less earth-shaking.

That origin story isn't quite true, and the idea of antibiotics being the magic bullet -- the cure-all for every disease -- is just as shaky. In fact, the overuse of antibiotics is making some of them unreliable for treating even the most common illnesses.

Antibiotic resistance is one of the biggest challenges facing doctors and the public today.

How It Started

Penicillin, the first manufactured antibiotic, was discovered in 1929 when Sir Alexander Fleming, a Scottish bacteriologist, went on vacation and left a Petri dish full of staphylococcus bacteria uncovered. When he returned, he found that mold had started to grow in the dish, but that no staph bacteria grew around the edges of the mold. He named the mold penicillum, and from it penicillin was born.

The idea of bacteria fighting other bacteria was actually first put forth by Louis Pasteur, as part of his germ theory of disease. However, during the 1800s, the technology did not exist to reliably identify helpful bacteria or replicate them.

As far back as 3500 B.C., Sumerian doctors treated ailments with a beer-based soup mixed with snakeskins and turtle shells. That rather exotic brew actually contained natural antibiotics and had real curative properties.

During the beginning of World War II, the need for antibiotics was critical, and the drive began to find a way to mass-produce penicillin. After numerous fits and starts, a new strain of penicillum was found growing on a moldy cantaloupe, and it proved both more potent and more easily grown than previous strains.

Over the next 10 years, the discoveries continued, with streptomycin, tetracycline and chloramphenicol joining the antibiotic arsenal.

Bacteria Fight Back

It was not long after this, though, that the first antibiotic-resistant diseases began appearing. During a shigella outbreak in Japan in 1953, a strain of dysentery resistant to most antibiotics was discovered. Tuberculosis bacteria also began to show signs of resistance around that time.

The race was on between disease and remedy, but most doctors didn't know it. For the next 40 years, antibiotics were the weapon of choice for doctors, especially pediatricians. The overprescription and overuse of antibiotics were widespread, but those terms had yet to penetrate the public consciousness.

"Parents came to believe that antibiotics were the fix for everything from the common cold to sprained ankles. If one doctor wouldn't give them the prescription, they'd move on until they found one who would," said Ellen Beatty, a nurse in Charlotte, N.C., with 37 years experience.

In the war against disease, just as in any war, a strategy that is overused eventually loses its effectiveness. One of the main downfalls with antibiotics, according to Beatty, is that people frequently stop taking them when they begin to feel better, thinking they'll save the rest of the prescription for the next time they get sick.

But the disappearance of symptoms does not mean the disappearance of the bacteria that caused them. If you stop taking your antibiotic, it's likely that some disease-causing bacteria remain in your system, and there's a good chance they will begin to breed again, eventually coming back to haunt you.

Diseases Get Stronger

The next time those bacteria emerge, they may well have become resistant to that antibiotic. It's similar to the way in which roaches become resistant to insecticides: Ones that get only a partial dose, not a fatal one, quickly develop a resistance to the chemical.

Jennifer Morcone, a representative for the Centers for Disease Control and Prevention, said, "Antibiotic resistance is one of the world's most pressing public health problems. Almost every bacteria has become stronger, and some are almost impossible to treat."

The CDC has started the Get Smart campaign to educate the public and health care providers about the dangers of antibiotic overuse. One of the strategies mentioned is giving antibiotics only when they will actually work. This sounds simple, but according to Morcone, it's one of the hardest things to get across.

When To Use

Ear infections, or otitis media, are one of the most common childhood maladies. According to Kidshealth.org, more than 75 percent of children will have had at least one ear infection by the age of 3. However, according to Morcone, most cases are viral, and thus antibiotics will not work on them.

Instead, as British physicians have learned, the body must be allowed to fight the battle on its own, with symptom relief being the course of treatment.

It's hard to tell a parent whose child is suffering that the condition must be allowed to run its course, but more and more research is pointing toward that being the best treatment, provided the condition is not acute or involving fever.

Using the right drug is also of critical importance. Treating bacteria with an antibiotic to which they are resistant does the patient no good and may even increase the bacteria's resistance. Careful culturing and attention to detail are vital.

The National Institutes of Health is working on the other main front, developing new antibiotics to treat the resistant bacteria. According to Morcone, the development of new drugs -- combined with a more sensible, judicious application of those drugs -- gives hope that one of medicine's oldest weapons may continue to be one of the best.

If the pace of development fails to keep up with the rate of bacteria evolution, however, superbugs may become far more common.