When Antibiotics Lose Control of the Chat

Written by Mahathi Chunduru

Antibiotic resistance is the evolution of bacteria, who learn to survive with the exposure of antibiotics. It’s a global public health threat: constant cases of high mortality, failure and risk of treatments, and financial burden affect low and middle income regions the most. They lack regulations, infrastructure, and sanitation. But mainly, they lack education, as nobody explicitly tells them that they have to finish their antibiotic treatment. Let’s crack down the numbers per country (World Health Organization [WHO], 2015):

• Sudan: 62%
• Egypt: 55%
• China: 53%
• India: 42%

This amount of people in each country think they can stop taking antibiotics when they feel better, instead of their full prescribed course. “Saving” the expensive pills for later and self-medicating leads to a global 5 million deaths annually.

This isn’t just misunderstanding, it’s active evolutionary selection. Each bacterium has “personality,” like mutations and resistance genes, which can complicate the situation. These populations of bacteria are highly connected systems, sharing genetic information to help other members survive the antibiotic exposure.

Think of the bacteria living in your body as members of a group chat. A typical day in bacterial life: everybody interacts, swaps genetic information, and adds other bacteria with genetic exchange. Most of the time, the group chat is just having a friendly conversation. However, on occasion, a few members start causing problems — the bacteria behind the infections. Instead of inappropriate texts, they’re driven by molecular evolution and biochemical selection. (WHO, 2022).

That’s where the moderators come in and kick a few members out — AKA our antibiotics. Antibiotics are drugs that hinder essential bacterial processes in pathogenic bacteria. Some functions include the creation of cell walls, proteins, DNA, and other processes. Here are a few examples:

It doesn’t take much for the admin to kick you out of the group chat — just a simple click of a button. Equivalent to you taking your antibiotics, kicking out the harmful bacteria, and making the group chat normal again. However, some members avoid the bans: the antibiotic-resistant bacteria. The name sounds intimidating, like something only doctors need to worry about. But it’s honestly quite simple: some bacteria just stick around longer than the rest. (WHO, 2022).

These resistant bacteria are amplified with misused antibiotics, accelerated through Charles Darwin’s natural selection. Natural selection is simply when organisms with desirable adaptations tend to reproduce more successfully. Enzymes such as β-lactamases, penicillinases, cephalosporinases, and carbapenemases inactivate antibiotics. With the acceleration of misuse, resistant bacteria multiply and this can lead to multidrug-resistant bacteria that are harder to treat. As time goes on, the chat is filled with users who can’t be removed.

In the end, antibiotic resistance isn’t about the moderator not doing their job right, it’s about the members getting better and better at avoiding the moderator. (WHO, 2022).

The reality is that AMR requires individual compliance, and isn’t an issue that can be solved overnight. Engineering new antibiotics fast enough to outpace irresponsible usage is nearly impossible, the best course of action is to finish the full course of your medication, never self-medicate, and advocate for global awareness!

Remember, every single time you take a pill, you are managing an ecosystem of complex microorganisms. Finish the course, halt the evolutionary clock, and don’t let the bacteria hijack the chat.

References:

1. Bonomo, R. A. (2017, January 3). Β-lactamases: A focus on current challenges. Cold Spring Harbor perspectives in medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC5204326/
2. Centers for Disease Control and Prevention. (2023). Antibiotic resistance threats in the United States. https://www.cdc.gov/drugresistance
3. Oxford University Press. (2024). Moderator. In Oxford English Dictionary. https://www.oed.com
4. Ventola, C. L. (2015). The antibiotic resistance crisis: Part 1: Causes and threats. Pharmacy and Therapeutics, 40(4), 277–283.
5. World Health Organization. (2022). Antimicrobial resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
6. World Health Organization. (n.d.). Who multi-country survey reveals widespread public misunderstanding about antibiotic resistance. World Health Organization. https://www.who.int/news/item/16-11-2015-who-multi-country-survey-reveals-widespread-public-misunderstanding-about-antibiotic-resistance