Antibiotics Are Dead; Long Live Antibiotics!

We’ve been hearing the tales of doom for quite a few years now: the breathtaking promiscuity of bacteria, which allows them to mix and match their DNA with others’ to an extent that puts Genghis Khan to shame, has increasingly allowed them to accumulate genetic resistance to more and more of our antibiotics. It’s been trumpeted for decades that the rate at which this occurs can be slowed by careful use, especially by not ceasing a course of antibiotics early—but inevitably there is a lack of compliance, and here we are with MRSA, rife in hospitals worldwide, and other major species becoming more broadly antibiotic-resistant with every passing year. The bulk of high-profile expert commentary on this topic is becoming direr with ever passing year.

But this pessimism rests entirely on one assumption: that we have no realistic prospect of developing new classes of antibiotics any time soon, antibiotics that our major threats have not yet seen and thus not acquired resistance to. And it now seems that that assumption is unwarranted. It is based on history—on the fact that no new antibiotic class with broad efficacy has been identified for decades. But very recently, a novel method was identified for isolating exactly those—and it seems to work really, really well.

It arose from a case of sheer chutzpah. Scientists from Boston and Germany got together and reasoned as follows:

  1. Antibiotics are generally synthesised in nature by bacteria (or other microbes) as defences against each other.
  2. We have identified antibiotics in the lab, and thus necessarily only those made by bacterial species that we can grow in the lab.
  3. Almost all bacterial species cannot be grown in the lab using practical methods.
  4. That hasn’t changed for decades.
  5. But those bacteria grow fine in the environment, typically the soil.
  6. So… can we isolate antibiotics from the soil?

And that’s exactly what they did. They built a device that allowed them to isolate and grow bacteria in the soil itself, with molecules freely moving into and out of the device, thereby sidestepping our ignorance of which such molecules actually matter. And then they were able to isolate the compounds that those bacteria were secreting and test them for antibiotic potency. And it worked. They found a completely new antibiotic that has already been shown to have very broad efficacy against several bacterial strains that are resistant to most existing antibiotics.

And as if that were not enough, here’s the kicker. This was not some kind of massive high-throughput screen of the kind we so often hear about in biomedical research these days. The researchers tried this approach just once, in essentially their back yard, on a very small scale, and it STILL worked the first time. What that tells us is that it can work again—and again, and again.

Don’t get me wrong—there is certainly no case for complacency at this stage. This new compound and those discovered by similar means will still need to grind their way through the usual process of clinical evaluation—though, it must be said, there is reason for considerable optimism that that process is dramatically speeding up, with the recent case of an Ebola vaccine being a case in point. But still, even though any optimism must for now be cautious, it is justified. Pandemics may not be our future after all.