Medscape Antibiotic Myths Debunked
10/31/2016 www.medscape.com/viewarticle/870145_print http://www.medscape.com/viewarticle/870145_print 1/7 www.m edscape.com |October 20, 2016 M yths S urrounding A ntibiotics After 80 years of experience, m uch is known about antibacterial agents. Unfortunately, som e of what is "known" is incorrect. To paraphrase Osler, half of everything we're taught is wrong— the problem is, which half? Here, we seek to debunk five widely believed m yths about antibiotics and resistance. Myth 1: Hum ans Invented Antibiotics in the 20th Century The first clinically useful antibacterial agent that was safe and effective was prontosil rubrum , a sulfa drug synthesized in 1931. However, prontosil was not the first antibacterial agent to be invented, and hum ans were not the initial inventors. Genetic analysis indicates that bacteria invented antibiotics and an antibioticresistance m echanism som ewhere between 2 and 2.5 billion years ago. Bacteria have been killing each other with these weapons, and using resistance m echanism s to protect them selves against these weapons, for 20 m illion tim es longer than we have even known that antibiotics exist. To underscore the point, in 2011, a study was published in which investigators explored a deep cave in the Carlsbad Caverns system in New M exico, a geological form ation that has been isolated from the surface of the planet for 4 m illion years. The section of the cave that they explored had never before been accessed by hum ans. The investigators cultured m any different types of bacteria from the walls of the caves. Every strain of bacteria was resistant to at least one m odern antibiotic; m ost were m ultidrugresistant. Not only was resistance found to naturally occurring antibiotics, it was also found to synthetic drugs that were not created until the 1960s1980s (including fluoroquinolones, daptom ycin, and linezolid). Im plications of busting this m yth. After 2 billion years of m icrobial evolutionary warfare, m icrobes have already invented antibiotics to poison every possible biochem ical pathway, and resistance m echanism s to protect every one of those pathways. Thus, resistance m echanism s to antibiotics that have not yet been invented are already widespread in nature. Resistance is...
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