Posted on behalf of Andrew Jermy
At the age of 12, I was knocked off my bicycle by a car, resulting in a compound fracture to my right leg that required pins and an external cage to enable the bone to reset and the wound to heal. Antibiotic therapy kept the threat of infection at bay. Recently during childbirth my wife contracted an infection that, fortunately, was cleared in her and our new-born baby following a brief course of antibiotics.
In each case, resistance to those drugs could easily have led to death. Something that, like many of those interviewed in Resistance, an alarming documentary film by Michael Graziano, I find almost incomprehensible in the twenty-first century. Campus screenings in the United States last year have now been followed by a release on ITunes.
The film weaves often harrowing personal tales to tell the story of the rise and fall of antibiotics over the past 85 years. We hear from adults and children who have suffered from infection — for example, Jesse Beam, a teenager who contracted MRSA (methicillin-resistant Staphylococcus aureus) on a camping trip with his father. Some, like Jesse, survived with long term-health impacts; others, tragically, did not. We witness medical experts, such as Brad Spellberg from the Geffen School of Medicine at UCLA, their emotions clearly visible as their most powerful tools fail. Spellberg describes treating a woman in her twenties with leukemia who died after contracting Acinetobacter, which developed resistance to all of the antibiotics available.
A natural resource squandered
How have we squandered what one specialist rightly describes as a precious natural resource? Graziano takes us from the discovery of penicillin to the present day, showing how overuse of these wonder drugs has blunted their effectiveness to a point where we are now on the brink of a post-antibiotic era. He covers all the bases: overuse in medicine, where doctors still prescribe antibiotics to patients infected with viruses; overuse in agriculture, where antibiotics are still gratuitously used as growth promoters; a pharmaceutical industry that by its very structure has become inimical to the costly development of drugs that should be used only rarely.
Resistance paints a sobering picture, albeit a US-centric one. The challenges posed by antimicrobial resistance are global in nature and increasingly need to be dealt with internationally. The film also devotes too little time to those striving to develop solutions, such as people working on phage therapy or others mining drugs from previously unculturable bacteria.
Furthermore, in framing the ineffective government bodies, the agriculture industry and (to a lesser extent) overprescribing doctors as having gotten us into this mess, Graziano lets the public off the hook too easily. Why is it that in Denmark the agriculture industry took heed of public debate and voluntarily agreed to stop the use of antibiotics as growth-promoters, but in the United States and other parts of the world this hasn’t happened?
Graziano walks the line between covering the science in sufficient depth while delivering a narrative accessible to lay audiences. Hopefully this balance will ensure that the documentary is shown as widely as possible, in schools, on prime-time television, so that its message is heard clearly by the general public, the media who inform them and the politicians who represent them. Changing the way that we use antibiotics is hard, but it is a pill that we must all swallow.
For Nature’s full coverage of science in culture, visit www.nature.com/news/booksandarts.