A ‘slow catastrophe’ unfolds as the golden age of antibiotics comes to an end, by Melissa Healy.

It was a milestone public health officials have been anticipating for years. In a steady march, disease-causing microbes have evolved ways to evade the bulwark of medications used to treat bacterial infections. For a variety of those illnesses, only colistin continued to work every time. Now this last line of defense had been breached as well. …

The golden age of antibiotics appears to be coming to an end, its demise hastened by a combination of medical, social and economic factors.

Harvard University infectious disease epidemiologist William P. Hanage cautions that “we will not be flying back into the dark ages” overnight. Hospitals are improving their infection control, and public health experts are getting better at tracking new threats. But in a race against nature, he said, the humans are losing ground.

“We’re seeing more drug-resistant infections,” Hanage said. “And people will die.”

The struggle to sustain the effectiveness of antibiotics is a never-ending arms race. If humankind were regularly finding new anti-microbial agents and turning them into medicines, there might be less cause for worry.

Researchers haven’t identified a new class of antibiotic medication since 1987. As a result, while bacteria have continuously evolved new ways to thwart antibiotics, the medicines have not gained new mechanisms to fight back.

The economics of drug development are partly to blame. … Antibiotics won’t pay the freight. They should be prescribed sparingly and only used for about a week. They could be rendered obsolete at any time by resistance genes. Worst of all, they compete in a field of inexpensive generics.