The news media is rightly covering the new potential antibiotic, Teixobactin, which was found in soil, and has multiple targets in bacteria, making it unlikely that bacteria can develop a resistance to this.
On the surface this is great news, because the development of drug-resistant tuberculosis and MRSA and other superbugs have become the new plague. These superbugs have infected two million people in the United States last year alone, killing 23,000 (according to the CDC). Drug resistant strains of bacteria are affecting all countries, and new antibiotics are not being made. One caution – this drug has not been tested in humans, and may not be available for five to seven years.
For many bacteria are the “dark side of the force” causing disease, plagues, and one of the leading causes of death, so finding a new weapon against the dark side is welcome. The question is not can this drug kill bacteria that are resistant, and causing life-threatening infections in people, the question is what will this drug do to the human microbiome.
The human microbiome is our resident bacteria, of which are over one trillion bugs that occupy every bit of our cells, from our skin throughout our gut. Our own microbiome contains trillions of bacteria that do remarkable things for us: they synthesize vitamins, provide protection against colon cancer, break down fats, and occupy space that provides protection against invaders that are not so friendly to us. The microbiome is “the force.”
Some have suggested that the microbiome is responsible for regulating our immune system, may be responsible for obesity, and allow us to eat Nori without getting bloated.
Every time that microbiome is assaulted by antibiotics some of these bacteria (the good guys) are killed, and replaced.
Since Louis Pasteur discovered that bacteria were responsible for spoiled milk, spoiled beer, and disease we have waged a war against bacteria. But our war against infection is nothing compared to the war found in the microbiologic world. It is from that world that we discovered Penicillin, and this new drug, Teixobactin.
Antibiotics have saved billions of lives, but like any war it has come against a cost, at the price of “collateral damage” to our own microbiome. As a result of the collateral damage is that opportunistic bacteria that cause other infections, such as antibiotic associated diarrhea from Clostridium difficille, are able to take a foothold in our body, in this case, the colon.
Clostridium difficille takes advantage of when the normal bacteria of the colon are lost from “friendly fire” of antibiotics meant for other infections. The Clostridium set up shop in the colon leading to diarrhea and in some cases perforation of the colon and death.
H pylori, the bacteria responsible for stomach ulcers and perhaps cancer. The first instinct has been to wipe H pylori out. But recently microbiologists have been asking the question that H pylori might be doing some good, and was not just a bug that provided us with ulcers and cancer? This has been suggested by more than one researcher, who noted that the increase in obesity correlates with the increase in children receiving antibiotics that kill off H. pylori. People who don’t have this bacteria have increased secretion of ghrelin (an appetite hormone) and have a higher incidence of gastric reflux, with a correlation of the fastest growing, and deadly cancer, esophageal adenocarcinoma.
The ability to utilize our microbiome to reestablish health has included fecal transplants – where patients who have chronic infections of C. difficile get a transplant of their significant other’s colon bacteria (either through colonoscopy, a capsule, or a feeding tube). It sounds “gross” but it has had spectacular success in reestablishing colonies of friendly bacteria in the colon.
Our race to find the perfect antibiotic and then prescribe them is done without regard to the damage done to our microbiome. It may be that we need to pay more attention to what happens to that, and work to use probiotic bacteria for help against the colonization of bacteria that cause severe damage to our bodies. It may be the answer to infections is not another antibiotic, but probiotics. For example, people who harbor MRSA in their nose might benefit from a more harmless bacteria that can’t cause infection. While probiotics do work, we have to be careful of hucksters and the food industry who use them to sell junk, as written about in probiotics the lipstick stained glass.
The answer to some diseases such as autoimmune diseases, food allergies, obesity, and asthma may be establishing new colonies of friendly bacteria. While the new antibiotic would be a welcome addition, over prescribing of the antibiotic needs to be jealously guarded against. We want our microbiome healthy and intact: may the force be with you.
Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.