Antibiotics, Taken Strategically, Could Actually Help Defeat Antibiotic Resistance

The same antibiotics driving antibiotic resistance evolution forward could help put it in reverse.

Principal investigator Sam Brown holds a petri dish of common infectious bacteria in his lab at Georgia Tech. Credit: Georgia Tech / Christopher Moore

In the war on antibiotic-resistant bacteria, it’s not so much the antibiotics that are making the enemy stronger as it is how they are prescribed. A new study suggests that doctors can beat antibiotic resistance using those same antibiotics but in a very targeted manner and in combination with other health strategies.

The current broad application of antibiotics helps resistant bacterial strains evolve forward. But using data about bacteria’s specific resistances when prescribing those same drugs more precisely can help put the evolution of resistant strains in reverse, according to researchers from the Georgia Institute of Technology, Duke University, and Harvard University who conducted the study.

One researcher cautioned that time is pressing: New strategies against resistance that leverage antibiotics need to be in place before bacteria resistant to most every known antibiotic become too widespread. That would render antibiotics nearly useless, and it has been widely reported that this could happen by mid-century, making bacterial infections much more lethal.

“Once you get to that pan-resistant state, it’s over,” said Sam Brown, who co-led the study and is an associate professor in Georgia Tech’s School of Biological Sciences. “Timing is, unfortunately, an issue in tackling antibiotic resistance.”

The new study, which was co-led by game theorist David McAdams, a professor of business administration and economics at Duke University, delivers a mathematical model to help clinical and public health researchers devise new concrete prescription strategies.  And to aid in developing those supporting health strategies centered on the analysis of bacterial strains to determine what drugs they are resistant to, and which not.

Some medical labs already scan human genomes for hereditary predispositions to certain medical conditions. Bacterial genomes are far simpler and much easier to analyze, and though the analytical technology is currently not standard equipment in doctors’ offices or medical labs they routinely work with, the researchers think this could change in a reasonable amount of time, which would enable the study’s approach.

The researchers published their study in the journal PLOS Biology on May 16, 2019. The work was funded by the Centers for Disease Control and Prevention, the National Institute of General Medical Sciences, the Simons Foundation, the Human Frontier Science Program, the Wenner-Gren Foundations, and the Royal Physiographic Society of Lund.