Rising Plague

The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them, Brad Spellberg, M.D., Prometheus Books.

No one is safe from antibiotic-resistant bacteria. That’s the message  conveyed by infectious disease specialist Brad Spellberg in "Rising Plague,” a frightening new book that sounds the alarm about the rise of untreatable infections, while also drawing attention to the collapse of antibiotic  research and development (R&D), potentially cutting off the supply of drugs we’ll need to avert a return to the pre-antibiotic era. It’s a nightmare scenario that has received precious little media attention, especially as compared to swine flu, which continues to hog the health media spotlight.

Spellberg begins by telling the heart-breaking stories of patients—often young and in excellent health—who were unlucky enough to suffer untreatable infections caused by bacterium like acinetobacter baumanii and staphylococcus aureus, infections that left them dead or maimed, even when all possible treatment options were exhausted. Sometimes the origin of their infections could not be determined, as is often the case with MRSA, which is passed by contact with people who carry the bacterium on their skin, or by fomites—that is, inanimate objects (like doorknobs or silverware) that have been touched by carriers.

Spellberg goes on to explain why pharmaceutical companies are abandoning antibiotic R&D programs. (In part, it’s because antibiotics are short-course therapies and therefore have a low rate of return compared to other drugs. The fact that the easiest-to-develop antibiotics have already been identified is another factor.) More importantly, he presents concrete ideas for reversing this trend and encouraging development of powerful new antibiotics. At the same time, he warns against complacency—the assumption that there will always be new miracle drugs in the pipeline to cure the infections that ail us. "There is no other technology that becomes less effective the more it is used,” reminds Spellberg. "And it is entirely conceivable that we will reach a time when our precious antibiotic resource is exhausted.”

Hoping to head off that nightmare scenario, Spellberg provides tips for protecting oneself from antibiotic-resistant infections, while also stressing the importance of taking antibiotics only when absolutely necessary.

Spellberg knows better than anyone what’s at stake. Not only does he specialize in treating infections, he contracted a MRSA infection—on his face—while in the late stages of writing "Rising Plague,” a condition that necessitated prompt, aggressive treatment. 

"To paraphrase the old adage, I’m not only a prescriber of antibiotics, I’m a satisfied customer as well,” he notes. "I only hope that purveyors and customers alike will continue to be able to access effective antibiotics in the coming years.”

MRSA: Superbug