In 2020, we saw the entire world change dramatically because of the COVID-19 epidemic. Unfortunately, because of this serious virus that has now claimed well over 2 million lives around the globe in 12 months, many other serious medical conditions have been under investigated and under managed leading to a number of people avoiding attending accident and emergency departments because of chest pain and many other people missing out on vital cancer screening, to give two examples.

Another major concern is that of antibiotic microbial resistance. The World Health Organisation (WHO) has estimated that by the year 2050, these multi-resistant strains of bacteria could claim around 10 million lives per year, globally. This is 5 times what we have seen this year from the coronavirus pandemic. Any breakthrough in this area would be widely received and appreciated by the medical profession and the public. Some exciting work from the Wistar Institute in Pennsylvania has developed new treatments that not only appear to kill these resistant infections but also enhance the natural immunity of the host. The group at Wistar has launched a new generation of antimicrobials known as dual acting immuno-antibiotics (DAIAs).

Current antibiotics kill bacteria by damaging either the nucleus; the ability to synthesise proteins or even breaking down the cell membrane or through other metabolic pathways. As the function of every living organism is to survive, bacteria develop mechanisms to do so by preventing antibiotics affecting any of these processes and therefore inactivating the antibiotics.

The research has found a metabolic pathway that is present in bacteria but not in humans known as MEP is responsible for a production of chemicals known as isoprenoids, which are essential for cell survival. A particular enzyme known as IspH is vital for the production of these chemicals and through extensive research, an inhibitor of this enzyme was discovered that was shown to be harmless to humans but toxic to bacteria. The IspH inhibitor out-performed current antibiotics, including resistant bacteria, with the added benefit of stimulating the immune system improving the body’s ability to eliminate pathogenic bacteria.

Although this work has only been performed in the laboratory, the next logical step is human trials to demonstrate efficacy and lack of toxicity. Although these treatments are still probably 5-10 years away, it will probably be around the same time that the multi-resistant bacteria start to become a very prominent and concerning aspect of human health, even more so than it is at present.

This study highlights the vital importance of ongoing research in other areas of medicine, other than just focusing on the current pandemic, which has certainly grabbed the attention of the entire world over the past 12 months and unfortunately will probably continue to do so throughout 2021 until we see the potential benefits of the current vaccine roll-out. Unless we can conquer this increasing scourge of antibiotic resistance, in around a decade, we will enter the post antibiotic era which, in my view, is a much scarier thought than our current COVID-19 pandemic.