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Superbugs: An Arms Race Against Bacteria
Antibiotics are powerful drugs that can prevent and treat infections, but they are becoming less effective as a result of drug resistance. Resistance develops because the bacteria that antibiotics target can evolve ways to defend themselves against these drugs. When antibiotics fail, there is very little else to prevent an infection from spreading.Unnecessary use of antibiotics in both humans and animals accelerates the evolution of drug-resistant bacteria, with potentially catastrophic personal and global consequences. Our best defenses against infectious disease could cease to work, surgical procedures would become deadly, and we might return to a world where even small cuts are life-threatening. The problem of drug resistance already kills over one million people across the world every year and has huge economic costs. Without action, this problem will become significantly worse.Following from their work on the Review on Antimicrobial Resistance, William Hall, Anthony McDonnell, and Jim O’Neill outline the major systematic failures that have led to this growing crisis. They also provide a set of solutions to tackle these global issues that governments, industry, and public health specialists can adopt. In addition to personal behavioral modifications, such as better handwashing regimens, Superbugs argues for mounting an offense against this threat through agricultural policy changes, an industrial research stimulus, and other broad-scale economic and social incentives.
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First published April 9, 2018
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About the author
William Hall
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Displaying 1 - 10 of 10 reviews
May 14, 2020
Very interesting and important book that focuses less on the biology of antimicrobial resistance and more on the surrounding economic, political, and societal factors that contribute to its spread, but that could also be used to help solve the problem.
The book touches on the economics of antimicrobial drug development, how to nudge doctor and patient behaviour around prescriptions, agricultural use of antibiotics, environmental contamination from agriculture and manufacturing, and the need for rapid diagnostics and ongoing global monitoring for resistant strains.
The authors also make specific recommendations in each of these areas. For example, new antimicrobial drugs aren't very lucrative options for pharmaceutical companies under the current system, as any effective new drug will most likely be held in reserve as a "last resort" treatment for infections that are resistant to everything else. Sales volumes will therefore be much lower than for other types of drug. The book lays out various options for fixing this problem, such as:
- introducing subscription-style payments by healthcare systems for antibiotics, rather than conventional payments based on the amount of drug used;
- requiring all companies that benefit from antibiotics (e.g. if their own cancer drug or surgical innovation relies on patients being able to take antibiotics to survive the treatment, as many do), but that aren't developing their own solutions, to pay royalties to fund antimicrobial drug R&D;
- giving companies that develop new antimicrobial agents rewards such as extended patent life on their other, more lucrative, products.
There's much food for thought here, and I'm going to have to revisit the many, many pages I flagged.
The book touches on the economics of antimicrobial drug development, how to nudge doctor and patient behaviour around prescriptions, agricultural use of antibiotics, environmental contamination from agriculture and manufacturing, and the need for rapid diagnostics and ongoing global monitoring for resistant strains.
The authors also make specific recommendations in each of these areas. For example, new antimicrobial drugs aren't very lucrative options for pharmaceutical companies under the current system, as any effective new drug will most likely be held in reserve as a "last resort" treatment for infections that are resistant to everything else. Sales volumes will therefore be much lower than for other types of drug. The book lays out various options for fixing this problem, such as:
- introducing subscription-style payments by healthcare systems for antibiotics, rather than conventional payments based on the amount of drug used;
- requiring all companies that benefit from antibiotics (e.g. if their own cancer drug or surgical innovation relies on patients being able to take antibiotics to survive the treatment, as many do), but that aren't developing their own solutions, to pay royalties to fund antimicrobial drug R&D;
- giving companies that develop new antimicrobial agents rewards such as extended patent life on their other, more lucrative, products.
There's much food for thought here, and I'm going to have to revisit the many, many pages I flagged.
October 16, 2021
A fantastic foundational read for anti microbial resistance and it’s importance. It was incredibly enlightening and even though I did have an existing amount of prior knowledge on this subject, this book still taught me more!
I loved that it had several chapters focusing on improvements for change and the future of AMR, with all of its politics, government influences, current problems and how we can be on our way to tackling it.
It included such things as the process of drug approval and development and the Pharmaceutical industry which was interesting and I also loved the pages on alternative treatments and potential areas for further research.
Overall, it was a great read on this topic and I really enjoyed how it was written and the information presented. One to read if you’re interested in AMR or are currently studying it in higher education.
I loved that it had several chapters focusing on improvements for change and the future of AMR, with all of its politics, government influences, current problems and how we can be on our way to tackling it.
It included such things as the process of drug approval and development and the Pharmaceutical industry which was interesting and I also loved the pages on alternative treatments and potential areas for further research.
Overall, it was a great read on this topic and I really enjoyed how it was written and the information presented. One to read if you’re interested in AMR or are currently studying it in higher education.
January 15, 2021
Excerpt from a review for Small Things Considered
Published by Harvard University Press in 2018, Superbugs by Hall, McDonnell, and O'Neill (Figure 2) presents a well-documented argument for why we should be concerned about antibiotic resistance, with its relevance still applicable here two years later. According to 2019 estimates from the CDC, approximately 2.8 million infections and 35,000 deaths occur each year in the United States due to antibiotic resistance. Globally speaking, antibiotic resistance claims an estimated 1.5 million deaths per year. While we expect a single virus pandemic to pass relatively soon, the harm from antibiotic resistance could continue from decades past through decades future, worsening to a point where currently treatable bacterial infections could conceivably retake their place from cancer as the number one killer of humans.
For those not versed in the realities of microbial drug resistance, the first two chapters of Superbugs cover the essential details, from the discovery of antibiotics to the almost immediate appreciation of bacterial resistance. The authors cover the basic microbiology alongside a brief historical narrative on the birth of germ theory and an outline of the general mechanisms of resistance. They focus most of their attention in their introduction on the societal consequences of antibiotic use on bacterial biology. They summarize and review studies that help quantify both the degree of the resistance problem and the costs it engenders, both economic and human.
The third chapter closes out the introductory part with an argument of why society has thus far failed to tackle the problem of increased antibiotic-resistant infections. They use data from studies and interviews with scientists and medical professionals to describe three factors that have played into the difficulty of dealing with antibiotic resistance: the difficulty of the science involved, failed economic models, and academic disengagement.
Superbugs isn't like other books that focus on the microbiology surrounding antibiotic resistance. The authors come from backgrounds outside of biology. In 2014 they took part in an economic Review on Antimicrobial Resistance. Economist Jim O'Neill served as chair of that committee, and his two coauthors of Superbugs, William Hall and Anthony McDonnell were also members as senior policy advisor and head of economic research, respectively.
Superbugs therefore gives an outsider's perspective on microbiological/medical issues and centers on proposing a wide range of solutions to the problem of antibiotic resistance rather than just summarizing the problem and its mechanisms. The entire second part of the book, in five chapters, tackles that broad question of what best to do now for the future.
In the eighth, and final, chapter of Superbugs, the authors summarize their conclusions and propose the next steps for combating antibiotic resistance, stressing in their final paragraphs that this is "A Problem That Can Be Solved." Their proposals are not particularly surprising: education/awareness, economic incentives, political engagement, and above all coordination between diverse groups/fields/expertise. This includes the agricultural industry, the focus of chapter 7, which has had as much (if not more) of an impact on rising antibiotic resistance than the medical industry.
Even if not shockingly novel conclusions in general, they are helpful to see spelled out concisely after the bulk of the book that has reviewed specific examples of actions to continue exploring or expand. Those who are interested in this topic, but might not know as much from the economic and political perspective as the microbiological, will find Superbugs an immensely readable and indispensable resource.
Published by Harvard University Press in 2018, Superbugs by Hall, McDonnell, and O'Neill (Figure 2) presents a well-documented argument for why we should be concerned about antibiotic resistance, with its relevance still applicable here two years later. According to 2019 estimates from the CDC, approximately 2.8 million infections and 35,000 deaths occur each year in the United States due to antibiotic resistance. Globally speaking, antibiotic resistance claims an estimated 1.5 million deaths per year. While we expect a single virus pandemic to pass relatively soon, the harm from antibiotic resistance could continue from decades past through decades future, worsening to a point where currently treatable bacterial infections could conceivably retake their place from cancer as the number one killer of humans.
For those not versed in the realities of microbial drug resistance, the first two chapters of Superbugs cover the essential details, from the discovery of antibiotics to the almost immediate appreciation of bacterial resistance. The authors cover the basic microbiology alongside a brief historical narrative on the birth of germ theory and an outline of the general mechanisms of resistance. They focus most of their attention in their introduction on the societal consequences of antibiotic use on bacterial biology. They summarize and review studies that help quantify both the degree of the resistance problem and the costs it engenders, both economic and human.
The third chapter closes out the introductory part with an argument of why society has thus far failed to tackle the problem of increased antibiotic-resistant infections. They use data from studies and interviews with scientists and medical professionals to describe three factors that have played into the difficulty of dealing with antibiotic resistance: the difficulty of the science involved, failed economic models, and academic disengagement.
Superbugs isn't like other books that focus on the microbiology surrounding antibiotic resistance. The authors come from backgrounds outside of biology. In 2014 they took part in an economic Review on Antimicrobial Resistance. Economist Jim O'Neill served as chair of that committee, and his two coauthors of Superbugs, William Hall and Anthony McDonnell were also members as senior policy advisor and head of economic research, respectively.
Superbugs therefore gives an outsider's perspective on microbiological/medical issues and centers on proposing a wide range of solutions to the problem of antibiotic resistance rather than just summarizing the problem and its mechanisms. The entire second part of the book, in five chapters, tackles that broad question of what best to do now for the future.
In the eighth, and final, chapter of Superbugs, the authors summarize their conclusions and propose the next steps for combating antibiotic resistance, stressing in their final paragraphs that this is "A Problem That Can Be Solved." Their proposals are not particularly surprising: education/awareness, economic incentives, political engagement, and above all coordination between diverse groups/fields/expertise. This includes the agricultural industry, the focus of chapter 7, which has had as much (if not more) of an impact on rising antibiotic resistance than the medical industry.
Even if not shockingly novel conclusions in general, they are helpful to see spelled out concisely after the bulk of the book that has reviewed specific examples of actions to continue exploring or expand. Those who are interested in this topic, but might not know as much from the economic and political perspective as the microbiological, will find Superbugs an immensely readable and indispensable resource.
January 17, 2019
Tragedy of the global commons, what we have been witnessing is essentially overfishing in the sea of antibiotic effectiveness.
Aelin Therapeutics is an interesting Belgian life sciences company innovating in this field, weaponising protein aggregation.
Aelin Therapeutics is an interesting Belgian life sciences company innovating in this field, weaponising protein aggregation.
July 25, 2020
A slim volume about a large problem – we are losing the evolutionary arms race with bacteria. See my full review at https://inquisitivebiologist.com/2018...
October 13, 2018
A very sad prescient story on humanity’s future
August 4, 2019
Good overview of AMR for a lay audience, however as a scientist I was disappointed at the economic focus of the book without much regard to ethical and scientific problems.
November 15, 2021
Decent introductory primer to antimicrobial resistance primarily through a mainstream economics lens
July 28, 2022
This book is primarily a proposal, not a source of information.
March 2, 2023
This book is brilliant.
A lot of the facts in here weren't surprising to me as I'm currently doing a PhD in AMR. I did really appreciate how exoteric this was though. I find that research into antimicrobials in general has a lot of jargon and acronyms, which this did not fall into.
I was expecting this to fall into the type of non-fiction that gives evidence of a problem in the world and then ends. I was pleasently surprised however, that it gave viable solutions to the issues raised. It is disapointing how little has been done since this books publication though. I would be interested to see an updated version using current data.
A lot of the facts in here weren't surprising to me as I'm currently doing a PhD in AMR. I did really appreciate how exoteric this was though. I find that research into antimicrobials in general has a lot of jargon and acronyms, which this did not fall into.
I was expecting this to fall into the type of non-fiction that gives evidence of a problem in the world and then ends. I was pleasently surprised however, that it gave viable solutions to the issues raised. It is disapointing how little has been done since this books publication though. I would be interested to see an updated version using current data.
Displaying 1 - 10 of 10 reviews