Blaser also details the still-unfolding links between antibiotics and diseases that are not infections. Depleting the body’s friendly bacteria may precipitate asthma and other allergic diseases, and may elevate risk for some autoimmune diseases. Some evidence supports including diabetes and even autism on the list. Just like cattle, young mice can be fattened with antibiotics in their chow. Researchers now wonder if the same applies to pudgy young humans unnecessarily dosed up for every viral infection they acquire.
Looking to the future, what is to be done? We can escalate the war on bugs: Most of the roughly 100 antibiotics on the market are quite venerable, and many experts (including Blaser, ironically enough) are calling for the urgent development of newer, stronger agents.
Inevitably, though, resistance will disarm even the newest and strongest. So we must also learn to pick our battles. Good evidence suggests that the less we use antibiotics, the more useful they will become. In the meantime we must cast around for scientifically valid alternatives.
That’s what Steffanie Strathdee did. Strathdee and her husband, Tom Patterson, both scientists, were on a vacation in Egypt in 2015 when Patterson suddenly collapsed. By the time he was airlifted first to Frankfurt, then home to San Diego, doctors had diagnosed a giant abdominal infection caused by a strain of drug-resistant bacteria so commonly seen in the Middle East that military medics call it “Iraqibacter.”
No antibiotics were effective against this infection, and neither were any antibiotic combinations. As Patterson got sicker and sicker, weeks turning to months in the I.C.U., Strathdee finally headed for the internet.
There, as she writes in this year’s “The Perfect Predator” (Hachette, $28), she discovered a growing body of literature on phage therapy. Phages are viruses that kill bacteria without directly affecting human cells. They can be cumbersome to use for treatment, and American scientists are late to the phage game: It was in Stalinist Georgia that much of the early research was done. One attractive feature of these agents, though, is that each one is targeted to very specific bacteria, so that, at least in theory, the right phages can annihilate an Iraqibacter without harming any of the body’s other microbes.
Spoiler alert, but it’s right there on the book’s cover: Patterson, who wrote the book with Strathdee, was saved by a concoction of phages urgently assembled by a nationwide network of researchers and clinicians. Had he not been so sick, and had Strathdee not been so persistent, it seems unlikely Patterson’s doctors would have signed onto the effort. Still, use of phages in cases like Patterson’s is becoming more common, and they can sound welcome notes of hope and success in an otherwise bleak story.
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