The Age of Antibiotics Is Over
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Starting with the mass-production of penicillin during World War II, antibiotics revolutionized modern medicine. But their effectiveness is rapidly waning. Overuse and misuse in both humans and livestock is spurring the evolution of drug-resistant superbugs, which kill at least 23,000 people in the U.S. each year. Resistance threatens to set back the entire field of medicine—imagine returning to a time when a minor wound could spell death by infection. To prepare for a post-antibiotic era, we tracked down four promising alternatives that target specific pathogens and kill them in novel ways.

Method Inject And Burst Chomp And Disembowel Shoot And Poison Silence And Disperse
Class Bacteriophages Lysins Bacteriocins Cationic peptides
Identity Virus Phage enzyme Bacteria-made toxin Positively charged peptide
Tactic A phage injects its DNA into a bacterium, where it hijacks cellular machinery to make copies of itself, filling the cell until it pops like a balloon. Lysins—harvested from phages to be mass-produced in a lab—chew on bacterial-cell walls until they break open, spilling the cell’s guts. Bacteria shoot these lethal toxins at closely related species to reduce competition when conditions are cramped and food is scarce. Breaks up biofilms—a “strength in numbers” bacteria cluster—by disrupting the communication signals between the organisms.
Upsides Targets specific bacterial species; found abundantly in nature; quick to develop. Lower chance of complications for the patient than when using the whole phage. Potent and produced by all studied bacteria; can attack specific bacteria species. May boost antibiotic effectiveness, stimulate immune system, and lower inflammation.
Feasibility Doctors in Eastern Europe have used phages as a topical treatment for wound care. Rockefeller University is conducting preclinical trials on pneumonia bacteria. Certain bacteriocin products exist overseas, such as tonsillitis lozenges in New Zealand. University of British Columbia researchers hope to have them in clinical trials within a year.

_This article originally appeared in the August 2014 issue of _Popular Science.