What will happen when antibiotics stop working?

The first person to receive penicillin — a powerful antibiotic discovered in 1928 — was a British policeman who had a life-threatening infection.

He’d scratched his face on a thorn while strolling through his garden. The infection caused sores on his scalp to ooze pus; doctors even had to remove one of his eyes.

In a recent TED Talk, Maryn McKenna — a journalist who spent a decade reporting on the CDC and who has authored an award-winning book on the drug-resistant superbug, MRSA — tells this tale to warn against the reality we will face now that, as experts warn, we’re fast-approaching a “post-antibiotic era.”

Hailed as “miracle drugs” in the 1940s and 1950s, antibiotics turned raging infections — which were once seen as veritable death sentences — into manageable conditions. What killed us in the early 20th century was now easily remedied with a shot or a pill.

But now, bacteria are developing defenses against these potent medicines, rendering them increasingly useless for some types of infections. Doctors try one antibiotic, then a stronger one, and eventually the strongest ones we have — when none of them work, a patient is often out of options.

That means infections that were easily treatable are becoming life-threatening once again.

When it comes down to the warfare between humans and bacterial invaders, we are fighting a losing battle if we aren’t armed with effective antibiotics, or at least developing new alternatives. If we don’t come up with some innovative strategies and new solutions quickly, everyone around the globe will be affected. Millions already are.

The “golden age” of antibiotics is coming to an end, and it’s not going to be pretty. “Antibiotics support almost all of modern life,” McKenna says in her talk. Here is what she warns we’ll lose when they stop working.

Minor infections will be something to fear.

As with the British policeman, everything from a scratch to catching a cold could kill before antibiotics were introduced. Strep throat led to heart failure. Simple cuts and scrapes induced raging infections requiring amputations.

The simple fact is that bacteria — from innocuous ones that we don’t even notice are there, to those that help us digest nutrients from food and even those that cause us harm — are everywhere. There’s no avoiding them, and if we’re left with nothing that can effectively fight them off, risks that are now considered minor ones will suddenly loom large.

“More than anything else, we’d lose the confident way we live our everyday lives,” McKenna says. “If you knew that any injury could kill you, would you ride a motorcycle? Bomb down a ski slope? Climb a ladder to hang your Christmas lights? Let your kid slide into home plate?”

Life will be especially dangerous for pregnant women and children.

Even in the cleanest hospitals, McKenna notes, giving birth used to kill about one in every 100 women. Pneumonia killed three children out of every 10. Antibiotics changed this, but if they stop working, these horrors could once more become a terrifying reality.

Receiving treatment for other diseases will be more dangerous.

Because some therapies impact our ability to fight off infections, a lack of working antibiotics will make certain cures and treatments more dangerous and sometimes unfeasible.

Cancer patients receiving chemotherapy are particularly at risk of developing an infection. Certain chemo drugs damage and tamp down infection-battling white blood cells.

Organ-transplant recipients, who take immune-weakening drugs to stop their bodies from attacking their new organs, are also in danger. If they can’t take antibiotics to help fight infections they get while on these drugs, they are more likely to get sick and even die.

Many other people with compromised immune systems – including AIDS patients and premature babies — will be much more likely to get ill and potentially die without antibiotics.

Anyone whose treatment involves a foreign object like an artificial joint or a catheter will also be at high risk for a potentially deadly infection.

People who have stents in their arteries to prevent stroke by enhancing blood flow to their brain, for example, will be susceptible to resistant infections. Similarly, those who have insulin pumped through their skin for diabetes or those on dialysis will be affected. Joint replacements are also particularly vulnerable. Of those receiving new hips and knees, for example, about one in every six patients would die if antibiotics no longer worked, McKenna says.

Most surgeries will become nearly impossible.

Among the vulnerable would be people in need of now-common procedures such as heart surgeries, prostate biopsies, and cesarean sections. “We’d lose the ability to open the hidden spaces of the body,” McKenna says.

The main function of our skin is to keep bad things, like bacteria, out. So when we open up the body cavity it’s dangerous, even in a “sterile field.” While not all patients undergoing surgery get antibiotics pre-emptively, it’s important to have them on hand in case an infection occurs afterward.

More than 200 million surgeries are performed every year, many of which are necessary to keep patients alive. Researchers estimate that at least 20% of the global health burden is treatable with surgical interventions — losing the ability to treat all of these conditions would be devastating. A broken arm could mean a lifetime of disability; a ruptured appendix could end in death.

This article is published in collaboration with Business Insider. Publication does not imply endorsement of views by the World Economic Forum.

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Author: Julia Calderone is a science reporter at Business Insider. 

Image: Pharmaceutical tablets and capsules in foil strips are arranged on a table. REUTERS/Srdjan Zivulovic.