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Ask Dr. Mike: Why Do You Build Resistance to Antibiotics & What Are the Latest Developments?

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans.

Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

Why do we build resistance to antibiotics?

Some bacteria strains, that were previously controlled (like staph infection), have reappeared and become harder to treat. Dr. Mike wants you to understand that it's not you who is becoming resistant to antibiotics, it's the bacteria. Within hours, bacteria can divide into new bacteria depending on the environment.

Since they are able to multiple quickly, new strains are more likely to form and become resistant.

What are the latest developments in antibiotic resistance?

Brilacidin, created by Cellceutix, is a new class of antibiotics called defensin-mimetics that are modeled after your own immune defense proteins.

Currently, it's in phase three trials, which means it could be available relatively soon.

If you have a health question or concern, Dr. Mike encourages you to write him at This email address is being protected from spambots. You need JavaScript enabled to view it.  or call in, toll-free, to the LIVE radio show (1.844.305.7800) so he can provide you with support and helpful advice.

RadioMD Presents:Healthy Talk | Original Air Date: June 3, 2015
Host: Michael Smith, MD

It's time for you to be a part of the show. Email or call with questions for Dr. Mike now. Email This email address is being protected from spambots. You need JavaScript enabled to view it. or call now 877-711-5211. What are you waiting for? The doctor is in.

DR. MIKE: Pretty consistently now, about every three of four weeks, I have to make a call out for more email questions. I usually, then, get a whole bunch over a couple of day time span and then they drop off. But that usually keeps me going for a while.

This email address is being protected from spambots. You need JavaScript enabled to view it. . Send me any question you want, as vague or as detailed as you want. You can give me your name, ask me to try to answer the question on a certain day and I will do my best to do that. Or you can just be anonymous. Whatever. This email address is being protected from spambots. You need JavaScript enabled to view it. . So, here was a question:

"Why do we build resistance to antibiotics and are there new ones coming soon?"

More and more - and this is a good thing – we are seeing mainstream media talk a little bit about a very serious situation. We are developing more and more bacteria that are resistant to antibiotics that we have been using for a long time. It is scary because some of these bacteria that we were able to control like staph infections, for instance, are now becoming a significant problem. T.B.--a significant problem. There is a growing list of bacteria – what we call super bugs – that we really have no treatment for anymore. Even more scary, the sexually transmitted ones. Syphilis is becoming harder and harder to treat. This is a significant medical issue about resistance to antibiotics.

Let's make sure we're clear here because this person is asking, "Why do we build resistance to antibiotics." It is not us that are becoming resistant to the antibiotics. It's the bacteria. It is a very simple concept.

You have a bacteria that can divide very quickly and it goes through several generations in just a short time span. For us as humans, a generation - what do we consider a generation? 40 years now or 50? Generation X, baby boomers, they are generations. It is years; it's not hours. But that is the problem. Bacteria, literally within hours, can go through hundreds of generations given the right environment. If it's an environment that is beneficial to them and providing there are plenty of nutrients, plenty of room, whatever, they divide like crazy. That's the problem. Every time a bacteria divides and makes another bacteria, there is the potential for just forming these random mutations.

When you are overusing antibiotics and you are putting that antibiotic in the environment surrounding that bacteria and it starts to divide, if there is this random mutation, that, then, allows it to be resistant to that bacteria you essentially select for that resistant bacteria. Because the bacteria that can still be killed by that antibiotic--they die off and now you just have this one sole bacteria who is resistant to the drug--and the bacteria begins to divide and starts making sister bacteria that are resistant.

It is just random mutation. It's just the fact that viruses and bacteria are just dividing like crazy, hour by hour, allowing for the chance of resistance from random mutations to increase significantly. It's the big problem with HIV, the virus, right? Why do we have to put the patients with HIV on 3 drugs? Because it reduces the chance of resistance. Because the virus divides like crazy.

It is not that we are becoming resistant to penicillin. There are strains of syphilis out there that penicillin is less and less effective against. It's the bacteria. It's scary. If we don't make some changes and if we don't slow down the use of antibiotics – which I don't think is going to help us that much anyway.

We need to control how often and how much we use antibiotics, not just in us, but also in our livestock. We need to do that but I think it might be a little bit too late, to be honest with you. We need the development of new types of antibiotics that bacteria have never been exposed to. We need whole new classes of drugs. Unfortunately, there is not a lot of research going into new classes of antibiotics at this point. There is not a lot of incentive for pharmaceutical companies to do that. You don't make a lot of money off of antibiotics.

Even though they are used a lot, they are pretty cheap overall. There is more money to be had in things like chemotherapy and cholesterol lowering drugs and what have you. But there are some interesting new developments. Because the second part of the question was "Are there any new ones coming soon?" I did some research. I think the most interesting to me are a new class of antibiotics called defensin mimetics.

These are chemical compounds that we are developing in a lab that are modeled after intrinsic – your very own immune defense proteins. These are proteins that play a role in the defense. Kind of like front line defense against bacterial infections.

You have immune cells called antiprogestin cells that will recognize a foreign bacteria. It will engulf that bacteria. Once it does that, it breaks the bacteria down and takes those broken up pieces of the bacteria and places it on its surface. So, the real immune fighting cells will come into contact with that antiprogestin cell – that bacteria presenting cell – will recognize that this is a antiprogestin cell and that activates the other immune cells. These defensin proteins are really important in that activation process. So, they help the antiprogestin cells to activate. They help the B cells to activate to make more antibodies. They help the T cells to activate and attack the bacteria quicker.

So, these defensin proteins play a critical role in controlling the infection before it gets out of hand. They are like the first responders, if you will. There are companies developing new antibiotics that are modeling these defensin proteins. We are going to get a faster activation of the immune system. We are going to use our own immune system with these drugs to fight the infection and these defensin mimetics drugs also can kill the bacteria themselves.

They do so in the same way that the immune cells do which is usually with free radicals – pro-oxidative molecules--that can penetrate into the bacterial cell wall and break it down and that kills the bacteria.

When you do it that way, when you enhance the immune response, when you kill the bacteria in the same way that your own immune system does it, the chance of resistance is significantly decreased. So, you don't have to worry so much about those random mutations from bacteria that are dividing like crazy when you use defensin mimetics--compounds modeled off of these defensin proteins that your immune system uses anyway. I think that is really awesome.

I think this is a new class of antibiotics that we really need to do a lot more research in. I could really only find one defensin mimetics that is in human clinic trials right now. It is called Brilacidin. It is made by a company called Cellceutix. Cellceutix is making Brilacidin which is a defensin mimetics and it is in what is called Phase 3 clinical trials, which is in humans. That should be, hopefully, available soon.

This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.