Looking Back and Ahead From the Age of Resistance

Biography of Resistance: The Epic Battle Between People and Pathogens, by Muhammad H. Zaman, PhD (Amazon / Book Depository)

Muhammad H. Zaman is a researcher and professor of biomedical engineering and international health at Boston University. In Biography of Resistance he traces the evolution of superbugs, namely how strains of bacteria have become resistant to antibiotics and what that indicates for the future state of human health. Alongside this, chapters look at the evolution of antibiotics and treatment as well, and how these world-changing scientific and medical advances came about.

We’re entering deeper into a scary age of resistance. Tens of thousands of people die annually from drug-resistant infections, but in September 2016 a Nevada woman was the first to die of a superbug resistant to every known antibiotic. Considering how many people used to die from conditions easily treated now with antibiotics, this development underscores the urgency in understanding how we got to this point and where we go from here.

Our increasing era of drug resistance is a topic I got interested last year in the excellent The Perfect Predator, which is also where I realized that learning about developments in this area is much less scary than just imagining the possibilities. It’s also an area where I especially think knowledge is power, if recent events have taught us anything about how dangerous a lack of basic knowledge in health and medicine can be.

Zaman examines a different step in humanity’s constant battle against pathogens in each chapter, giving the book a vignette-like feel. These developments span decades and the entire globe. Some are better known, like the stories (and potential myths) around penicillin’s discovery, and others were completely new to me. He details many of the figures who played significant roles in monumental discoveries and developments, and those who are significant today in some way, sometimes for what they represent about common usage of antibiotics in medical systems that vary greatly from the US. Zaman’s explanations of how bacteria thrive and mutate were helpful to understand as well.

I liked getting so many different stories and perspectives to this story over time and in every far-flung location from the Arctic to the Amazon, but it does make for a somewhat jumpy structure. Still, Zaman found good ways to link each chapter to the next, and show how interconnected the developmental journeys of antibiotics and bacterial resistance have both been. Because each chapter was so brief, it’s one that definitely deserves a re-reading if you want to more deeply engage with the material and retain it, and I think this is one that’s absolutely worth holding on to. That might sound odd but it really is that well-written and fascinating that I can confidently say you’ll want to revisit chapters in a book about bacteria. I promise.

The misunderstandings around bacteria and antibiotic use are more terrifying to me than the reality of increasing resistance coupled with no new antibiotics coming for those resistant strains. Far too many people seem to think that almost any illness automatically requires treatment with an antibiotic, a ridiculous fallacy that’s been allowed to proliferate in part because some doctors will prescribe antibiotics for conditions that these drugs won’t even touch — common colds, for example, just to get the patient out of their office while knowing the illness will clear on its own.

This isn’t just harmless indulgence of the patient’s lack of knowledge though, it’s contributing to a resistance that we can’t return from, and will be especially difficult to counter when there’s more financial motivation to develop drugs that patients will need long term (i.e., antidepressants) than ones taken as short courses. Zaman also points to phage therapy, the life-saver in The Perfect Predator, as a potential alternative to antibiotics, but there’s still a long way to go.

A timely and completely accessible account of the makings of another potential public health crisis (don’t let that scare you off; again, it’s better to know). It’s level-headed and informative instead of alarmist, and far more compelling than the cover might indicate. 4.5/5

Biography of Resistance: The Epic Battle Between People and Pathogens
by Muhammad H. Zaman
published April 21, 2020 by Harper Wave

I received an advance copy courtesy of the publisher for unbiased review.

Amazon / Book Depository