There has been a lot in the news recently about antibiotic stewardship and resistant bacteria. Someone even died recently due to a bacteria that was resistant to all our currently available antibiotics! But rather than lecture you on antibiotic resistance, I thought it might be fun to tackle the topic with a few little musical numbers.
Part 1
[The curtain opens on a single E coli bacterium.]
E coli: It sure is lonely here. [Splits in two] Oh! That was unexp- [Splits in two again] Wow! Hi you guys, I was just- [Splits in two again, and again, and again. Before we know it there are millions of bacteria on stage.]
E coli: Hey guys, I’m bored here in the colon. Let’s see if we can go stir up some trouble in the bladder.
The crowd: Yeah! Sounds great! Sure, let’s go!
[All the bacteria take the path of least resistance from the colon to the bladder.]
You Need Some Relief (sung to the tune of Beauty and the Beast)
Standing in the line
For the Porta-John
Then you take your turn
And it starts to burn
Unexpectedly
Just a little bug
Small to say the least
But it brought some friends
Now the burning will not end
You need some relief!
Take the little pill
Take it twice a day
Until the pills are gone, don’t leave even just one, or you’ll have to pay
One bacterium
Allowed to survive
I can guarantee
Continues to breed
Right before your eyes
This time it has learned
How to evade the meds
It’s quite a bitter pill
When you find you still
Dread your bathroom break
There will be a time
You’ll think of these words
The infection will not clear
You’ll shed a little tear
You need some relief!
The infection will not clear
You’ll shed a little tear
You need some relief!
Part 2
Strep pneumonia: [talking to himself] Don’t mind me, just hanging around in my natural habitat, the lungs—ohh, look at that cute little virus, so tiny…[gazes adoringly at the virus] What’s your name, little guy?
Virus: Name’s RSV, and I’m here to get this party started!
Strep pneumonia: Are you sure that’s a good idea? I mean, things have been going pretty well…
[RSV ignores strep pneumo, starts infecting cells]
[Host starts to sneeze and cough]
It’s a Cold (to the tune of Let it Go)
Mucus is thick in the lungs tonight
Not an alveolus to be seen
A kingdom of inflammation
And I think I hear a wheeze
The host is coughing like they’re going to drop a lung
The power here has shifted
Pendulum has swung
Chills, body aches
Sore throat, fatigue
Fever to one-oh-one point three
His kids, his wife
All blow their nose
Well now he knows
It’s a cold, it’s a cold
It’s gonna have to run its course
It’s a cold, it’s a cold
A Z-pac could make things worse
I don’t care
If it helped last time
It was likely a fluke
A cold never killed anyone, anyway
It’s funny how a man-cold
Makes everything seem worse
And dealing with the sniffles
Can feel like it’s a curse
It’s true, it sucks, a cold just blows
But normal flora that’s exposed
To antibiotics, right or wrong
Gets strong!
It’s a cold, it’s a cold
Don’t you let them see you cry
It’s a cold, it’s a cold
You don’t wanna be that guy
The doctor says
Penicillin won’t help
It’ll just take time…
The virus flurries through the air each time you sneeze
Cover your mouth and wash your hands, keep friends free from disease
You’ll give your immune system the extra boost it needs
And next time you’re exposed, you’ll fight it off with ease
It’s a cold, it’s a cold
It’s gonna have to run its course
It’s a cold, it’s a cold
A Z-pac could make things worse
I don’t care
If it helped last time
It was likely a fluke
A cold never killed anyone, anyway
Part 3
[Enterococcus is in the boxing room with his trainer]
Trainer: Okay, now we’re going to practice everything you’ve learned. Ready?
Enterococcus: Ready.
Trainer: Cipro.
Enterococcus: Jab, jab, uppercut.
Trainer: Augmentin!
Enterococcus: Head-body, head-body.
Trainer: Good. Now, Zosyn!
Enterococcus: Right-left, right-left, kick, kick, uppercut.
Trainer: Excellent. Now we’re going to try the one that tripped you up before. If you can get this, you’ll be unstoppable. Meropenem!
Enterococcus: Jump kick, jump kick, jab, jab, jab, cross, cross, head-body.
Trainer: [looks pleased] We’re going to go out there and crush your opponents.
Love, Your M.D. (sung to the tune of Part of Your World)
Look at these meds, aren’t they neat?
Wouldn’t you think my job is complete?
I’ve got so many treatment plans,
How could none of them work?
Look at this plate where bacteria grow
At your first glance, you’d never know
This bacteria has become
Resistant to everything
We’ve got antibiotics aplenty
Some are oral and some are I.V.
You want it rectally?
Go ask Jenny
So what’s wrong?
It’s not enough.
We need more!
It can take decades to make a new med
And if it doesn’t work
Then it’s right back to square one
Right back to work in the
Whadd’ya call it? oh- lab
Penicillin doesn’t get too far
When you’re treating resistant pneumonia
A quinolone may work
Or – what’s that name again? Vanc
Cellulitis
Kidney infection
Acute bacterial endocarditis
Harder to treat
We’re getting beat
At our own game
Oh, how I wish
That petri dish
Showed no resistance
How would I feel
If I could heal
Without I.V.s?
Gotta be smart
‘Cause there’s an art
To diagnosing each patient’s infection
It might be viral
Worth a trial
Of the tincture of time
Be ready to hear what your doctor thinks
Ask ‘em your questions
And get some answers
Why don’t they write scripts for everything
Every time?
Why not this once?
Just on the chance
That I’m the one in ten that might improve?
Not trying to be a jerk,
But that’s not how it works.
Love,
Your M.D.