The issues faced by healthcare communities is ever-evolving and the rise of antimicrobial resistance (AMR) poses a formidable challenge. Antimicrobial agents are losing their effectiveness as microbes adapt and develop resistance mechanisms. In this blog post, we will explore the intricate issue of antimicrobial resistance, its implications for modern healthcare, and the strategies being employed to combat this global threat.
Understanding Antimicrobial Resistance
What is antimicrobial resistance? Antimicrobial resistance occurs when microorganisms, including bacteria, viruses, fungi, and parasites, adapt to the drugs designed to eliminate them. This adaptability is a natural evolutionary process, but human activities, particularly the overuse and misuse of antimicrobials, have accelerated the emergence of resistant strains.
The Scope of the Problem
The World Health Organization (WHO) identifies AMR as one of the most significant threats to global health (1). Infections caused by resistant pathogens are associated with increased morbidity, mortality, and healthcare costs. A study published in The Lancet estimates that, without effective intervention, deaths attributable to AMR could reach 10 million annually by 2050 (2).
Contributing Factors to Antimicrobial Resistance
- Overuse and Misuse: inappropriate prescribing and overuse of antimicrobials in both human and animal health contribute significantly to resistance development.
- Incomplete Treatment Courses: failure to complete a prescribed antibiotic course allows surviving bacteria to develop resistance, creating a breeding ground for resistant strains.
- Agricultural Practices: the use of antimicrobials in agriculture, particularly for growth promotion in livestock, contributes to the spread of resistant strains through food and the environment (3).
Strategies for Tackling Antimicrobial Resistance
- Antimicrobial Stewardship Programs: these programs promote careful use of antimicrobials, emphasising appropriate prescribing, dosage, and duration to optimise patient outcomes while minimising resistance.
- Global Surveillance and Reporting: monitoring the prevalence of resistant strains on a global scale helps identify emerging threats and informs public health interventions. The Global Antimicrobial Resistance Surveillance System (GLASS) is a collaborative effort addressing this need (1).
- Research and Development of New Antibiotics: investing in the discovery and development of novel antimicrobial agents is critical to stay ahead of evolving resistance mechanisms. Initiatives like the Global Antibiotic Research and Development Partnership (GARDP) focus on filling the gaps in research and development (4). However, there hasn’t been a new class of antibiotics discovered since 1987 (5).
- Education and Public Awareness: raising awareness about the responsible use of antimicrobials is crucial. Educational campaigns for both healthcare professionals and the general public can contribute to a culture of antibiotic stewardship.
Conclusion
Antimicrobial resistance is a complex, multifaceted challenge that requires a concerted effort from the global healthcare community. By implementing antimicrobial stewardship programs, investing in research and development, and raising awareness about responsible antibiotic use, the global healthcare community can work towards the mitigation of the impact of AMR on public health.
References:
- World Health Organization. (2019). Global Antimicrobial Resistance Surveillance System (GLASS) Report: Early Implementation 2016-2017.
- Cassini A., Högberg L. D., Plachouras D., Quattrocchi A., Hoxha A., Simonsen G. S., & Magiorakos A. P. (2019). Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. The Lancet Infectious Diseases: 19(1), 56-66.
- O’Neill J. (2016). Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. Review on Antimicrobial Resistance.
- Global Antibiotic Research and Development Partnership (GARDP). (2021). Annual Report 2020.
- Hutchings M. I., Truman A. W., Wilkinson B. (2019). Antibiotics: past, present and future. Current Opinion in Microbiology: 51, 72-80.
