Getting a simple infection isn’t a big deal. You just go to the doctor and get a prescription for an antibiotic. For the most part, this is a good thing. After all, people no longer die from a simple cut like they used to. However, the ease with which antibiotics can be obtained also has a disadvantage. Their excessive use or abuse can lead to antibiotic resistance (AMR), which has negative health effects worldwide.
In fact, the World Health Organization (WHO) has identified AMR as one of the top ten global public health threats to humanity.
What is antibiotic resistance?
“Antimicrobial resistance is the ability of bacteria, viruses, fungi and parasites to change over time and become unresponsive to medication, making infection difficult to treat and, in many cases, untreatable,” said Dr. Debra Goff, PharmD, an infectious disease specialist and one of 25 global experts appointed to the WHO Antimicrobial Stewardship Program.
These resistant microbes, also known as superbugs, form naturally over time but can also be caused by other conditions such as overuse of antibiotics, poor hygiene and hygiene, and poor infection and disease prevention. Antimicrobial resistant organisms are found in water, soil, air, humans, animals, food and plants – and can be spread between humans and animals and from person to person.
We have a wide variety of antimicrobial drugs in our arsenal, including antibiotics, antivirals, antifungals, and antiparasitics. However, antibiotic resistance is one of the most common forms of (AMR). The CDC estimates that 2.8 million Americans get infections from antibiotic-resistant bacteria each year.
“Microbes are constantly changing and receiving new genetic information. This information is passed on to other germs that have never come into contact with the antibiotic, and they also develop resistance,” said Dr. Jose Mateo-Contreras, an infectious pediatrician disease specialist in Florida.
AMR has also occurred because the development of new treatments has not matched the rate of drug resistance.
“Bacteria share their resistance genes, which makes it more difficult for us to develop new antimicrobials. Antibiotic resistance is a global problem because we have overused antimicrobials while pharmaceutical companies have stopped discovering new antimicrobials,” said Goff.
Why does it matter?
AMR is a big problem because infection from a drug-resistant microbe may be untreatable and can lead to poor outcomes for patients.
“One of the superbugs, gonorrhea … is now becoming resistant to multiple antibiotics, and if left untreated, it can become sterile,” said Mateo-Contreras.
Worse, infection from a drug-resistant microbe can lead to death.
The WHO reports that 700,000 people die from AMR worldwide each year, with 35,000 of those deaths occurring in the US, according to the CDC.
Who is most affected by antibiotic resistance?
Nobody has immunity to AMR, but certain populations and certain drugs are at higher risk for resistance.
“Any antibiotic that is constantly prescribed and unnecessary is at risk of resistance,” Goff said, adding, “The more you use an antibiotic, the less effective it becomes.”
For example, erythromycin is a short-term antibiotic that has been widely used since the 1950s. It is prescribed to treat a number of infections caused by bacteria, including respiratory infections, pneumonia, ear infections, urinary tract infections, and sexually transmitted diseases (STDs). Over the years, the streptococcal group of bacteria group A has become resistant to the drug, making erythromycin unusable against many of these infections.
According to Mateo-Contreras, people who are hospitalized or who live in long-term care facilities such as nursing homes are more likely to use antibiotics than other people and are at higher risk of developing antibiotic resistance. He adds that people with chronic conditions that affect the immune system, such as: B. cancer, are also more prone to resistance.
What is being done
Antimicrobial resistance and the emergence of superbugs is a global public health problem that is being addressed both in the US and around the world.
“In the US, hospitals must have antimicrobial stewardship (ASP) programs run by pharmacists and infectious disease doctors to monitor the use of antimicrobials in hospitals,” Goff said. She added that these programs are spreading to outpatient settings such as clinics and nursing homes, where the bulk of antimicrobial prescribing is done.
Other initiatives include the Antimicrobial Resistance Fighter Coalition, which is committed to engaging stakeholders and raising awareness of antibiotic resistance in over 45 countries. In 2018, the CDC launched the AMR Challenge, a year-long global initiative to combat AMR.
What can individuals do?
Antibiotics are now so common that the CDC estimates that 30% of antibiotic prescriptions are unnecessary. Patients and healthcare providers must work together to address this issue. Health care providers can help by being conservative in prescribing these types of drugs, and individuals can play a role in combating antibiotic resistance by not requiring antibiotics from their doctor, Goff said.
When antibiotics are properly prescribed, the patient must follow the directions carefully and stop the prescription, as taking medication for a shorter period of time can cause the remaining bacteria to duplicate and mutate into resistant forms.
People should also refrain from sharing antimicrobial medication, using expired or old medication, and using the wrong type of antimicrobial medication. For example, people shouldn’t use an antibiotic to treat a viral infection.
To ensure good public health for all, health care providers and the community as a whole need to take steps to prevent AMR. People can help reduce the emergence of new strains of AMR by carefully following the prescribing instructions. But they can also help by educating them about the causes of AMR and primarily by reducing the risk of infection by washing their hands regularly and practicing safe sex, for example.
The less resistant we as a society are to these precautionary measures, the less resistant our microbes will be.