What is Antimicrobial Resistance?
Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer responds to medicines, thus making infections harder to treat and increases the risk of diseases spreading, severe illness, and death.[1] AMR threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses, and fungi.[2]
How Does Antimicrobial Resistance Occur?
AMR occurs naturally over time, usually through genetic changes. Antimicrobial resistant organisms are found in people, animals, food, plants, and the environment. It can spread from person-to-person or between people and animals, including from food of animal origin. The main drivers of antimicrobial resistance are the misuse and overuse of antimicrobial; lack of access to clean water, sanitation, and hygiene (WASH) for both humans and animals; poor infection and disease prevention and control in health-care facilities and farms; poor access to quality and affordable medicines, vaccines, and diagnostics; lack of awareness and knowledge; and lack of legislation enforcement.[1]
AMR, A Threat to Public Health System
AMR is considered a significant threat to public health systems throughout the world.[3] Infection with AMR leads to serious illnesses, prolonged hospital stays, increases in healthcare costs, and greater risk of treatment failures.[4] The impact of AMR causes potentially disastrous consequences for the treatment of both infectious diseases and non-communicable diseases (NCDs). A clear example is shown by a threat that AMR poses to the safety and effectiveness of procedures such as surgical interventions, cancer treatment, and organ transplants. The emergence of AMR creates bottlenecks for the achievement of UHC and the United Nations Sustainable Development Goals, directly and indirectly affecting 15 out of the 17 goals.[5] Without concrete action, progress made will be lost. The fact that infectious diseases can no longer be treated with antibiotics promises an unknown future in health care.
Factors Accelerating the Rate of AMR
Some factors are contributing to the accelerating rate of AMR, namely (1) Misuse and overuse of antibiotics, administering unnecessary antibiotics, and prescribing lengthy courses of antibiotics. Misuse of antimicrobials is facilitated in developing countries through its over-the-counter availability, unregulated supply chains, and the non-compliance use of antimicrobials that has many repercussions upon resistance and poverty.[6] (2) Agricultural use of antibiotics, for instance in the utilization to treat sick animals, antibiotics is largely added to healthy animal food and water (as prophylaxis) to prevent sickness in animals to a large extent, further grow herds at sub-therapeutic levels, and elevating feeding efficiency. (3) An Increase in Income Levels is having a direct impact on the overconsumption of antibiotics in developing countries, predominantly causing a significant rise in global antibiotic use. (4) Easy Travel Routes. Studies have suggested that modern routes for people, animals, and goods have contributed to the dissemination of AMR across the globe. (5) Biological Factors, such as mutation and bacterial evolution may cause antibiotic resistance. (6) Gaps in Knowledge about antibiotic resistance contribute to the continuing trends of AMR since the statistics and particulars about the use of different antibiotics in both healthcare settings and animal production are not systematically gathered worldwide. [7][8]
Then, What’s Next?
The increasing trends in AMR should be stopped, otherwise, it will set us back to the dark ages of medicine. Antibiotic resistance is a naturally occurring mechanism that can be slowed down gradually but not completely because resistance is an inevitable consequence of the drug selective pressure. Combating AMR requires collective action, political momentum, and robust multi-sectoral collaboration as well as partnerships between stakeholders worldwide including governmental and non-governmental agencies, researchers, health providers, public health practitioners, pharmaceutical companies, agricultural industry leaders, and patients.
References:
- https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
- https://www.who.int/health-topics/antimicrobial-resistance
- Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015;109(7):309. doi:10.1179/2047773215Y.0000000030
- Shrestha P, Cooper BS, Coast J, et al. Enumerating the economic cost of antimicrobial resistance per antibiotic consumed to inform the evaluation of interventions affecting their use. Antimicrob Resist Infect Control. 2018;7(1):98. doi:10.1186/s13756-018-0384-3
- Jasovský, D., Littmann, J., Zorzet, A., & Cars, O. (2016). Antimicrobial resistance-a threat to the world’s sustainable development. Upsala journal of medical sciences, 121(3), 159–164. https://doi.org/10.1080/03009734.2016.1195900
- Dempsey PP, Businger AC, Whaley LE, Gagne JJ, Linder JA. Primary care clinicians’ perceptions about antibiotic prescribing for acute bronchitis: a qualitative study. BMC Fam Pract. 2014;15(1):194. doi:10.1186/s12875-014-0194-5
- Antibiotic resistance: a global threat | features | CDC. Available from: https://www.cdc.gov/features/antibiotic-resistance-global/index.html.
- CDC. National action plan for combating antibiotic-resistant bacteria; 2015. Available from: https://www.cdc.gov/drugresistance/pdf/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf
