Drug Resistant Infections
Antibiotics have long been considered one of the greatest marvels of modern medicine. Since their discovery in the early 1900s, antibiotics have promoted a previously unprecedented large-scale fight against disease. Their effectiveness, however, is starting to show its limits.

CDC Analysis

According to the Center for Disease Control (CDC), antibiotic resistance—also known as antimicrobial resistance or general drug resistance—is becoming more and more prevalent, with over 23,000 people dying from a drug-resistant infection or disease in the United States alone. Studies have shown that over 700,000 people die annually worldwide from drug-resistant infections. Diseases once thought to be treatable, such as tuberculosis and common bacterial infections, are slowly becoming harder to cure with standard antibiotics and antimicrobial drugs.

A Mounting Crisis

The sheer overuse of antimicrobial drugs, such as antibiotics, antimicrobials, or antifungals, is often cited as a factor in the rise of drug resistance. Numerous studies show that these medications are grossly overprescribed, specifically drugs in the antibiotic category. The overexposure of antimicrobial drugs to different bacteria drastically reduces the drug’s ability to fight infections and diseases, leading to a resistance that is almost impossible to treat. This phenomenon is only growing, with the United Nations estimating that resistant infection could kill up to 10 million people annually by the year 2050.

The Developing World at Risk

Developed nations like the United States and Western Europe have far greater chances of eliminating the problem by fighting diseases from the backend, with access to clean water, food and sanitary living conditions. But for underdeveloped countries where over half of the population lives below the poverty line, drug-resistant infections pose even more serious risks. These countries rely on antimicrobial drugs and vaccines to stave off epidemics and diseases and cannot afford to develop drug resistance of any kind. The United Nation’s (UN) latest findings point towards economic hazards of drug resistance as well, showing that if resistance continues to develop, healthcare costs and lack of resources could potentially send the economy into a decline similar to that of the 2008-2009 era.

Innovative Solutions

Finding innovative ways to combat drug resistance is the most urgent goal. The UN is among several groups looking to solve the resistance crisis, calling upon major pharmaceutical companies, research groups and investors to accelerate funding and assistance. Emphasizing the need for a worldwide plan, Dr. Margaret Chan, Director General for the World Health Organization, has stressed the need for a timely response, “Antimicrobial resistance is a crisis that must be managed with the utmost urgency. As the world enters the ambitious new era of sustainable development, we cannot allow hard-won gains for health to be eroded by the failure of our mainstay medicines.”

As a part of the much-needed urgent response plan, the WHO proposed a new strategy to the World Health Assembly in 2015 that highlights five main goals to fight drug resistance:

  1. Raise awareness
  2. Gain knowledge
  3. Reduce risk of infections overall
  4. Optimize the current use of antimicrobial drugs
  5. Increase investment in research and technology for new antimicrobial drugs

Hope for the Future

The CDC has also constructed what is known as the National Action Plan, a five-year goal with similar objectives working under their Antibiotic Resistance Solutions Initiative. Despite the imminent threat of drug resistance, the crisis is being taken seriously with appropriate responses in progress and clear plans of action to follow.

Olivia Bendle
Photo: Pixabay

overuse of antibiotics
Prescriptions, particularly antibiotics, are alarmingly easy to get a hold of these days. Antibiotics are usually used to treat bacterial infections and not viruses, though recently doctors have begun prescribing them more liberally. The New England Healthcare Institute (NEHI) says that physicians often resort to prescribing antibiotics because “determining if an infection is viral or bacterial is expensive and time-consuming,” so the seemingly “safe” solution is to provide the drugs. Additionally, doctors want to avoid issues of malpractice, which could arise if an actual bacterial infection goes untreated.

Patient influence also has some weight in a physician’s decision on whether to prescribe antibiotics or not. NEHI states “patients may pressure providers to prescribe antibiotics for conditions for which they are inappropriate…or inappropriately save antibiotics for later use.” These ostensibly commonplace habits may seem harmless, but they have unfortunately led to a rise in antibiotic resistance.

The CDC claims that instead of resorting to antibiotics as a quick fix for clearing up viruses, “symptom relief might be the best treatment option.” Overuse of antibiotics for viruses, such as colds or other respiratory issues, could lead to the drug losing its effectiveness against bacterial infections. Bacterial infections like MRSA and C-difficile are drug-resistant and have been a major cause of concern in the past decade due to their high mortality rates.

According to the Tufts University Alliance for the Prudent Use of Antibiotics (APUA), antibiotics resistance happens when “an antibiotic has lost its ability to effectively control or kill bacterial growth.” Antibiotic resistance also occurs naturally. During the use of an antibiotic, some bacteria can resist being killed, which can increase future survival of even more of that “resistant strain” of bacteria. The overuse of antibiotics can exacerbate this process. Genetic mutation of bacteria and “acquired resistance” from other bacteria can also breed more resistant bacterium.

Preventing disease in the first place by practicing good hygiene is the first suggestion that Tufts gives to combat antibiotic resistance. Additionally, they suggest that overall, antibiotics must be used less frequently. Patients who are prescribed antibiotics should complete the course of their antibiotics, even if they are feeling better partway through, and not save antibiotics for future unsupervised use.

This issue not only exists in the first world, where antibiotics are clearly incredibly accessible, but this problem also plagues developing countries. According to Nature: International Weekly Journal of Science, “around the globe, overuse of these drugs has created resistant strains of deadly bacteria.”

In developing nations like India and Pakistan, as high as 95 percent of adults “carry bacteria that are resistant to β-lactam antibiotics,” whereas only 10 percent of adults in Queens, N.Y. are carriers, says Timothy Walsh of Cardiff University in an interview with Nature. This could be attributed to poor sanitation in developing countries. Due to a lack of restrictions on hygiene, bacteria are spread more easily. Additionally, training of pharmacists must be improved so that the incorrect use of antibiotics decreases.

Potential solutions to this crisis have been broached. Developing new antibiotics can be incredibly expensive, “requiring approximately 10 years and $300 million” according to Tufts. However, scientists have considered strengthening existing antibiotics or using “decoy molecules” to trick bacteria into attacking the decoy instead of the antibiotic. Additionally, it has been suggested that antibiotics be altered to combat “the mechanisms that promote resistance,” rather than solely focus on destroying the bacteria itself.

While these solutions are certainly credible, decreased use of antibiotics and more strict regulations are the primary step toward eliminating the antibiotic resistance epidemic.

  — Bridget Tobin

Sources: New England Healthcare InstituteCenter for Disease ControlTufts (1)Tufts (2)Nature
Photo: Nature