Antibiotic resistance: a global threat and an urgent need for action

Antibiotic resistance (AMR) represents one of the greatest global health threats of the 21st century. According to a study published in the prestigious journal The Lancet AMR has devastating impacts on the health of populations, economies and health systems around the world.

What is antibiotic resistance?

Antibiotic resistance occurs when bacteria become resistant to drugs that were originally designed to eradicate them. This phenomenon is a natural evolution of bacteria, but human activity - particularly the overuse and inappropriate use of antibiotics - has dramatically accelerated this process. Bacteria adapt, mutate and pass on genetic information, leading to the spread of resistant strains that are difficult to treat.

According to a study in The Lancet, AMR is responsible for millions of deaths each year. In 2019, approximately 1.27 million deaths were directly linked to resistance, and millions more were indirectly affected. Without drastic action, this number is expected to rise to 10 million deaths per year by 2050, surpassing deaths from cancer or heart disease.

The study identifies several key factors contributing to the spread of AMR:

1. Overuse of antibiotics in medicine: Antibiotics are often prescribed unnecessarily, for example for viral infections such as flu, for which they have no effect. In some countries, the practice of self-medication, where patients take antibiotics without a prescription, is common.
2. Antibiotic use in agriculture: up to 70 % antibiotics are used in livestock production worldwide, often as prophylaxis or to promote animal growth. These substances enter the environment and the food chain, encouraging the development of resistant bacteria.
3. Inadequate hygiene and infection control: In low- and middle-income countries, the spread of infections is exacerbated by lack of access to clean water, sanitation and quality health care. This increases the need for antibiotics and thus the risk of resistance.
4. Limited development of new antibiotics: in recent decades, the pharmaceutical industry has focused on developing drugs for chronic diseases that bring in more profits. Developing new antibiotics is financially and technically challenging, leading to a shortage of new drugs against resistant bacteria.

Consequences of AMR

The impact of antibiotic resistance is profound and multifaceted. From a health perspective, AMR increases the risk of treatment failure for common infections such as pneumonia, urinary tract infections or sepsis. Surgery, chemotherapy and other medical interventions that rely on effective antibiotics become more risky.

The economic impacts are also significant. The study estimates that AMR could reduce global GDP by 2-3.5 % by 2050, equivalent to trillions of dollars. The costs of longer hospital stays, more expensive treatment and lost workforce productivity are enormous, especially for developing countries.

Social impacts include worsening inequalities. Low-income countries are hardest hit because they have limited access to alternative medicines and modern health technologies. AMR thus exacerbates global health disparities.

The authors of the study stress that addressing AMR requires a coordinated global approach. Key recommendations include:

1. Judicious use of antibiotics: introducing stricter prescribing rules and educating doctors and patients about the correct use of antibiotics. In agriculture, the use of antibiotics should be limited to necessary cases and banned for animal growth.
2. Investing in the development of new medicines: governments and international organisations should support research and development of new antibiotics, vaccines and diagnostic tools. Incentives such as grants or tax breaks could encourage pharmaceutical companies to be more active in this area.
3. Improving sanitation and infection prevention: investing in infrastructure such as clean water and sanitation and strengthening vaccination programmes can reduce the need for antibiotics. Hospitals should implement stricter infection control protocols.
4. Global cooperation: the AMR knows no borders and therefore international coordination is essential. The World Health Organization (WHO) and other organisations play a key role in developing global strategies and monitoring progress.
5. Education and awareness: the public must be informed about the risks of AMR. Campaigns on the correct use of antibiotics and infection prevention can change individual and community behaviour.

Antibiotic resistance is a complex problem that cannot be solved by a single measure. It requires the collaboration of governments, health systems, scientists, industry and the public. A study in The Lancet warns that without immediate action, we could return to an era before the discovery of antibiotics, when common infections meant death. Conversely, if effective measures can be put in place, the impact of AMR can be significantly mitigated.

The Lancet/gnews.cz - GH