The Antibiotic Resistance Crisis
Experts predict that by mid-century, 10 million people a year will die of antibiotic-resistant infections. What are we doing about it?
Modern medicine is built on our ability to use antibiotics to fight infections. The overuse and misuse of antibiotics, however, has led to the rapid development of bacteria that are resistant to antibiotics. Experts predict that by 2050, about 10 million people a year will die of antibiotic-resistant infections.
A recent study published last year in the Journal of the Pediatric Infectious Diseases Society, found that 3 out of 5 children admitted to hospitals already had an antibiotic-resistant infection, suggesting these infections are spreading more often in the community right now.
The World Health Assembly, the decision-making body of the World Health Organization, took the lead recently when it created the Global Antimicrobial Resistance and Development Hub to promote research into combating antimicrobial resistance. It also launched World Antibiotic Awareness Week (WAAW) three years ago to increase global awareness of antibiotic resistance and its impact on public health. WAAW is this week and the key themes are tailored to fit the five strategic objectives set out in the Global Action Plan that the World Health Assembly passed in 2015. Those objectives include:
- Improve public understanding of resistance
- Gather data
- Reduce the incidence of infection
- Combat overuse/misuse of antibiotics
- Increase investment in novel compounds and approaches to treating infection.
We all have a responsibility in the global fight against antibiotic resistance. At a personal level, it can be as simple as frequent handwashing or keeping vaccinations up to date. On a macro scale, we need to educate consumers on the proper uses of antibiotics and the dangers when we misuse them.
Contract research laboratories, like mine, have been part of the solution by partnering with drug companies to discover new antimicrobial agents and develop preventive vaccines that reduce our reliance on antibiotics. We have also been part of research looking at novel approaches at treating infections, such as the use of bacteriophages (viruses that specifically target bacteria). Phage therapy has been around for nearly 100 years, but due to poor success rates of early trials and the rapid development of antibiotics, research into the field declined.
Bacteriophage have, however, been used successfully in Eastern Europe for 80 years and are slowly gaining attention in the West. Bacteria can still develop resistance to phage, but it is much easier and faster to develop new phages than new antibiotics, making it an exciting potential avenue to pursue.
Other methods we have worked on include drugs targeting resistance mechanisms, such as enzyme inhibitors and inactivating the genes that encode for resistance mechanisms. There are several ways in which bacteria can become resistant to antibiotics, such as efflux pumps to remove the compound from the cell; modification of the target site, or by the direct inactivation of antibiotics. For example, β-lactamase inhibitors have been shown to be effective against drug-resistant M. tuberculosis strains. Targeting these mechanisms can re-sensitize resistant bacteria to existing antibiotics, allowing previously ineffective compounds to be used again.
So while the bugs keep coming back, so can the antibiotics.
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