Why Is Increasing Antimicrobial Resistance So Dangerous?

The last week of November saw the seventh World Antimicrobial Awareness Week 2022, which is part of a global campaign to raise awareness of the growing resistance to antibiotics. This is a serious issue, because it is more difficult to treat infections, and makes it easier for contagious diseases to spread. 

Antimicrobial resistance (AMR) is a growing problem, because as antibiotics are used more frequently, it aids the development and spread of drug resistant viruses and bacteria. Antimicrobial is an umbrella term for medical antibiotics, antivirals, antifungals, and antiparasitics. 

When drug-resistant strains of bacteria and viruses develop and begin to spread, it can lead to an out-of-control situation, where novel pathogens spread quickly and cannot be easily treated. These are sometimes called ‘superbugs’, and examples include MRSA (methicillin-resistant Staphylococcus aureus), and Clostridium difficile (C. diff).

For this reason, the NHS no longer recommends the use of antibiotics as the first line of treatment for chest infections, sore throats, or ear infections in children. Patients seeking treatment for these conditions may be advised to consult a home pharmacy service in the first incidence. 

Dr Amit Aggarwal, The Association of the British Pharmaceutical Industry Executive Director, Medical Affairs, explains: “AMR occurs over time as part of a natural evolutionary process. Bacteria replicate very quickly, producing new genetically different versions in each new generation.”

He continues: “To put this into perspective, over 6000 years, there have been around 300 generations of humans, in comparison, the common bacteria E. coli, produces the same number of generations in just over 4 days.”

“This means that bacteria can change and adapt very swiftly, finding different ways to evade human immune systems through the natural selection of those bugs which survive. These new generations can also quickly become resistant to the antibiotics we have available for use.”

“The consequence of this resistance means we could reach a time when we are unable to treat everyday infections or diseases with antibiotics.”

The World Health Organisation (WHO) is leading a multi-pronged response to tackle the AMR resistance problem. The first line of defence is to reduce the overprescribing or inappropriate use of antibiotics, which makes it easier for resistant microbes to develop. 

Other important factors include improving infection control awareness and practice, particularly in healthcare settings. There is also a drive to develop new antibiotics which are effective against novel pathogens. 

This is an area which has historically seen an underinvestment in research and development, because the major pharmaceutical companies do not see it as a profitable enterprise.  

However, the consequences of not addressing the problem also have a severe economic impact. It makes treating patients more time consuming and expensive, as they may need longer stays in hospital and more intensive nursing. 

There is an increased risk that patients will face long-term complications, which may lead to lost income and a reliance of sickness benefits. All this puts extra strain on the healthcare system, social services, and has consequences for the productivity and economic health of the whole country.