Antimicrobial Resistance: What is it and how to avoid it

What is antimicrobial resistance?

Antimicrobial resistance (AMR) is the ability of microorganisms, such as bacteria, viruses, and fungi, to resist the effects of antimicrobial medicines, such as antibiotics, antivirals, and antifungals. This means that the microorganisms can survive and continue to grow even when exposed to these medicines, which are designed to kill or inhibit their growth.

Antimicrobial resistance occurs when microorganisms develop genetic mutations or acquire resistance genes that enable them to evade the effects of antimicrobial medicines. This can happen through various mechanisms, including:

1. Mutation: Microorganisms can spontaneously develop genetic mutations that make them resistant to antimicrobial medicines.
2. Gene transfer: Resistance genes can be transferred between microorganisms through horizontal gene transfer, which occurs when bacteria share genetic material through physical contact or other mechanisms.
3. Antibiotic misuse: Overuse or misuse of antimicrobial medicines can lead to the selection of resistant microorganisms, as they are more likely to survive and thrive in environments with high levels of antimicrobial exposure.
4. Environmental factors: Environmental factors, such as soil contamination, water pollution, and poor sanitation, can contribute to the development and spread of antimicrobial resistance.

Antimicrobial resistance is a significant public health concern because it:

1. Reduces the effectiveness of antimicrobial medicines: When microorganisms become resistant to antimicrobial medicines, these treatments are no longer effective in treating infections.
2. Increases the risk of infections: Antimicrobial resistance can lead to a higher risk of infections, as resistant microorganisms are more likely to spread and cause disease.
3. Increases healthcare costs: The rise of antimicrobial resistance can lead to increased healthcare costs due to the need for more expensive treatments and longer hospital stays.
4. Threatens global health: Antimicrobial resistance is a global problem that requires a coordinated effort to address.

The World Health Organization (WHO) has identified AMR as one of the top 10 global health threats facing humanity. To combat this issue, there is a growing need for new antimicrobial medicines, improved infection control practices, and enhanced surveillance and monitoring systems to track the spread of antimicrobial resistance.

What can be done about antimicrobial resistance?

To combat antimicrobial resistance, a multi-faceted approach is needed. Here are some strategies that can be implemented:

1. Preserve antibiotics: Reduce the use of antibiotics in agriculture and human medicine to prevent the development of resistant bacteria.
2. Improve infection control: Implement proper hygiene practices, such as handwashing, and use personal protective equipment (PPE) to reduce the spread of infections.
3. Develop new antibiotics: Invest in research and development of new antibiotics, and encourage pharmaceutical companies to invest in this area.
4. Strengthen regulation: Enforce laws and regulations to prevent the misuse of antibiotics, and monitor antibiotic use to detect emerging resistance.
5. Promote antibiotic stewardship: Encourage responsible use of antibiotics by healthcare professionals, patients, and the public.
6. Enhance surveillance and monitoring: Monitor antibiotic use, track resistance patterns, and identify areas where resistance is emerging.
7. Support global coordination: Encourage international cooperation to address antimicrobial resistance, share knowledge, and develop common strategies.
8. Invest in diagnostic tools: Develop rapid and accurate diagnostic tools to identify infections quickly and correctly, reducing the need for broad-spectrum antibiotics.
9. Encourage vaccination: Promote vaccination to prevent infections, which can reduce the need for antibiotics.
10. Support research on alternative therapies: Investigate alternative therapies, such as bacteriophages, probiotics, and antimicrobial peptides, which may be effective against resistant bacteria.

Specific actions that can be taken:

1. Healthcare professionals:
   • Use antibiotics judiciously and only when necessary.
   • Monitor antibiotic use and report any concerns.
   • Implement antibiotic stewardship programs.
2. Patients:
   • Take your antibiotics exactly as prescribed.
   • Don’t share antibiotics with others.
   • Complete the full course of antibiotics even if you’re feeling better.
3. Pharmaceutical industry:
   • Develop new antibiotics with novel mechanisms of action.
   • Improve antibiotic formulations to reduce resistance.
4. Government:
   • Establish policies and regulations to promote antibiotic stewardship.
   • Provide funding for research and development of new antibiotics.
   • Implement public awareness campaigns to educate the public about antimicrobial resistance.

By taking these steps, we can slow the spread of antimicrobial resistance and ensure that we have effective treatments for infections in the future.