New Delhi: The discovery of penicillin heralded an era of relative safety for patients. We could now treat many maladies like pneumonia and syphilis without resorting to options that were poorly effective and often came with lots of prayers. The unbridled enthusiasm that followed resulted in massive abuse, which continues unabated as of today. Unfortunately, we did not understand the consequences of our actions, either then or now. Alexander Fleming’s words in his Nobel acceptance urged us to consider being sensible in using it and protecting it from resistance development. His words have proven prophetic.
In an interaction with News9Live, Dr Subramanian Swaminathan, Director of Infectious Diseases, Gleneagles Hospitals, Bengaluru,
Economist Jim O Neill examined the magnitude of the problem in 2014, under the direction of the UK prime minister, and his findings were startling to everyone outside of Infectious Diseases and public health. It is expected that by 2050, more people will die of untreatable infections than those dying of cancer or diabetes. The cost of treating these extremely drug-resistant infections would be very crippling even to developed economies.
Paul Ehrlich had warned more than a century ago, that drug resistance follows the drug like a faithful shadow. To be sure, the presence of drug-resistance genes in bacteria is not new: they have been found in ancient bacteria with no exposure to current drugs. The issue is the alarming spread of such strains, replacing the “wild type” drug-sensitive strains. Infections in such situations do not respond to therapy, cause longer hospital stays, induce more complications, carry a higher risk of death and significantly increase the cost of care.
Now, we have these genes packed very nicely into a ring, called plasmid, which can conveniently be transferred between the bacteria. The plasmids often hold genes that provide resistance mechanisms to many different types of antibiotics which makes treatment options very difficult, sometimes non-existent.
How did we get here?
The wanton abuse of antibiotics for viral infections- like azithromycin use for respiratory infections is a good example. Every household now carries antibiotics in their medicine cupboard, and most people feel that they should use an antibiotic for any fever, often seeking the advice of a pharmacist, instead of seeking a medical opinion. The bigger issue is the abuse in the animal husbandry industry worldwide, which contributes significantly to antibiotic exposure.
What is the way forward?
We need to urgently educate the general public on the risks of antibiotic misuse and abuse; have more control on use in animal feed; antimicrobial stewardship for antibiotic use in healthcare. We also need to invest in the development of new drugs- there have been very few drugs developed in the last few decades, as most pharma companies are now unwilling to invest in this field. We also need to improve the quality of care and prevent infection, so that the need for antibiotics can be reduced. We also require better diagnostics to make faster and more accurate diagnoses, so that treatment is tailored to the pathogen and overtreatment can be prevented. The United Nations had the second General Assembly special session on antimicrobial resistance on 26 September 2024, highlighting the threat it posed to the poorest countries. Without an emergent response to this crisis, this is a threat that could come true in our lifetime.
Economist Jim O Neill examined the magnitude of the problem in 2014, under the direction of the UK prime minister, and his findings were startling to everyone outside of Infectious Diseases and public health. It is expected that by 2050, more people will die of untreatable infections than those dying of cancer or diabetes. Medicine Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
