The fight to avoid an antibiotic ‘apocalypse’
Antibiotic resistance kills an estimated 700,000 people each year and has fuelled the re-emergence of illnesses that had become a rarity in many parts of the world. Here, Inez Cornell from chemistry experts Radleys explains why the problem needs to be tac
THE fight against antibiotic resistance is real and is something we all have a responsibility in tackling. We are at risk of losing the many benefits antibiotics have given us, including a longer life expectancy and the ability to perform complex surgery and survive deadly infections.
This is not something trivial or over-dramatic. Even the UK’s chief medical officer Dame Sally Davies has warned of the spectre of a “post-antibiotic apocalypse”.
Although antibiotic resistance is inevitable, thanks to bacteria’s ability to rapidly evolve, it has been made worse by the misuse of antibiotics. An estimated 50% of antibiotics worldwide can be bought without prescription. They can be bought on black markets in areas like South America and Asia, and are even available over the counter in some parts of the world.
Education about antibiotic misuse is just one aspect of dealing with the resistance problem.
Avoiding catching and spreading bacterial infections by washing hands and being vaccinated also play a vital role.
The World Health Organisation ran World Antibiotic Awareness Week earlier this year, followed by European Antibiotic Awareness Day on November 18.
In the run up to this year’s campaign, the WHO called for antibiotics not to be used in healthy animals being reared for food.
Many governments and organisations are also collaborating to tackle antibiotic resistance.
Public Health England’s Antibiotic Guardian campaign calls on the public, health professionals and scientists to pledge to play their part in combating resistance. One of the pledges scientists can make is to participate in collaborative research into antibiotic resistance.
Bacteria have acquired resistance to nearly all antibiotics that have been developed to date.
The development of new antibiotics has steadily decreased in the past three decades and now resistance is on the rise faster than we can develop new treatments.
According to the Association of the British Pharmaceutical Industry, it takes over 12 years and costs £1.15bn to do all the research necessary to gain the licence for a new medicine. Many agree that this is inadequate when it comes to developing antibiotics.
They want the regulatory process to make it easier to bring new drugs to market more quickly.
The nature of bacterial infections also makes it hard to design clinical trials. It is often hard to accurately diagnose a bacterial infection and therefore identify enough appropriate patients to participate in a clinical trial.
What’s more, most infections are acute rather than chronic, so patients may naturally recover during the course of the trial.
The short-lived nature of bacterial infections also creates economic challenges for pharmaceutical companies because it is difficult to recoup the investment put into developing the drug.
And of course antibiotics are meant to be used sparingly too. A report by the Office of Health Economics in London found that the net present value of a new antibiotic is $5m compared to $1bn for a neuromuscular drug.
To tackle antibiotic resistance, far greater investment is needed.
A review in the Lancet said tackling antibiotic resistance needs investment somewhere between the Large Hadron Collider, which cost approximately £6bn, and the International Space Station, which cost £96bn.
Antibiotic Research UK has proposed setting up a UK Discovery Fund with contributions from the government, medical charities and the pharmaceutical industry.
In return for their contribution, pharmaceutical companies would be reimbursed for their efforts.
But not all the research geared towards tackling antibiotic resistance is focused on developing new drugs. Some researchers are looking at alternatives to antibiotics like pre and probiotics.
Another interim solution being explored is the use of antibiotic resistance breakers (ARB) which involves co-administering a nonantibiotic drug with a failing antibiotic.
Tackling antibiotic resistance will take a concerted effort from large organisations to individuals and more education. Whoever you are, the effects, now and in the future, cannot be ignored and we all must take steps today.