Clinical, economic and societal impact of antibiotic resistance

Area of Science:

• Microbiology and Infectious Diseases
• Pharmacology and Drug Development
• Public Health and Epidemiology

Background:

• Antibiotic resistance has been a concern for over 75 years, escalating with widespread overuse in human medicine and animal agriculture.
• Gram-negative bacteria resistant to last-resort drugs like polymyxin B and colistin are increasing, alongside pan-resistant strains.

Discussion:

• The development of new antimicrobial agents, a key strategy against resistance, has lagged significantly in the past 10-15 years.
• Despite promising new agents, none currently address all potentially resistant bacterial strains.
• The potential return to a pre-antibiotic era, marked by dramatically increased morbidity and mortality, is a serious, albeit unlikely, possibility.

Key Insights:

• Overuse of antibiotics in human and animal health is driving the global rise in antibiotic resistance.
• The pipeline for novel antimicrobial drugs has slowed, creating a critical gap in treatment options.
• Emergence of pan-resistant bacteria and strains resistant only to older drugs like polymyxins highlights the severity of the crisis.

Outlook:

• Continued antimicrobial stewardship and accelerated development of novel antimicrobial agents are crucial.
• Addressing the multifaceted challenge of antibiotic resistance requires a global, collaborative effort.
• Failure to control resistance could lead to a future where common medical procedures become dangerously risky due to untreatable infections.