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How to overcome the growing antibiotic resistance problem

Key data: the antimicrobial resistance crisis 

Agnès Vernet, Science journalist
On June 16th, 2022 |
2 mins reading time
3
Key data: the antimicrobial resistance crisis 
Key takeaways
  • To avoid a health catastrophe, we not only need to find new antimicrobial solutions but also reduce unnecessary use of treatments.
  • In particular, the ECDC has published a recent infographic showing the evolution of antibiotic resistance in different bacteria.
  • This antibiotic resistance is also a veterinary problem because the use of antibiotics in livestock is one of the drivers.
  • 252 antibiotic agents targeting priority pathogens are in preclinical phase. Only a small proportion of these molecules that will prove safe and effective in human health, and will not be available for a decade.

It is clear that to avoid a health cat­a­stro­phe, we must not only find new antimi­cro­bial solu­tions but also reduce the unnec­es­sary use of treat­ments; both com­ple­men­tary and vital solu­tions, accord­ing to the experts. And yet, when we look at the fig­ures, the efforts are not yet high­ly noticeable.

Use may still be on the rise

Glob­al con­sump­tion of antibi­otics in hos­pi­tals between 2019 and 2020 accord­ing to San­té publique France rose by +2.1%. Even though, at the same time, con­sump­tion in towns and cities has decreased, large­ly due to the reduc­tion in care caused by Covid lockdowns.

DDJ/1000 JH = Num­ber of dai­ly dos­es per 1,000 hos­pi­tal days.
DDJ/1000H/J = Num­ber of dai­ly dos­es per 1,000 inhab­i­tants per day.
Sources: San­té publique France, report in the hos­pi­tal sec­tor and in the com­mu­ni­ty sec­tor.

Data from the Euro­pean Cen­tre for Dis­ease Sur­veil­lance (ECDC) show that even in Europe, resis­tance to treat­ment is present. For Kleb­siel­la pneu­mo­ni­ae, most strains cir­cu­lat­ing on our con­ti­nent are resis­tant to car­bapen­ems, a wide­ly used class of antibi­otics. This trend is still on the rise despite the efforts of expert cen­tres. On the oth­er hand, meti­cillin-resis­tant Staphy­lo­coc­cus aureus is becom­ing less fre­quent. Progress is there­fore possible.

And this trend is not lim­it­ed to com­mon antibi­otics. This inter­ac­tive info­graph­ic from the ECDC shows the growth of resis­tance against antibi­otics of choice.

© ECDC

Agriculture is part of the problem

A human health issue, but also a vet­eri­nary health issue. The use of antibi­otics in live­stock is one of the dri­ving forces behind the devel­op­ment of antimi­cro­bial resis­tance. Although high­ly con­trolled in Euro­pean farms, they are still gen­er­ous­ly admin­is­tered to live­stock in oth­er regions. In the Unit­ed States, this prac­tice that pro­motes the growth of ani­mals remains autho­rised but lim­it­ed since 2017 to antibi­otics that are not impor­tant for human health. But they remain appro­pri­ate for treat­ment and even remain the main­stay of the vet­eri­nary pharmacopoeia. 

Solutions that are difficult to come by

50 new antibi­otics are in devel­op­ment accord­ing to the WHO. 32 tar­get pathogens con­sid­ered to be a pri­or­i­ty for human health, but the transna­tion­al med­ical author­i­ty recog­nis­es their lim­it­ed ben­e­fit com­pared to exist­ing mol­e­cules. Only two of them act on mul­ti-drug resis­tant Gram-neg­a­tive bac­te­ria, strains whose health con­se­quences are grow­ing rapidly. 

Most of these drug can­di­dates are still in the ear­ly stages of eval­u­a­tion and 252 antibi­ot­ic agents tar­get­ing pri­or­i­ty pathogens are in pre-clin­i­cal phase. The small pro­por­tion of these mol­e­cules that will prove safe and effec­tive in human health will not be avail­able for anoth­er decade.