The Resistance Against Antibiotic Resistance

Resistance Against Antibiotic Resistance Due to their widespread use as medical interventions to combat infections caused by bacteria in both animals and plants, the negative impacts of antibiotics have become increasingly pronounced on a global scale. Bacterial resistance to antibiotics is a prominent issue, as they are the common solution to fighting off infections in many animals. In the United States alone, approximately 2 million people become infected by antibiotic-resistant bacteria each year and roughly 23,000 people die as a result (CDC).

The absence of their effectiveness is the cause of the potential lethality of the once easily treated bacterial diseases. In order to prevent the inflation of these statistics, how can research, developing technologies, and new protocols be used to ease the medical stress brought about by antibiotic resistance? One of the leading causes of antibiotic resistance is overuse. Despite declining in recent years, antibiotic prescribing rates in the United States are still high compared to international standards (Antibiotic Resistance Project). For example, in 2014, for every 1000 people, there are 835 antibiotic prescriptions and about 30 percent of oral antibiotics in U.S. outpatient settings are unnecessary (Antibiotic Resistance Project). Diseases, such as pneumonia, tuberculosis, and gonorrhea, are growing increasingly difficult to treat, and in some cases, they are impossible due to the bacteria’s resistance to what at one point was a solution (WHO). As a result, medical costs increase because of the development of newer, more complicated, and more expensive drugs.

Despite these developments, there is little to no guarantee for these new drugs to be safe against antibiotic resistance. In fact, due to eventual overuse, misuse, and the high reproductive rates and a short generational gap of bacteria, it is only a matter of time before mutations and natural selection bring about resistance.

Without any specific solutions or strategies, new drug production is a seemingly futile attempt to outpace resistant bacteria. In an interview with the World Economic Forum, Nobel Prize winner and chemist based at the Laboratory of Molecular Biology at the University of Cambridge, Venki Ramakrishnan, called for worldwide cooperation in the impending crisis and for antibiotics to be used sparingly, as a last resort (Moskvitch). When asked for potential alternatives to antibiotics, he stated that vaccines could “be of enormous benefit”. The main drawback to this potential solution, however, is the difficulty of the development process, as well as a large amount of time it could take, all with the potential for failure. The World Health Organization (WHO) shares a similar view on the issue. They also call for the sparing use of antibiotics and for the healthcare industry to invest in the research and development of new vaccines and other tools to bring forward alternatives to antibiotics, making it easier to limit their use (WHO). However, Ramakrishnan goes on further to say that governments should be the ones involved in the development of new antibiotics because of the private enterprise business model.

Due to the high drug development costs and the limited market specific drug targets, it is not in a company’s interest to develop a particularly effective drug. He explains, “If you want to make a lot of money from a drug, it should be something the patient has to take all of their life.” Due to the role of government to work towards the benefit of their society, Ramakrishnan believes that they are the ones who are best suited to oversee the production of any new drugs. In the wake of the ever-growing dilemma that is brought about by antibiotic resistance medical professionals have sought to discover ways to effectively reverse the resistance. As a result of these efforts, there have been some successful results in areas, such as hospitals, which can be attributed to the implementation of antibiotic reduction policies. For example, at a hospital in Glasgow, Scotland, an outbreak in a neurosurgical ICU of a multidrug-resistant Klebsiella aerogenes was only controlled once the use of all antibiotics was suspended (Barbosa). The general consensus in the successes of decreasing antibiotic resistance in hospitals occurred after implementation of policies that regulate and control antibiotic use (Barbosa). This also holds true on a much larger scale. In 1998, Denmark began to restrict the use of antibiotics for growth promotion in livestock and poultry.

With the implementation of these new policies, all antibiotics used on food animals must be prescribed by a veterinarian who can not profit from the sale, and farmers, pharmacies, and veterinarians must report their use (Antibiotic Resistance Project). As a result of these restrictions, a diminution of resistance to antibiotics such as avoparcin and macrolides occurred (Casewell). Within a year after the ban took place, antibiotic resistance in Denmark’s livestock dropped 26 percent (Antibiotic Resistance Project). The World Health Organization has found that in general, the ban has reduced human health risk without causing significant harm to animal health or to the income of farmers (Chan). Currently, in fact, many consider Denmark to be “spearheading the fight against antibiotic resistance” (Technologist). However, it should also be noted that decreases in antibiotic resistance cannot be fully attributed to policies alone. The results in smaller case studies, such as in hospital communities, are not completely clear, as they do not account for other factors, such as infection control measures, and the other effects that arise from decreasing the use of antibiotics (Barbosa).

Generally, a decrease in the use of one antibiotic results in an increase in another, but the resistance levels of the other antibiotic are rarely reported in the case studies (Barbosa). On the larger scale of Denmark, the Animal Health Institute claimed that the ban was not a success, but caused increase death and disease among animals, labeling the ban as counterproductive. They also claimed that while resistance to some antibiotics has decreased in animals, resistance to other antibiotics has increased (Animal Health Organization). However, it is not fair to call the ban completely unsuccessful. Reportedly, the change in antibiotic policy had a little negative impact on the country’s pork industry. Since the ban, the cost of raising pigs has only gone up €1 per animal (Levy). To counteract the use of antibiotics, farmers in Denmark are now allowing piglets to remain with their mother for longer periods of time in order to build up their immune systems due to the fact that using antibiotics is no longer a viable means of doing so (Levy). Despite the supposed claims against it, however, the ban was recognized as a success in Europe and by 2006, the use of growth promoters was banned by the European Union (Levy). In order to properly combat the growing threat of antibiotic resistance, it is necessary to look at the evidence provided by the Danish ban on the use of antibiotics as growth promoters. As proven, antibiotic resistance rates decreased once they ceased being used haphazardly, and were only used when absolutely necessary (Antibiotic Resistance Project). Denmark’s success was made possible through the efforts of the agriculture industry, veterinarians, human health researchers, and the government working together (Levy). In order for a similar system to work on a global level, collaboration is needed on that large scale.

Governments need to take responsibility for the creation of any new antibiotics and work conjointly with the governments of other nations to draft effective policies to ease the medical stress brought about by antibiotic resistance.