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Tackling AMR

Drug resistant infections or Antimicrobial resistance (AMR) and in particular antibiotic resistance in bacteria is now a worldwide problem. The bacteria in which this resistance is now most important are called Gram negative bacteria, such as Klebsiella, Acinetobacter and Pseudomonas species. No new antibiotics to kill these bacteria have been discovered for many years.

The discovery of penicillin in the 1940’s meant that simple infections, such as scrapes and cuts that got infected, could be treated easily and would not lead to death as they could have done earlier. Surgery became safer because antibiotics could prevent infections of surgical wounds. Nowadays we expect that when we are ill we can go to the doctor and get a prescription for some antibiotics to make us better. But very often we do not need antibiotics and taking them will increase the risk of AMR developing. If we take no action to stop unnecessary use of antibiotics then by 2050 there will be more deaths caused by AMR than by today’s major diseases such as cancer and diabetes (O’Neill, 2016). Complex surgery will not be possible and very young children, the elderly and immunocompromised people will be particularly at risk.

Resistance to antibiotics is caused by their overuse both by us and in farming where they are often used as “growth promoters” and not to treat a specific infection of an animal. When bacteria are exposed to antibiotics it can lead to them developing resistance. So use of antibiotics when they are not needed increases the chance of resistance developing.

Antibiotics work by interfering with different processes that bacteria need in order to survive. But, as bacteria grow so quickly and there are so many of them, a few individual bacteria will develop changes in their DNA that allow them to fight off the effects of the antibiotic. These “resistant” bacteria can then multiply resulting in a new strain of resistant bacteria that can not now be killed by the antibiotic. There are now some strains of bacteria that are resistant to every antibiotic that we have and so people who get infected by these strains will die.

The UK has been at the forefront of the fight against the global threat of AMR. The UK government commissioned Jim O’Neill to chair a review panel which published its report “Tackling drug-resistant infections globally” in May 2016. You can read the full report here https://amr-review.org/.

There were ten recommendations in the report and these were;

  1. Have a massive world wide public awareness campaign about the AMR.
  2. Improve hygiene and prevent the spread of infection mainly by proper hand washing.
  3. Only use antibiotics in farming to treat sick animals and stop antibiotics in animal waste contaminating the environment.
  4. Improve the way we measure drug resistance and antibiotic use in humans and animals across the world.
  5. Develop and use new, rapid ways of diagnosing infections to stop antibiotics being used when they will not treat the disease.
  6. Develop other ways of tackling bacterial infections such as creating vaccines and other medicines.
  7. Increase the number of people working in infectious disease health care and research.
  8. Set up a Global Innovation Fund for early-stage and non-commercial research into tackling AMR.
  9. Provide incentives to encourage industry to develop new drugs and to improve existing ones.
  10. Make sure there is a global coalition for real action – via the G20 and the UN.

We will never stop bacteria developing resistance against antibiotics, but if we use these drugs properly then it will take longer and will give us more time to develop new antibiotics and alternative drugs.
You can play your part by not asking your doctor for antibiotics when they tell you they will not help you.

Rapid infection diagnostics (RID) to combat antimicrobial resistance is a MRC funded programme of research at the University of Leeds which focusses on recommendation number 5 above.