Antimicrobials—including antibiotics, antivirals, antifungals, and antiparasitics—are medicines used to prevent and treat infections in humans, animals, and plants. Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and death. AMR has become a major health concern in the world. The WHO has declared that AMR is one of the top 10 global public health threats facing humanity.
The emergence and spread of drug-resistant pathogens that have acquired new resistance mechanisms, leading to antimicrobial resistance, continues to threaten our ability to treat common infections. Especially alarming is the rapid global spread of multi- and pan-resistant bacteria (also known as “superbugs”) that cause infections that are not treatable with existing antimicrobial medicines, such as antibiotics. AMR has become a serious issue, because the clinical pipeline of new antibiotics is dry and super bugs are rapidly increasing. So, there might come a time when we will run out of antimicrobials to treat infections. AMR occurs due to inappropriate use of antibiotics.
Some of the factors that promote resistance and are related to inappropriate antimicrobial use:
• Antimicrobials for viral infections, especially for the common cold/flu
• Antimicrobials sold without supervision
• Exposure to sub-optimal levels, incorrect dosing regimens
• Exposure to broad-spectrum antimicrobials, especially when a specific organism is likely
• Exposure to microbes carrying resistant genes
• Lack of hygiene in clinical environments
• Use and abuse of antimicrobials in the food, carpentry, and agriculture sectors
Now, the question is; how to deal with AMR? It is a tough battle. All stake holders should contribute from their side in the fight against AMR.
1) Policy makers
Government and policy makers should make strong policies for the fight against AMR. Buying and selling of antimicrobial agents should be illegal without doctor’s prescription. Government should make different infection control policies, and antibiotics stewardship program mandatory, in hospitals.
We as clinicians should not prescribe antimicrobial agents unless absolutely indicated. We should always prescribe proper dose of antibiotics for proper duration.
I would like to request everyone not to buy medicines without prescriptions, especially antibiotics. As a patient, always ask your doctor about the medicines you have been prescribed. Make it a habit of asking the indication of starting antibiotics if you have been prescribed one.
Together we can, and we will, win the battle against AMR.