ANTIMICROBIAL RESISTANCE (AMR):

Pubblications MAY 2023 | FRI COMMUNICATION

ANTIMICROBIAL RESISTANCE (AMR):

THE GLOBAL EMERGENCY OF INCREASINGLY DRUG-RESISTANT BACTERIA

A recent study commissioned by the British government has suggested that AMR could kill 10 million people annually by 2050. 1,2.“Si tratta di una vera e propria pandemia, la prossima che dovremo affrontare”,”It is a true pandemic, the next one we will have to face,” stated Professor Giuliano Rizzardini, Director of the Department of Infectious Diseases at ASST Fatebenefratelli Sacco in Milan, in a recent interview.

AMR is perceived as a formidable threat that, without intervention to contain it, will surpass cancer in terms of mortality. Each year in Italy alone, nearly 11,000 people die due to infections caused by multidrug-resistant germs, highlighting the magnitude of the problem and its impact not only in terms of deaths but also economically and in public health.

Unfortunately, the pipeline for new antimicrobials is currently very limited. In 2019, the World Health Organization (WHO) identified 32 antibiotics in clinical development, of which only 6 were classified as innovative. There is an urgent need for new antibiotics, for example, to treat carbapenem-resistant Gram-negative bacterial infections. However, if the current patterns of antibiotic use do not change, these new drugs will suffer the same fate as the existing ones and become ineffective.

In a tweet, the European Medicines Agency (EMA) appeals to big pharmaceutical companies, stating, “We urge companies to focus more on the research and development of antimicrobials.” What other effective strategies can be adopted to contain the problem? A recent article in the prestigious journal “The Lancet” identified five possible areas of intervention that could help combat this phenomenon.3.

We believe it is important to raise awareness among as many people as possible on this topic. Contrary to popular belief, multidrug-resistant germs are no longer confined to hospitals or developed countries; they are a global reality spreading in hospitals, residential care facilities, communities, patients’ homes, and even in the field of animal husbandry. The following are the areas of intervention:

1) The principles of infection prevention and control remain the foundation for preventing infections. This includes both hospital-based infection prevention and control programs and community-based programs focused on water and sanitation. Supporting these programs is crucial to contain the problem.

2) Infection prevention through vaccinations is essential to reduce the need for antibiotics.

3) Minimizing exposure to antibiotics unrelated to the treatment of human diseases. The increased use of antibiotics in livestock has been identified as a potential contributor to antimicrobial resistance in humans, although the direct causal link remains controversial.

4) Minimizing the use of antibiotics when they are unnecessary for improving human health, such as in the treatment of viral infections.

5) Investing in the development of new antibiotics. In recent decades, investments in this area have been meager compared to those in other public health issues with similar or lower impact. Given the global importance of antimicrobial resistance, it is urgent to evaluate more effectively which policies have worked and where.

In light of these considerations, it is easy to understand how AMR is a global problem that needs to be addressed with a comprehensive vision and integrated approaches, decisively and without resigning ourselves to considering the problem insurmountable. Each of us can make a difference.

Editorial Staff: Medical Fri Communications Department

References:

1) O’Neill J. “Tackling drug-resistant infections globally: final report
and recommendations” – 2016 – London: Review on Antimicrobial
Resistance,
2) O’Neill J. “Antimicrobial resistance: tackling a crisis for the health and wealth of nations” – 2014 – London: Review on Antimicrobial Resistance,
3) Antimicrobial Resistance Collaborators “Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis” – 2022 – Lancet Feb 12;399(10325):629-655. doi: 10.1016/S0140-6736(21)02724-0.

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