A group of experts, including Dr. Jordi Vila, director of the Antibiotic Resistance Initiative at ISGlobal, has published the conclusions of the scientific debate that took place in Barcelona on the global threat of antimicrobial resistance. The goal of the meeting, organized jointly by Biocat and ISGlobal and Bio-Cat, was to launch a debate among the main stakeholders in order to define a coordinated and multifaceted approach to fight antimicrobial resistance. 

The document, published in the journal New Microbes and New Infections, resumes the views and recommendations that emerged during the debate, focused on three main areas:  

• Antimicrobial resistance in animals and the food chain: The massive use of antibiotics to prevent and treat infections in farm animals has increased the selective pressure on pathogenic and non-pathogenic microorganisms that can spread to humans through direct contact, the food chain or pollution of farm effluents. The experts recommend that antimicrobial agents critical for human health be identified and avoided for animal use. In this context, the WHO has established a list of antibiotics for exclusive human use, although it is neither regulated nor mandatory.  

• Antimicrobial resistance in the environment and the community: Inappropriate prescription and consumption of antibiotics, together with self-medcation, reflect a lack of awareness on the risks of antimicrobial resistance. To tackle this, the experts recommend the establishment of educational programs on the rational use of antibiotics addressed to different community sectors. In low-income countries there is the additional problem of lack of efficacy of certain antibiotics (including counterfeit drugs), insufficient dosages and poor levels of sanitation that increase the selection of resistant bacteria. In addition, the accumulation of these compounds in the environment further selects resistant organisms by generating a gigantic reservoir for resistance genes. The authors point out that the current legislation does not address antibiotic concentrations in sewages and water treatment plants.   

• Antimicrobial resistance within healthcare settings: Hospitals represent an ideal scenario for the spread of resistant bacteria and the transfer of resistance genes. The implementation of stewardship programs that guide the type, dosage, and treatment regime should be mandatory.  In addition, the rapid detection of resistance mechanisms and the identification of bacterial species and their resistance profiles will be an extremely useful tool for surveillance studies.

The authors emphasize the urgent need to relaunch the research and development of new antimicrobial agents based on innovative strategies that combine pharmaceutical and public health interests.   

Tackling the problem of antibiotic resistance will require global and collaborative effort from the general population, the scientific community and policymakers. The benefits of winning the battle are not only medical but also economical: antibiotic-resistant infections cause an estimated loss of 30,000 million USD in USA and 1,500 million USD in Europe every year.

Reference:

Roca I, Akova M, Baquero F, Carlet J, Cavaleri M, Coenen S, et al. The global threat of antimicrobial resistance: science for intervention. 2015. New Microbes New Infect. Apr 16;6:22-9

More information

Antibiotic Resistance Initiative