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Experts warn of “global pandemic of antibiotic resistance”

19 September 2008

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The threat of increased antibiotic resistance could return us to the “pre-antibiotic era”, threatening vital components of modern medicine, Swedish medical experts have warned.

Major surgery, organ transplantation, and cancer chemotherapy will be threatened if antibiotic resistance is not tackled urgently, Professor Otto Cars, of the Department of Medical Sciences, Uppsala University, writes in an editorial on the BMJ website.

The professor warns that a concerted global response is needed to address rising rates of bacterial resistance caused by the use and abuse of antibiotics.

All antibiotic use “uses up” some of the effectiveness of that antibiotic, diminishing the ability to use it in the future, say Professor Cars and his colleagues, and antibiotics can no longer be considered as a renewable source.

They point out that existing antibiotics are losing their effect at an alarming pace, while the development of new antibiotics is declining. More than a dozen new classes of antibiotics were developed between 1930 and 1970, but only two new classes have been developed since then.

According to the European Centre for Disease Prevention and Control, the most important disease threat in Europe is from micro-organisms that have become resistant to antibiotics.

In 2000, the World Health Organisation called for a massive effort to address the problem of antimicrobial resistance to prevent the “health catastrophe of tomorrow”.

So why has so little been done to address the problem of resistance, ask the Swedish authors in the BMJ editorial?

They say antibiotics are overprescribed and are still illegally sold over the counter in some EU countries, and self-medication with leftover medicines is commonplace.

The authors claim that a dearth of data on the magnitude and burden of antibiotic resistance may explain why there has been little response to this public health threat from politicians, public health workers, and consumers.

The authors believe that priority must be given to the most urgently needed antibiotics, and incentives given for developing antibacterials with new mechanisms of action.

In addition, “the use of new antibiotics must be safeguarded by regulations and practices that ensure rational use, to avoid repeating the mistakes we have made by overusing the old ones”, they say.

They point out that reducing consumer demand could be the strongest force to driving change — individuals must be educated to understand that their choice to use an antibiotic will affect the possibility of effectively treating bacterial infections in other people.

But, they claim, the ultimate responsibility for coordination and resources rests with national governments, WHO and other international stakeholders.