In the last few years, as sophisticated medicines were introduced in the market, disease-causing agents bacteria evolved rapidly to develop resistance. At some point, the pace of evolution outdid the pace of drug development and now scientists are baffled as the lines between treatable and untreatable diseases have blurred.
To explore this at a global scale, The Lancet Infectious Diseases printed a special report titled “Antibiotic Resistance: The Need For Global Solutions”, on the flanks of the Antibiotic Awareness Week.
It is based on the findings and opinions of a commission of 26 globally renowned scientists. Otto Cars, head of the Swedish-funded network ReAct, led this commission. Representing Pakistan were AKU’s Women and Child Health Division faculty members Drs Anita Zaidi, Farah Qamar, Fatima Mir and Zulfiqar Bhutta.
In a hard-hitting opening editorial, The Lancet pointed out: “Antibiotics have been used with great profligacy—prescribed pointlessly for viral infections, added to animal feed to boost growth of livestock, and handed out like cough sweets in the community.”
The rest of the issue kept up the tone as groups of authors wrote on the global situation of antibiotic resistance, its major causes and consequences, and identified key areas in which action is urgently needed.
The overarching message was that achievements in modern medicine – such as major surgery, organ transplantation, treatment of preterm babies, and cancer chemotherapy – that we today take for granted would not have been possible without access to effective treatment for bacterial infections.
However, within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken.
Dr Anita Zaidi, Professor and Chair, Department of Paediatrics and Child Health, AKU, says: “The selection pressure caused by the use of millions of tonnes of antibiotics over the past 75 years since antibiotics were introduced has made almost all disease-causing bacteria resistant to antibiotics commonly used to treat them.”
Simple infections, such as urinary infections, could become deadly in the near future as bacteria evolve to resist the drugs we use to treat them.
“Treatment of many infections such as multi-drug resistant tuberculosis and infections acquired in hospitals has become very challenging in Pakistan, and globally,” said Dr Anita.
“Sometimes, we are left with no antibiotic that works. There is a need, both for new antibiotics to be developed, and for proper use of antibiotics in humans and animals to preserve their effect when needed,” she added.
At the end, to ebb the tide, the commission recommends focusing on hospital stewardship programmes to use antibiotics responsibly, limiting use in agriculture, provision of access to appropriate therapy in countries with weak health systems, community education about when to use antibiotics, and environmental management.