Reasons for Resistance

There is no one cause that can be solely held responsible for the spread of resistance. The reasons are diverse and require multi-sectoral and multi-stakeholder cooperation on a global level.

Antibiotic Resistance current scenario

  • Antibiotic resistance kills: 214,000 newborns are estimated to die every year from blood infections (sepsis) caused by resistant bacteria – representing at least 30% of all sepsis deaths in newborns.
  • Antibiotic resistance spreads silently across the world. More than 60% of the populations in some areas carry multidrug-resistant bacteria in their normal bacterial flora.
  • Antibiotic resistance is costly. It is estimated that the median overall cost to treat a resistant bacterial infection is round 700 USD, equal to over one year’s wages of a rural worker in India. Novel treatments for multidrug-resistant infections can cost up to tens of thousands of dollars, making them unaffordable for many.
  • Antibiotic resistance is here now. Resistance has already developed to the last-line antibiotics for gonorrhea, which in some cases is nearly untreatable. With 106 million new cases/year, the consequences of total resistance would be devastating.

What will happen if antibiotics stop working?

The discovery and introduction of antibiotics to treat bacterial infections is one of the single most important advancements in human medicine. From treatment of pneumonia and gonorrhea to prevention and treatment of infections that can arise after major surgery or chemotherapy, antibiotics have become indispensable. Overall, antibiotics have greatly improved human health and animal welfare. They are really the cornerstones of modern medicine.

Unfortunately, the growing phenomenon of antibiotic resistance now threatens to leave us without effective treatment of bacterial infections. Over time, some bacteria have evolved the means to avoid and survive the action of antibiotics, for example by producing molecules that destroy the antibiotic. As resistance increases, antibiotics that were once effective stop working. Use and misuse of antibiotics in health care facilities, in agriculture to counteract infections and promote growth of crops and livestock, and in society has lead to the selection and proliferation of antibiotic resistant bacteria. These resistant bacteria then spread to other people, animals and in the environment, facilitated by poor hygiene and sanitation practices, human travel and trade. At the same time, very few new antibiotics are under development.

Antibiotic Consumption

Antibiotic use is a major driver of resistance. In 2010, India was the world’s largest consumer of antibiotics for human health at 13 billion units (10.7 units per person). The next largest consumers were China at 10 billion units (7.5 units per person) and the US at 6.8 billion units (22.0 units per person).

India will see the highest growth rate in antibiotic usage in food animals between now and 2030. Currently it ranks 4th among the 10 nations with high levels of antibiotic use in animal farms. Antibiotics use in animal food could increase 82 percent by 2030, putting human lives in danger.

Overuse of antibiotics results in antibiotic resistance which has been considered as dangerous and deadly as terrorism and global warming. Are we heading towards a post-antibiotic era? We cannot reverse this frightening trend, but we can slow it down. And all of us need to change our behaviour to once again gain the upper hand in the fight against antibiotic-resistant bacteria.

Infection Control

Hospitals are the breeding grounds for drug resistant bacteria and the transfer of such resistance from one bacteria to another is facilitated in hospitals with poor infection control. Human body is more susceptible to infections during illness as immune systems are compromised. Thus, it is crucial to ensure that hospitals implement disinfection guidelines to improve hospital ecology.

Lack of Surveillance Mechanisms

Mechanisms to capture data on resistant microorganismsis crucial to follow their spread among people and geographical regions. Lack of such surveillance mechanisms makes it incredibly difficult to track drug-resistant infection outbreaks and consequently prevents policy makers to take measures to control the spread of such infections.

Lack of Awareness

Antibiotic misuse due to lack of awareness is not uncommon. Improper dosage, incomplete course of antibiotic treatment are all factors that contribute towards drug resistance. Common misconceptions like using antibiotics for the treatment of infections like cold, flu, malaria etc. that are caused by viruses, parasites or any microorganism other than bacteria account for a major proportion of antibiotic abuse and lead to ABR.

Poor Vaccination and Hygiene

Poor vaccination leads to increased chances of infections, which leads to increased antibiotic usage. Similarly, improper personal and community hygiene leads to easier bacterial transfer, spreading resistance. Simple steps like cleaning hands properly and regularly can go a long way in combating the spread of resistance.