Are we making progress in the battle against antimicrobial resistance?

World Antibiotic Awareness Week runs in November each year, and we await the new UK Five-Year Strategy. The Cabinet Office classes antimicrobial resistance (AMR) alongside climate change on the overall risk agenda. The World Bank has predicted that, globally, AMR will lead to increases in morbidity and mortality, increase the burden on healthcare systems, increase extreme poverty, and could inflict heavy losses on the global economy. Without succumbing to tabloid hyperbole, this is a serious issue in healthcare that may turn back the clock to a future without effective antibiotics. Recently, Professor Leaper¹ was asked what steps should be taken to prevent antibiotic resistance becoming a reality, and he responded that it is already a real and present threat particularly to treat sepsis, in intensive care and renal units, and particularly where infections have been acquired in hospital.

The nature of the problem

Until the late 1980s the issue was rarely mentioned as being something we needed to worry about. New substances were being developed at that time and brought to market when resistance rendered existing drugs ineffective. That all changed in the 1990s when few new drugs were developed – a situation that continues to this day. The stark fact is that antibiotics and other antimicrobials do not provide drug companies with a decent return on investment, so research is directed elsewhere. It is essential therefore that we use wisely the antimicrobials that are still effective.