AMR: preventing the next pandemic

After years of excessive and sometimes inappropriate use of antimicrobials, an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi are no longer susceptible to the common medicines used to treat them. Simon Aylen discusses the history and challenges of antimicrobial resistance (AMR) and the strategies we can employ to control and contain this global threat.

Prior to 1900, infectious diseases were the leading cause of death worldwide, particularly pneumonia, influenza, and tuberculosis (TB).1 However, the successful implementation of public health initiatives, the introduction of vaccines, and the development of antimicrobial compounds, such as penicillin, greatly diminished the mortality rate from infectious diseases.

The discovery of penicillin by Alexander Fleming in 1928 marked the start of the golden age of antibiotic discovery. This period lasted until the 1970s, and in fact most of the drugs we commonly use today were discovered solely within the 1950s.2 Since then, antibiotics have significantly increased human health and lifespan by supporting modern life-saving medical procedures such as cancer chemotherapy, advanced surgery, and organ transplants, in addition to curing deadly infectious diseases like tuberculosis and pneumonia.

However, the widespread use of these drugs for decades has spawned a new generation of antibiotic-resistant strains (aka 'superbugs'). Due to this, treatment options for common infections are fast running out and AMR now presents a major health issue globally, with a high proportion of resistance reported within both the healthcare setting and the general community.3 Consequently, routine surgery and many immune-suppressing cancer treatments could soon become simply too dangerous to perform due to the risk of infection.

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