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Antibiotic Resistance – an Increasing Threat to Health

09-03-2012 08:00:00

Bacteria cultivated in petri dishes at a laboratory

Photo: DTU

Every year more than 25,000 European citizens die from infections caused by bacteria that have developed resistance towards antimicrobials. Treatments that used to work efficiently have lost their effect. One of the big sinners is overuse of antimicrobials for human and for veterinary purposes.

The importance of antibiotics
Modern life is closely connected to the use of antibiotics. They cure diseases such as pneumonia and bacterial abdominal infections, and are indispensable in connection with major surgery.
Modern livestock farming is also dependent on antibiotics as animals may get ill exactly like us. Animals, that previously would die or be killed, are now cured and able to reproduce and be delivered at slaughterhouses. Altogether:  If antibiotics lose their potency, we lose a fundamental basis of modern society.

Development of resistance
There is an inherent risk for the development of bacterial resistance when using antibiotics. When bacteria are exposed to antibiotics they try to defend themselves by altering their genes in order to develop resistance. The more antibiotics used, the greater the risk of resistance developing. And the risk is even greater when using broad-spectrum antibiotics that attack a broad variety of bacteria.  

In recent years, we have experienced a significant increase in the use of antibiotics including the broad-spectrum antibiotics.  At the same time we have seen the development of resistance among ordinary intestinal bacteria. So, in the future we may face a reality where it is very difficult, to cure e.g. a common urinary tract infection.

Moreover, in the EU Member States the estimated increased costs for health care is 1.5 billion euro each year – all due to antibiotic treatments that have failed because of resistance.

Surveillance and guidelines
If we want to preserve the ability to treat serious diseases with antibiotics, we need to stop the overuse and misuse of antibiotics. Some of the tools, which have been successfully used in Denmark, are surveillance, guidelines and restrictions on the use of antimicrobials in general and on the critically important antibiotics in particular.

Time for joint action
Development of antibiotic resistance does not respect borders. Increased international trade with both food and live animals and travelling for business and leisure purposes contributes actively to the spread of resistant bacteria. The combat against exaggerated use of antibiotics and the development of resistance calls for joint action.

This is the main issue of the conference on antibiotic resistance, which will be held in Copenhagen 14 – 15 March, 2012.


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A short historical outline

The development of antibiotics has saved millions of human lives since the 1940’s, when the first commercial products of penicillin and streptomycin were introduced on the market. Early on it was recognized that the microorganisms could develop resistance towards the applied antibiotics, leading to treatment failure. When a strain resistant to a specific drug becomes common – the usefulness of the treatment becomes limited. 

Soon after antibiotics became commercially available they were also used in animal production, not only to treat animals with infections but also as growth promoters.  Adding a low dose of antibiotics to the feed made the animals grow faster. As the use of growth promoters in food animal production increased globally, the concern for a potential human health risk also increased within the scientific community. The same types of antibiotics that were vital for treatment of human infections were also being given in huge volumes as growth promoters to pigs and poultry – with the risk that antibiotics critically important to human medicine could become useless.

During the last century solutions to these problems were generally sought through the development of new types of antibiotics. However, by the turn of the century, such developments slowed down significantly, and a majority of scientists now finds it urgent to ensure that the effectiveness of drugs considered critically important to human treatment is preserved.

In 2007, WHO listed fluoroquinolones, 3rd/4th generation cephalosporins and macrolides as the types of antibiotics most critical for human medicine and urged for comprehensive risk management strategies worldwide.