The Antibiotic Resistance Crisis

By: Tara Gandhi

“The Antibiotic Resistance Crisis: Part 1: Causes and Threats.” Pharmacy and Therapeutics, vol. 40, no. 4, Apr. 2015, p. 277, pmc.ncbi.nlm.nih.gov/articles/PMC4378521/.

This article aims to explore the antibiotic resistance crisis, its causes, and its effects. In modern society, antibiotics are treated as the magical cure to bacterial infections and diseases; however, what many fail to realise is that the use of antibiotics opens the deadly Pandora’s box of antibiotic-resistant bacteria, which have fatal side effects. Antibiotics are medicines that kill bacteria or stop their growth. They do this through several methods such as destroying the cell wall of the bacteria, which causes the bacteria to burst, and blocking protein and DNA synthesis, which prevents bacteria from acquiring the genetic and chemical material required for multiplication. Penicillin, initially discovered by Alexander Fleming in 1928, is an example of an antibiotic that effectively reduces the growth of bacterial infections, such as strep throat and pneumonia.  Other uses of antibiotics include chemotherapy for cancer, organ transplants, and the management of chronic diseases such as diabetes and kidney failure. 

Overview of Antibiotic Resistance: 

Yet, this medical marvel comes with a dangerous consequence of the rise of antibiotic-resistant bacteria, which threaten to undo decades of medical progress. Antibiotic resistance is when bacteria change in response to exposure to antibiotics, making antibiotics less or completely ineffective. This means that infections that were once treatable with antibiotics become harder to cure due to the adaptive ability of bacteria, leading to longer illnesses, higher medical costs and increased death rates. 

Misprescription and Misuse 

There are numerous causes of antibiotic resistance, including misprescription, overuse, inadequate development, agricultural practices, and even global policy. Firstly, a pressing reason is the overuse and misuse of antibiotics. It is estimated that 30-50% of antibiotic prescriptions are incorrect in terms of drug choice, dosage, and the duration of the antibiotic course. Oftentimes, antibiotics are incorrectly prescribed for colds, flus, or sore throats, which are viral infections, not bacterial; therefore, harmless bacteria in the body are exposed to antibiotics, allowing resistant strains to develop even in the absence of a bacterial infection. Moreover, prescribing the wrong antibiotic for an infection may partially expose the bacteria to the medicine, which won’t be killed due to the incorrect medication. Still, it will experience stress that may trigger genetic mutations or horizontal gene transfer (HGT), allowing resistance genes to spread between bacteria. Lastly, people often take extra antibiotics, which they don’t actually need to either “speed up” recovery or as a precaution,but this unnecessary use only increases bacterial exposure, giving microbes more chances to develop and spread resistance.

Agriculture

Secondly, the use of antibiotics in agriculture can also lead to antibiotic resistance. Approximately 80% of all antibiotics sold in the U.S. are used in animals, mainly to promote growth and prevent infection rather than to treat disease. Resistant bacteria that evolves from livestock can survive in meat products, entering humans through consumption, causing spread of antibiotic-resistant infections in humans.

Decline in development

Further, a decline in new antibiotic development and a lack of new medicines in the market, makes it so that bacteria have more time to adapt to existing antibiotics as they naturally mutate, leading to strong and difficult to combat infections. This is due to high research costs and low profit returns on antibiotic research as well as strict regulatory barriers and physicians reserving new and expensive antibiotics for only the most severe cases, reducing market demand. 

Poor Global Healthcare 

Lastly, poor regulation, limited healthcare access, and lack of sanitation in many developing countries make antibiotic misuse and resistance significantly worse. In several regions, antibiotics can be purchased without prescriptions, leading to self-medication, incorrect dosages, and unnecessary use for viral illnesses. Limited access to qualified healthcare professionals means that patients often rely on unverified advice or leftover medicines, further promoting misuse. Furthermore, the absence of coordinated global policies and weak surveillance systems makes it difficult to track, control, or respond to emerging resistant strains, allowing many resistant bacteria to develop without treatment.

Impacts:

These resistant strains of bacteria can be deadly, in fact resistant infections kill tens of thousands every year. Healthcare-associated infections or HAIs are infections that patients contract while receiving treatment, and globally, many tend to be due to antibiotic resistant pathogens. Nearly 2 million 2 million Americans develop HAIs annually, leading to around 100,000 deaths, many of which could be easily prevented.  MRSA (skin infection) or Methicillin-Resistant Staphylococcus aureus alone causes 11,000 plus fatalities in the US,which is more than Parkinson’s disease, HIV/AIDS and homicide combined. As one of the most frequently occurring resistant pathogens globally, it has spread to hospitals, communities and even animals. Others such as VRE (Vancomycin-Resistant Enterococci, infects urinary tract and blood) and Acinetobacter (causes HAIs) cause a combined approximately 78,000 HAIs each year and 2000 deaths in America alone. Moreover, patients who are diagnosed with resistant bacteria often experience 6-13 extra days in the hospital, along with higher chances of long-term disability and repeat infections, showing the fatal outcome of the antibiotic resistance crisis.  

Conclusion: 

Antibiotic resistance is a growing global health crisis fueled by misuse, overuse, and limited development of new drugs. Without responsible antibiotic use, stronger bacteria will continue to emerge, leading to longer illnesses, higher deaths, and increased impacts worldwide. The world requires urgent investment in research, as well as stricter global policies and public awareness, to combat this threat and preserve the effectiveness of antibiotics for future generations.

Additional Sources:

1. Cleveland Clinic. “Antibiotics.” Cleveland Clinic, 2023, my.clevelandclinic.org/health/treatments/16386-antibiotics.

2. Mayo Clinic. “MRSA Infection - Symptoms and Causes.” Mayo Clinic, 8 Nov. 2022, www.mayoclinic.org/diseases-conditions/mrsa/symptoms-causes/syc-20375336.

3. “Actinobacteria - an Overview | ScienceDirect Topics.” Www.sciencedirect.com, www.sciencedirect.com/topics/medicine-and-dentistry/actinobacteria.

4. CDC. “Vancomycin-Resistant Enterococci (VRE) Basics.” Vancomycin-Resistant Enterococci (VRE), 22 Jan. 2024, www.cdc.gov/vre/about/index.html.