What is antimicrobial resistance? Which is touted as the silent pandemic by doctors

Antimicrobial Resistance (AMR) in humans is primarily caused by the misuse and overuse of antimicrobial medications.

BySumit Jha

Published Jan 22, 2024 | 7:00 AMUpdatedJan 22, 2024 | 8:01 AM


Imagine our bodies have special soldiers called “antibiotics” that fight off tiny enemies called “germs” when we get sick. It’s like having superheroes inside us, right?

But sometimes, these germs can be very clever. If we use the same superhero too much or not in the right way, the germs can learn how to resist the superhero’s powers. It’s like if a bad guy figures out how to be immune to a superhero’s punch!

So, when we really need our superhero to help us when we’re sick, it might not work as well because the germs have become resistant.

That’s what we call Antimicrobial Resistance, where the germs become too strong for our superheroes (antibiotics) to defeat.

This makes it harder for doctors to make you better when you’re sick, and sometimes, people can get even more sick. That’s Antimicrobial Resistance (AMR).

Also Read: 3 out of 4 patients prescribed antibiotics, elevating risk of AMR

The consequences of AMR

AMR has serious consequences for individuals, healthcare systems and economies. AMR leads to prolonged hospital admissions, increased healthcare costs and higher costs in second-line treatments.

AMR also causes morbidity and mortality, affecting patients, and reducing productivity in farms, which threatens food security.

The World Bank estimates that AMR could result in $1 trillion in additional healthcare costs by 2050 and $1 trillion to $3.4 trillion in gross domestic product (GDP) losses per year by 2030.

If nothing changes, by 2050, AMR will be the leading cause of death, with an estimated 10 million deaths, surpassing the estimated 8.2 million deaths due to cancer.

This would mean one person every three seconds. The associated economic burden would mean a total GDP loss of $100 trillion, and each person in the world today would be $10,000 worse off.

AMR also damages the economy, disrupts the trade of livestock, and threatens food security. The emergence and spread of drug-resistant pathogens threaten our ability to treat common surgeries, such as hip replacements and organ transplantation.

AMR has significant costs for both health systems and national economies overall

According to Kochi-based Amrita Hospital, there were nearly 5 million human deaths annually from bacterial infections alone.

Dr Krishna Kumar, Head of Paediatric Cardiology at Amrita Hospital in Kochi, in a conference recently said that India and South Asia contribute to about 30 percent of the five million cases, it said.

Also read: A missing piece in Kerala’s antimicrobial resistance puzzle

What causes AMR in humans?

Antimicrobial Resistance (AMR) in humans is primarily caused by the misuse and overuse of antimicrobial medications. Here are some key factors contributing to AMR:

1. Overuse of Antibiotics: Taking antibiotics when they are not needed or not finishing the entire prescribed course can contribute to the development of resistant bacteria. If some bacteria survive the antibiotic treatment, they may become stronger and more resistant.

2. Inappropriate prescription: Sometimes, doctors may prescribe antibiotics even when they are not necessary. This can happen if the doctor is unsure whether an infection is caused by bacteria or a virus, as antibiotics only work against bacterial infections.

3. Self-medication: Taking leftover antibiotics or sharing them with others without consulting a doctor can lead to incomplete or improper treatment. This can contribute to the development of resistant strains of bacteria.

4. Incorrect dosage or duration: Not following the prescribed dosage or stopping treatment early can create an environment where bacteria are exposed to the antibiotic but not killed completely. This can encourage the development of resistance.

5. Use in agriculture: The use of antibiotics in agriculture, particularly in livestock for growth promotion and disease prevention, can contribute to the spread of resistant bacteria. People may be exposed to these resistant strains through the food chain.

6. Lack of access to clean water and sanitation: Improper sanitation and hygiene practices can lead to the spread of infections. In regions with limited access to clean water and proper sanitation, the need for antimicrobials may be higher, contributing to resistance.

7. Global travel and trade: Resistant bacteria can spread across borders through international travel and trade. This makes AMR a global concern that requires coordinated efforts to address.

8. Poor practices of infection prevention and control: In healthcare settings, poor practices of infection prevention and control can lead to the spread of infections, increasing the demand for antibiotics. This overuse can contribute to resistance.

9. Lack of new antibiotics: The development of new antibiotics has not kept pace with the emergence of resistant strains. The lack of innovation in antibiotic research limits the options available for treatment.

Also read: Study finds prevalence of antibiotic resistance in rural Karnataka

Prevention of AMR in Humans?

Prevention of AMR in humans requires a coordinated effort to address the various factors contributing to its emergence and spread. Some strategies that can be implemented include:

1. Infection prevention and control: Implementing adequate measures to reduce the spread of pathogens within healthcare facilities, such as hand hygiene, proper sanitation, and use of personal protective equipment.

2. Appropriate use of antimicrobials: Ensuring the judicious use of antimicrobials to prevent overuse and misuse, which could contribute to the development of AMR.

3. Universal access to quality diagnosis and treatment: Ensuring that patients have access to accurate diagnosis and appropriate treatment for infections, which can help reduce the unnecessary use of antimicrobials.

4. Strategic information and innovation: Utilising data and innovative approaches to address AMR, such as surveillance systems to monitor resistance patterns and promote research and development of new antimicrobial agents.

5. Global collaboration and awareness: Engaging in global initiatives and awareness campaigns, such as World Antimicrobial Awareness Week, to promote collaborative action and raise awareness about the impact of AMR.

6. Promote responsible animal husbandry: Limit the use of antibiotics in agriculture, especially for growth promotion, and follow responsible practices in animal husbandry.

7. Educate the public: Raise awareness about the consequences of AMR and the importance of responsible antibiotic use. Encourage community engagement in preventing the spread of infections.

8. Preserve the efficacy of existing antibiotics: Reserve certain antibiotics for specific situations to prevent widespread resistance. Avoid unnecessary use of broad-spectrum antibiotics when a narrower-spectrum option is effective.

Also read: New class of antibiotics developed to fight drug-resistant bacteria