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In the last century, revolutionary medical innovations have saved the lives of many and drastically increased human life expectancy. One of these inventions is the development of antibiotics: drugs that can kill or prevent disease-causing bacteria from reproducing while simultaneously not harming the patient’s cells. From pneumonia to sepsis, antibiotics can be used to treat a variety of bacterial infections, largely for those with life-threatening complications. Antibiotics also help to protect against infection from chemotherapy as well as from common surgeries such as Caesarean sections. Despite their immense utility, the widespread use of antibiotics has caused a pandemic of antimicrobial resistance (AMR), which is now a leading cause of death worldwide.
What is AMR and what causes it?
AMR occurs when bacteria, fungi, viruses, and parasites become resistant to the drugs normally used to treat the infections that they cause. The ability of bacterial pathogens to reproduce rapidly and easily exchange fragments of genetic code allows them to evolve much faster than multicellular organisms, such as humans, are able to. When a single mutation of a bacterial cell arises, a mutation that is resistant to the antibiotic used to treat it, a large population of resistant pathogens can emerge. Furthermore, the mutation can be shared with other lineages of pathogens if there is contact.
According to a 2022 editorial in The Lancet by researcher Ramanan Laxminarayan, AMR is caused by both the excessive and unneeded use of antibiotics as well as insufficient access to antibiotics, often occurring in the same geographical areas.
Moreover, the COVID-19 pandemic has led to a misuse of antibiotics such as ivermectin and chloroquine, drugs that have strong evidence they do not help with the coronavirus. Not only does this misuse risk losing drugs that hospitals are reliant on to treat many infections, but it also led to a rise in AMR infections that likely contributed to high mortality rates of hospitalized COVID-19 patients.
In a separate study from The Lancet, an international team of researchers found that at least 1.27 million people died from drug-resistant bacterial infections in 2019. “By any metric, bacterial AMR is a leading global health issue,” the study explains. More deaths were caused by AMR than both HIV and malaria.
What are the potential solutions to the crisis?
Scientists have put forth many potential solutions to help alleviate the AMR pandemic. Researchers at the University of Portsmouth are using powerful supercomputers to fully redesign antibiotics before diseases have the opportunity to mutate. The leader of the study, computational chemist Dr. Gerhard Koenig, explains that developing entirely new antibiotics to fight the AMR crisis is often “extremely difficult.” His research team has found that modifying an existing antibiotic with robust technology has proven to be an effective way to combat AMR. One of the drugs his team has developed is 56 times more effective at killing certain bacterial strains than medicines listed as ‘essential’ by the World Health Organization (WHO).
Scientists at Plymouth University have taken a different approach to tackle AMR: harnessing the deep sea. In the north Atlantic, they have found sponges that contain molecules capable of killing virulent superbugs.
A team of researchers from the University of Texas at Austin has discovered a novel method to battle deadly antibiotic resistance in bacteria such as E. coli, K. pneumoniae, and P. aeruginosa. The team is making the bacteria vulnerable to antibiotics again by inhibiting a protein that is responsible for resistance abilities.
Yale University has also recently established a Center for Phage Biology and Therapy. Researchers at the Center are promoting research for the use of lytic phages, viruses that can kill bacteria rather than antibiotics. Scientists at Yale are currently conducting clinical trials to further their research in the fight against antimicrobial resistance.
New studies have demonstrated the severity of antimicrobial resistance, exacerbated by the misuse of antibiotics during the pandemic. Politicians and leaders in the health industry must verify that antibiotics are being used appropriately, ensure that effective antibiotics are available for low-income families, and fund efforts to tackle infections without antibiotics.