Use and effects of antibiotics
EHUko Immunologia, Mikrobiologia eta Parasitologia Saileko ikertzailea, eta irakaslea Medikuntza eta Erizaintza Fakultatean
Some drugs, and especially antibiotics, have been used since the early 20th century to control and destroy bacteria that damage man. Undoubtedly, this use has been very beneficial in reducing the infectious diseases and deaths that have occurred. However, this same use has been one of the greatest threats to public health in the 21st century: resistance. Undoubtedly, the development of resistance is an inevitable process, as it is a natural characteristic of the evolution and life of bacteria. The problem is that this adaptation process has accelerated and expanded in recent years around the world. One of the main causes has been the lack of awareness and knowledge about the misuse and abuse of antibiotics, taking into account human, animal or environmental use.
A few years ago, a review in the UK suggested that by 2050 antimicrobial resistance could kill 10 million people a year. Some critics question this estimate, but today in Europe more than 35,000 deaths are related to this problem, 100 people a day! Limited to the Spanish state, there would be 8 deaths per day due to the problem of antimicrobial resistance.
A 2019 study evaluated different pathogens and drug combinations, estimating that nearly 5 million deaths were directly related to drug resistance.
One of the main challenges in the fight against antimicrobial resistance is to understand its true dimension, especially in countries where surveillance and data are scarce, in order to develop effective prevention and control strategies. In short, multi-resistant bacteria travel, which can spread within hours from one country to another.
Solution, work of all
Robust health systems are essential to cope with this burden. In case of an infectious disease it is necessary to make a rapid diagnosis and choose the best antibiotic. The care of microorganisms is fundamental to observe their evolution. And if resistance occurs, you should have knowledge and ability to choose the most appropriate antimicrobials. Professionals prescribing antibiotics should be trained at all times, know the problems and novelties that exist to perform their work effectively.
In the case of some bacteria, the problem is enormous, and the medicines that are available today are not useful. Major research and investment must be encouraged, both public and private, to find new antibiotics.
Prevention strategies should increase vaccination rates and develop new vaccines. If infectious disease is prevented by a vaccine, it will not be necessary to prescribe antibiotics. This would reduce the use of drugs.
If there were no effective antibiotics, surgery, transplantation or chemotherapy would become very dangerous processes, as the infections that usually bring these processes would not be dominated.
This irrational and uncontrolled use of antimicrobials, along with the nature of bacteria, is responsible for this “silent pandemic.” The implementation of solutions is a task for all of us and we must put them in place as soon as possible. The objective is therefore to reduce the development and spread of antibiotic resistance and to ensure its permanent availability, guaranteeing the concept of Single Health, that is, taking into account humans, animals and the environment.
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