How Antibiotics Changed The Course Of History:
When antibiotics were first discovered, they changed the way physicians treated certain conditions. A case of infection due to a simple cut, chest infection, or childbirth complications would have historically resulted in death for countless people. However, once penicillin was introduced in the 1940’s, bacterial infections could then be effectively treated. This also improved the level of safety associated with surgery, cancer treatment, or organ transplants because doctors could appropriately manage the risk of infection. The era of antibiotics could potentially be coming to an end.
What Is Antimicrobial Resistance (AMR)?
Antimicrobial resistance (AMR) is the term for this situation. AMR is no longer a future problem; it has arrived! Globally, since 2019, AMR (bacterial) was responsible for 1.27 million deaths and contributed to nearly 5 million deaths in total. It is predicted that, since 1970, the projected number of direct deaths from AMR will rise by approximately 68% based on the numbers from 2021.
Why Pakistan Should Pay Close Attention
AMR is not a distant issue, and there is an ongoing public health crisis, particularly in Pakistan, due to the emergence of drug-resistant Typhoid. The province of Sindh has now become a globally recognised epicentre of disseminated Extensively Drug Resistant (XDR) Typhoid fever. Approximately 25% of diagnosed Typhoid cases in Pakistan are now XDR, and approximately 65% of confirmed cases of diagnosed Typhoid in Sindh and 44% of those diagnosed in Punjab are XDR. The majority of bacterial strains that cause Typhoid fever have now been shown to be resistant to virtually all antibiotics available for treatment. Presently, there are only 2 licensed treatment options remaining that are still effective against XDR Typhoid; however, resistance to those 2 anti-Typhoid antibiotics has recently been confirmed in Pakistan.
Challenges of Developing New Antibiotics
The development of new antibiotics is a slow process despite the growing problem of antibiotic resistance. Research, testing, and regulatory approval of new antibiotics require many years and are costly, with significant financial risk involved. Many pharmaceutical manufacturers have drastically decreased their investments in developing antibiotics compared to chronic condition medications because antibiotics typically have short treatment courses. Developing antibiotics is less likely to be a financially attractive investment opportunity for companies since shorter treatment courses equal less potential profit.
The effect that pharmaceutical companies’ reduced antibiotic investment has on the number of new antibiotics available in the market is clear.
Searching for New Solutions
Many researchers globally are working on new methods or improvements to combat this growing problem. Researchers are assessing cutting-edge technologies such as artificial intelligence to improve their ability to discover and develop new antibiotic compounds more quickly than traditional methods.
Another innovative approach being pursued is the use of bacteriophages as antibacterial agents; these are viruses that only infect specific bacteria. Other innovative treatment modalities such as antimicrobial peptides and other new treatments are being developed to treat resistant infections.
Improving diagnostic testing equipment is very important in fighting antibiotic resistance. Faster turnaround time for laboratory testing will allow practitioners to make a more accurate diagnosis of bacterial infections and prescribe treatment rather than use broad-spectrum antibiotics while waiting for test results.
What Is Currently Being Done
Progress is being made. The World Health Organisation produces periodic publications of global target product profiles to help researchers identify the most critically needed new antibiotics. Governments and other global health organisations are testing new financing alternatives, such as providing financial incentives to companies for having effective antibiotics on the market, rather than providing financial incentives based on the volume of antibiotics sold. Separating profitability from new antibiotic development and antibiotic sales volume may result in renewed financial interest in developing new antibiotics.
The Future of Antibiotics
Antibacterials are one of the most successful medications ever invented, and there continue to be significant advancements in how they are used in very complex diseases. However, the future of antibiotics is not so certain. There has been a significant increase in the resistance of organisms to medications, expected sooner than anticipated, and there have been very few advancements in the development of new therapies.
While the challenge of developing newer antibacterials is serious, progress can be made through collaboration, appropriate use of new medications by healthcare providers, and innovative science.