Friday, March 16, 2012

Chan: World Faces A `Post-Antibiotic Era’



# 6226


World Health Organization Director-General Margaret Chan - in a keynote address to the Conference on Combating Antimicrobial Resistance this week in Copenhagen, Denmark - painted a bleak picture of the future of antibiotic availability if action is not taken.


The D-G’s entire remarks may be viewed on the WHO’s website at Antimicrobial resistance in the European Union and the world, but I’ve excerpted a few choice statements below, after which you’ll find a link to the World Health Organization’s latest publication on antibiotic resistance.


Excerpts from D-G Chan’s March 14th, 2012 speech.


Antimicrobial resistance is on the rise in Europe, and elsewhere in the world. We are losing our first-line antimicrobials. Replacement treatments are more costly, more toxic, need much longer durations of treatment, and may require treatment in intensive care units.


For patients infected with some drug-resistant pathogens, mortality has been shown to increase by around 50%. Let me give an example of what this means for a disease of global significance.


Among the world’s 12 million cases of tuberculosis in 2010, WHO estimates that 650,000 involved multidrug-resistant TB strains. Treatment of MDR-TB is extremely complicated, typically requiring two years of medication with toxic and expensive medicines, some of which are in constant short supply. Even with the best of care, only slightly more than 50% of these patients will be cured.


Many other pathogens are developing resistance to multiple drugs, some to nearly all. Hospitals have become hotbeds for highly-resistant pathogens, like MRSA, ESBL, and CPE, increasing the risk that hospitalization kills instead of cures. These are end-of-the-road pathogens that are resistant to last-line antimicrobials.


If current trends continue unabated, the future is easy to predict. Some experts say we are moving back to the pre-antibiotic era. No. This will be a post-antibiotic era. In terms of new replacement antibiotics, the pipeline is virtually dry, especially for gram-negative bacteria. The cupboard is nearly bare.


A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.


Some sophisticated interventions, like hip replacements, organ transplants, cancer chemotherapy, and care of preterm infants, would become far more difficult or even too dangerous to undertake.



Director Chan called for greater restrictions in the use of antibiotics, and a crackdown on counterfeit drugs which not only can endanger the patients taking them, they can feed growing resistance.


This week the WHO released a 120 page book that provides options and strategies for combating this global threat.


The evolving threat of antimicrobial resistance - Options for action

World Health Organization

Publication details

Number of pages: 120
Publication date: 2012
Languages: English
ISBN: 978 92 4 1503181


Antibiotic resistance development is a natural process of adaption leading to a limited lifespan of antibiotics. Unnecessary and inappropriate use of antibiotics favours the emergence and spread of resistant bacteria. A crisis has been building up over decades, so that today common and life-threatening infections are becoming difficult or even impossible to treat. It is time to take much stronger action worldwide to avert an ever increasing health and economic burden. A new WHO publication "The evolving threat of antimicrobial resistance - Options for action" describes examples of policy activities that have addressed AMR in different parts of the world. The aim is to raise awareness and to stimulate further coordinated efforts.



As an aside, without a doubt  the `go to’ blogger on all things antibiotic resistant is Maryn McKenna, author of Superbug: The Fatal Menace of MRSA.  If you aren’t a regular visitor to her Superbug Blog, you should be.


While not in the same league, you’ll also find some of my humble offerings at the links below:


NDM-1: One Year Later

WHO Unveils 6-Point Plan To Preserve Antibiotic Effectiveness

Eurosurveillance On Antimicrobial Resistance

ECDC/EMEA: Joint Report On Resistant Bacteria

Carbapenemases Rising

WHO: The Threat Of Antimicrobial Resistance

NDM-1: A New Acronym To Memorize