Fighting Antibiotic Resistance: Insights Into Human Barriers and New Opportunities: Antibiotic Resistance Constantly Rises With the Development of Human Activities. We discuss Barriers and Opportunities to Get It Under Control

Abstract

The public health issue of bacterial multi-resistance to antibiotics has gained awareness among the public, researchers, and the pharmaceutical sector. Nevertheless, the spread of antimicrobial resistance has been considerably aggravated by human activities, climate change, and the subsequent increased release of antibiotics, drug-resistant bacteria, and antibiotic resistance genes in the environment. The extensive use of antibiotics for medical and veterinary purposes has not only induced increasing resistance but also other health problems, including negative effects on the patient's microbiome. Preventive strategies, new treatment modalities, and increased surveillance are progressively set up. A comprehensive approach is, however, lacking for urgently tackling this adverse situation. To address this challenge, we discussed here the main causes driving antimicrobial resistance and pollution of the environment by factors favorable to the emergence of drug resistance. We next propose some key priorities for research, prevention, surveillance, and education to supervise an effective clinical and sustainable response.

Keywords: antibiotic resistance; antibiotic stewardship; antibiotics; control; prevention.

FIGURE 1

Adverse events associated with antibiotics. Antibiotic use in patients is associated with direct and associated adverse effects. Direct effects include the development of multiresistant bacteria, allergic reactions, and nephrotoxicity. Associated effects comprise psychological disorders, increased risk of cancer as well as modifications of the gut microbiome.

FIGURE 2

The direct contribution of antibiotics use in the development of AMR. The direct impact of antibiotic on antibiotic resistance (AR) starts by their administration to humans (medical use (blue)) or animals (veterinary transmission (green)). Overuse of antibiotics (ATB) in clinic comes from their easy access, their empiric and excessive utilization by medical doctors, as well as their extensive prescription in hospitals to treat critically ill patients. Through their use, multi‐resistant bacteria can develop in hospitals, industries and homes. Bacteria, as well as antibiotics, are released usually through waste, can transit through waste treatment plants (WTPs), where conditions are reunited to increase AR, and can lead to environmental pollution, with contaminated water easily reaching individuals through running water, and agriculture. Additionally, the extensive use of antibiotics in farming also leads to the development of multi‐resistant bacteria in livestock animals. Bacteria and ATB are then transmitted to individuals, either directly through the consumption of contaminated meat, indirectly with the contaminated harvest due to the transmission from the stools to the soil, and waste from agricultural practices followed the same cycle as general waste. Antibiotics and drug resistant bacteria found in humans can start the same cycle again.

FIGURE 3

Solutions to overcome antibiotic resistance. Antibiotic resistance could be tackled by enhancing research, requesting better funding, as well as promoting the development of preventive measures, such as a larger system of MDR bacteria surveillance, and global initiatives with a continuous education of the public.