Antibiotic resistance is underestimated

Antibiotic resistance is underestimated


OfLorenzo Moja

Their correct use and “intelligent” prescription are essential. By 2050, this phenomenon is expected to cause 50 million deaths in the European community alone, a third of the total.

It is certain that death is an inevitable event. We have much less certainty about possible causes, even if we can identify macro areas. Among these, one, which has remained ignored for a long time, is antibiotic resistance, which indicates the ability of bacteria and microorganisms to escape the action of antibiotics. Although this phenomenon is very often mentioned in the media, its seriousness is not well understood. However, the phenomenon is much more concrete than it appears. And this concreteness also takes the form of death.

In recent decades the reasons behind a person’s death were roughly divisible into two categories: cancer and cardiovascular events (heart attack or stroke). Each covered just under 50% of causes of death. By 2050, antibiotic resistance is expected to cause 50 million deaths in the European community, a third of all deaths. In hospitals it is increasingly common to observe hospitalizations, even for health problems that are not insurmountable – for example heart tests, a fracture, an operation – which are complicated by this phenomenon.

During hospitalization, the weakened body becomes the target of the action of a resistant bacterium. Various antibiotics are administered, but the bacterium has multiple forms of resistance and mocks the drugs: the infection spreads to multiple parts of the body, with related consequences. What policies can be activated against resistance to antimicrobial drugs? Resistance is strongly associated with the frequency of antibiotic use. The more we use, the more the bacteria learn to blunt our weapons. However, the type of antibiotic also matters: some create more resistance than others.

For these reasons, the World Health Organization proposed a classification of antibiotics into three categories in 2022: Access, Watch and Reserve. Access antibiotics (of Access) are molecules effective against several bacteria (although not all), generate little resistance and have reduced side effects. Antibiotics Watch (Special Observations) are more powerful than the previous ones in some pathologies, generate greater resistance and are accompanied by more serious side effects.

Finally, there are Reserve antibiotics (backup) to be used as a last bastion against resistant bacteria. This classification was quickly accepted by many countries; in Italy, for example, it was adopted by the Italian Medicines Agency in 2023. Currently we cannot completely eliminate the biological phenomenon of antibiotic resistance; However, we can avoid encouraging it by using antibiotics only when strictly necessary and favoring Access antibiotics as the first choice.

*Dep. of Health Products Policy and Standards, World Health Organization

March 17, 2024

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