Antibiotic resistance

Overuse or misuse of antibiotics can cause bacteria resistant to these treatments. Good control and stricter guidance on antibiotic use are needed for a good prevention of the spread of resistant bacteria, and consequently, the spread of an infection.

Multiple guidance strategies are proposed to provide the correct doses of drugs, know when to prescribe antibiotics, and know when to discontinue antibiotic use to limit the development of bacteria resistant to our current treatments.

How to optimize antibiotics use? How to raise awareness and develop therapeutic and medical education on antibiotic resistance and antibiotics usage? Which tool? Which channel?

Antibiotics are not profitable for pharmaceutical companies because they are expensive and long to develop, and their price is usually low, impairing the financial return on investment compared to traditional drugs.

The lack of innovative solutions in this area results in a limited number of new antibiotics coming to market, which compromises their effectiveness. On average, antimicrobial resistance is reported for most new agents two to three years after they are introduced to the market.

New antibiotics, sometimes from start-up companies, face difficulties related to the requirements of the agencies regulating marketing authorizations, as well as to the lack of appropriate business models that allow for sufficient profitability. This has led to a succession of failures and a lack of interest from industry. Ultimately, even if new antibiotics do reach the market, they may only reach the third line of treatment and are therefore rarely prescribed.

Besides, to date, we do not have many methods to prevent the development of antimicrobial resistance (AMR). Fundamental research, empowered by data science probably, is needed to develop predictive models to resistance development.

What are the innovative funding mechanisms for antibiotic R&D? How to develop a profitable case with a new antibiotic? Can AI help in the discovery of new antibiotics or in the prediction of antibiotic resistance?

The most problematic antibiotic resistance, including multidrug resistance, occurs in low- and middle-income countries. Despite the production of new antibiotics, only about one-third of antimicrobial drugs are covered by access strategies in these countries. Getting antibiotics to emerging countries requires optimization of logistics and restructuring of health care systems.

Joint efforts are being made by public and private organizations to combat antibiotic resistance. Communication, management and organization are not necessarily in place and need to be defined, which may vary by country and antibiotic.

For example, the One Health initiative, created in 2000, promotes an integrated, systems approach to human, public, animal, and environmental health at the local, national, and global levels to combat emerging illnesses with pandemic potential, including antibiotic resistance.

Their primary focus is to provide guidelines for mitigating this crisis, given the differences in regulation, access, and stewardship already in place depending on the geography.

How are public organizations helping with resistant bacteria? What global health initiatives exist to contrast antibiotic resistance that could be leveraged?

The use of antibiotics in livestock and agriculture, which we ultimately consume, impacts the generation of antibiotic resistance. This represents the largest consumption of antibiotics worldwide.

Antibiotics are used on animals and in agriculture to prevent and treat diseases caused by bacterial infections, as well as to rapidly increase the growth of animals. The pressure of mass production of livestock and agriculture therefore leads to unnecessary overuse of antimicrobials drugs.

Even if in some countries the use of antibiotics as growth promoter is banned, guidelines and restrictions on the use of antibiotics for animal health and agriculture should be developed and implemented globally.

What are the effective alternatives to antibiotics for rent animals and for plants? What kind of agricultural practice or setting can help in reducing the antibiotic use?