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Antibiotic Resistance

  • Writer: Teen Medical Research Club
    Teen Medical Research Club
  • Feb 13, 2021
  • 4 min read

Antibiotic resistance is one of the biggest global threats, where modern medicine and advancements could cease to exist. Antibiotic resistance occurs when bacteria and fungi evolve to be able to defeat antibiotics. Infections caused by antibiotic resistant germs (such as pneumonia, tuberculosis, gonorrhea, and blood poisoning) are more difficult and sometimes impossible to treat. Performing surgeries can also become very risky. This causes increased hospital expense and a higher chance of death.

When antibiotic resistance first became known in the mid-1900s, scientists were working hard to develop new drugs to counteract those bacteria. But recently, the rate at which new antibiotics are being discovered is slowing while antibiotic resistance is increasing rapidly. Consequently, about 2.4 million people each year are infected with drug-resistant germs in the U.S. and about 35,000 people die as a result. Health care costs associated with antibiotic resistance reach about 20 billion dollars each year in America. Additionally, a 2014 study by the Review of Antimicrobial Resistance evaluates that by 2050, if nothing serious has been done to terminate this problem, then it will cost the global economy 60-100 trillion dollars and kill an estimated 10 million people per year.

Over fourteen antibiotic resistant germs have been identified, with the first being Staphylococcus aureus, a penicillin resistant bacteria found to be resistant in the 1940s. Horizontal gene transfer allows the bacteria to transfer the antibiotic resistant gene to each other, and not just by the transfer of DNA from parent to offspring. Because of this, the percentage of drug resistant bacteria in each species grows rapidly. For example, according to the World Health Organization, antibiotic resistance is above 50% in large bacterial groups such as E. Coli and pneumonia.

Overuse of antibiotics is obviously a factor contributing to antibiotic resistant bacteria. Especially in certain countries where there are no standard treatment guidelines, antibiotics are often over-prescribed by healthcare workers. Even in countries with strict treatment guidelines, patients sometimes overuse antibiotics prescribed by their healthcare workers and demand them when they aren’t necessary.

About 80% of all antibiotics are used in the animal agriculture industry, making it the leading cause of drug resistant bacteria. Since the 1940s, antibiotics have been used in animal agriculture, which unintentionally resulted in faster animal growth. Because of this discovery, the industry started using antibiotics for reasons other than preventing disease. This went on until the FDA banned this practice in 2017. Low amounts of antibiotics are still put into livestock feed, to kill illnesses caused by the cramped and unsanitary conditions in industrial farms. Even though the amount of antibiotics used in livestock has decreased, the global consumption of antibiotics is predicted to grow about 67% by 2030, due to the increased demand of animal products.

But it doesn’t end there. As a result of the meat, dairy, and egg industries, 369 million tons of manure are dumped into lagoons and used as untreated fertilizer for crops. Around 75% of antibiotics given to livestock are found in the waste, therefore creating drug resistant bacteria in the water and soil. When the manure is sprayed as fertilizer on crops, the resistant bacteria and the antibiotics can contaminate groundwater and drinking wells, endangering people who live near the farms. Additionally, a John Hopkins University study showed that house flies in close proximity to poultry operations carried antibiotic resistant bacteria. These flies could enter households and hospitals, putting the health of patients and civilians at risk.

Crop farming also partly contributes to this problem by itself. In 2016, the EPA approved the use of streptomycin and oxytetracycline on citrus trees for the treatment of Citrus Greening Disease. 650,000 pounds of these antibiotics were wasted on spraying the trees, without any results of the disease being slowed down. Injecting the tree trunks proved to treat the infection more successfully, even though it left a much greater antibiotic residue in the fruits.

Fortunately, several organizations are working to stop antibiotic resistance. In 2015, the FDA enforced the Veterinary Feed Directive, and in 2017, Guidance for Industry #213. They made sure that all livestock feed was under veterinary supervision, and that antibiotics were only used for medical purposes, prohibiting its use for growth enhancement. These new regulations did help, as the sales of medical antibiotics between 2015 and 2018 dropped by about 38%

The Preservation of Antibiotics for Medical Treatment Act (PAMTA) was introduced to the House of Representatives numerous times, with the first being in 1999 and the latest being in 2015. When it was first introduced, the bill removed the non-medical use in animal feed of eight antibiotics, and prohibited the use of others. However, the bill has still not made it out of committee.

In 2015, the World Health Organization (WHO) endorsed the “Global action plan on antimicrobial resistance”. This strategic plan has five goals that includes verifying investments in fighting antibiotic resistance, spreading awareness of the issue, reducing infections as much as possible, improving research and surveillance, and optimizing the use of antibiotic medicines. Additionally, WHO and Drugs for Neglected Diseases Initiative (DNDi) partnered to form a joint initiative called the Global Antibiotic Research and Development Partnership (GARDP). This partnership intends to develop and deliver four new treatments by 2023.

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