Why antibiotic resistance is a threat

published on Sunday, November 21, 2021 at 3:00 p.m.

Bacteria are increasingly resistant to this type of medication. Their excessive consumption accelerates the phenomenon, which worries the world health authorities, because it has deadly consequences.

Antibiotics, discovered at the turn of the 1930s and 1940s and then used extensively after World War II, are molecules that destroy bacteria cause diseases or at least prevent them from developing.

But, over time, resistant bacteria appear due to genetic mutations. By killing off vulnerable bacteria, antibiotics have the perverse effect of letting their tougher counterparts take over the field.

Phenomenon exacerbated by excessive consumption

To this is added another phenomenon. Stubborn bacteria can transmit their characteristics to their neighbors who are still sensitive to antibiotics. “Most of the resistance observed, especially those which spread rapidly and problematically, are carried by (…) this capacity to be transferred”, underlines the microbiologist Christian Lesterlin. As a consequence of these different mechanisms, antibiotics, which today constitute a large part of the drugs in circulation, gradually lose efficiency.

Resistance to antibiotics is a natural phenomenon. But it is exacerbated by excessive or inappropriate consumption of these treatments, for example against seasonal influenza, which is of viral and not bacterial origin. Developed countries became aware of this twenty years ago with a wave of public campaigns such as, in France, the famous slogan “Antibiotics are not automatic”.

25,000 deaths per year in the EU

The consumption of antibiotics finally stabilized in the 2010s in many rich countries. But worries turn to developing countries, where their use is growing strongly although it’s not just bad news. “These trends reflect both better access to antibiotics for those who need them and an increase in their inappropriate use,” summarizes the CDDEP, an American public health research organization. The misuse of antibiotics in animals is also involved, with some farmers using them for their ability to speed up the growth of livestock. The European Union has banned this use since 2006.

“Antibiotic resistance today constitutes one of the most serious threats to global health “, summarized in 2020 the World Health Organization (WHO). With less effective drugs, there is a risk of less well curing a wide range of bacterial diseases that are often fatal, such as tuberculosis or many pneumonias. In this sense, antibiotic resistance kills. European health authorities estimate that 25,000 people die each year in the EU because of its consequences. Their American counterparts give a figure of 35,000 annual deaths in the United States.

Economic cost

It remains difficult to have a global estimate of the phenomenon, even though it is in developing countries that it is likely to be the most dangerous in the years to come. The subject is also conducive to some fear-mongering estimates. One of them, frequently mentioned, evokes 10 million annual deaths in 2050. But this figure, resulting from a report commissioned a few years ago by the British government, is only an assessment given by two cabinets of advice, and not the result of the work of researchers.

The economic consequences are also difficult to measure but are probably high: public health costs and, as regards the use of antibiotics in animals, deleterious effects on agriculture and food.

Find alternative treatments

We must therefore continue to use antibiotics in a targeted and not excessive way, although doctors sometimes feel helpless. “The fear of complications and the pressure felt by doctors from some patients pushes them more often to prescribe antibiotics to their elderly patients, “Public Health France noted this week, based on a survey of doctors.

Solutions must therefore also be found upstream, for example by seeking to identify as quickly as possible the appearance of more resistant bacteria to prevent their spread. Finally, research is moving towards the development of alternative treatments to antibiotics, in particular based on “bacteriophage” viruses which attack bacteria and neutralize them.