This article is more than 5 years old. Information may no longer be current.
Access, resistance to antimicrobials remains worldwide challenge
Click Here to Manage Email Alerts
Improved access to effective antimicrobials could prevent more than 75% of pneumonia-related deaths in children aged younger than 5 years, according to a recent report.
Researchers at the Center for Disease Dynamics, Economics and Policy (CDDEP) observed a growing trend in antibiotic consumption, with a 36% increase in 71 countries from 2000 to 2010. Further progress, however, could be hindered due to pathogen resistance, according to researchers.
Ramanan Laxminarayan
“Despite increases in worldwide antibiotic consumption, access to antibiotics is a problem: more than a million children with untreated pneumonia and sepsis die each year,” Ramanan Laxminarayan, PhD, director of CDDEP, and colleagues wrote. “At the same time, the effectiveness of these drugs is declining worldwide, driven by ever-higher rates of antibiotic use and selection pressure for resistance. Solving the challenge of providing effective antibiotics requires balancing the issues of access and resistance.”
Laxminarayan and colleagues used Latin Hypercube sampling to determine the impact of effective antibiotic use in 101 countries. They found that increased antibiotic delivery would avert approximately 445,000 community-acquired pneumonia deaths in children aged younger than 5 years.
However, earlier data published in The State of the World’s Antibiotics, showed that antibiotic resistance is increasing within lower income countries and is attributed to infrequent antibiotic stewardship and livestock growth practices.
In the current report, researchers estimated that worldwide antimicrobial consumption in livestock for growth promotion and disease prevention will increase by 67% from 2010 to 2030, intensifying the risk for resistance. Furthermore, first-line antibiotic effectiveness is decreasing due to the high expense of second-line treatments. Gram-negative bacteria are the biggest threat for resistance, the researchers wrote, and account for nearly 60% of neonatal infections. Nearly 1,000 resistance-related beta-lactamases were identified since 1990, yielding a 10-fold increase.
Due to these trends, the researchers investigated the potential effect that vaccines have in reducing the need for antibiotics. They estimated that pneumococcal conjugate vaccine (PCV) could prevent up to 11.4 million days of antibiotic use for Streptococcus pneumoniae in children aged younger than 5 years — a 47% reduction in 75 countries. Benefits of PCV and Haemophilus influenzae type b vaccines have been reported in the United States, South Africa, Denmark and Gambia; however, infant immunization and PCV coverage remains low, with 14 countries reporting less than 50% coverage. Improving access to effective antibiotics, therefore, is “an urgent priority,” the researchers wrote.
Laxminarayan and colleagues concluded that the best way to fight resistance is to improve hygiene practices and water quality while strengthening public health departments — all of which are currently being replaced with antibiotic use in low-middle income countries.
“Antibiotic resistance is a nuanced and multisectoral problem that threatens to erase decades of progress in medicine, food security and public health,” Laxminarayan and colleagues wrote. “Without better national health systems and worldwide coordination and cooperation between human and animal health sectors, we stand on the edge of an era of vastly greater antibiotic prices for those who can afford newer drugs and of higher morbidity and mortality consequences for those who cannot.” – by Stephanie Viguers
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts