According to many scientists and clinicians, antimicrobial resistance is one of the greatest threats to human health worldwide. However, without a clear understanding of the vital role of antimicrobials, and more specifically, antibiotics in modern life, a statement like ‘antimicrobial resistance is the greatest threat to human health worldwide’ may seem like hyperbole.
The discovery of antibiotics in the 1930s fundamentally transformed the way physicians care for patients. Treatment-focused approaches based on antibiotic use allowed physicians to save countless lives.
Since then, we have seen the top causes of mortality in humans change from things like kidney disease, gastrointestinal infections, and pneumonia to cancer and heart disease. More than eight decades later, the medical advances enabled by antibiotics are now threatened by rising antibiotic resistance. Without effective medications to treat infections, many fields of medicine will be hindered. Care of the critically ill, surgery, transplant medicine, neonatology, and the treatment of cancer patients, among others. Our ability to respond to national security threats like bioterrorism or pandemics will also be affected.
The causes of antimicrobial resistance are multifactorial and complicated. Chief among them is the lack of antibiotic stewardship. According to the Centers for Disease Control and Prevention (CDC), antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing and use is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance.
The CDC lists four primary efforts to address antibiotic stewardship in an outpatient setting. They are: 1 – a means to measure antibiotic prescribing, 2 – improve antibiotic prescribing by clinicians and use by patients so that antibiotics are prescribed and used when needed, 3- minimize misdiagnoses or delayed diagnoses leading to underuse of antibiotics, and 4- ensure that the right drug, dose, and duration are selected when antibiotics are needed.
Over the last 10-20 years, the medical community and general public in developed nations worldwide have made considerable gains in the implementation of antibiotic stewardship. For example, there has been a concerted effort to increase awareness about the inappropriateness of prescribing and using antibiotics to treat viral infections. At JASE, we strive to continue this trend while empowering our patients to care for themselves when access to appropriate and timely medical treatment may not be available.
The effectiveness of antibiotics is a limited resource, and we must treat them as such. Nevertheless, they are crucial to our health and well-being, and we should respect them as powerful medications that save lives but can cause significant harm when misused.