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We've Lost Another Battle In The War Against Antibiotic Resistance

We are heading towards that post-antibiotic era and there seems to be little that can be done to stop it.

Recently, Public Health England made a rather troubling discovery. A man showed up to a clinic complaining of a sexually transmitted disease. It was gonorrhea, one of the more commonly seen ailments. The doctors knew treating this illness was going to be a challenge. They just didn't realize how difficult it was going to be.

Gonorrhea bacterium.
Gonorrhea bacterium.

At one time, treating the bacterium responsible for the disease, Neisseria gonorrhoeae, was relatively easy thanks to antibiotics. That changed in the 1950s with the discovery of antibiotic resistance. As the years went by, members of the species gained the ability to defend against a greater number of treatment options. By 2011, the situation had become critical with the discovery of a near-fully resistant strain in Japan. To make matters worse, a similar strain was found in France the next year.

Back in England, the patient was asked about his history and revealed he had been to South-East Asia in the previous month and admitted to having had sexual contact. But the likelihood that he would have contracted the same strain as the highly resistant one from 2011 seemed quite low. That one isolate had never cropped back up again and was thought to have been a unique case.

However, when treatment was started, the worst fears were realized. The infection did not go away. Upon further inspection of the bacterium, it was not exactly the same as the 2011 strain. Although the individual was treated, the detection of this infection served to amplify the concerns of England's health officials.

The situation has become so bad the World Health Organization has made this phenomenon a priority.

This rather troubling story is just one of many occurring across the globe. Antibiotic resistance continues to spread like wildfire, making treatment options less likely to succeed. The situation has become so bad the World Health Organization has made this phenomenon a priority. The institution has learned the only answer to the problem is a reduction in the use of antibiotics. Unless we learn to use fewer antibiotics, we are destined to enter a post-antibiotic era in which these once life-saving drugs will become useless in our battles against bacterial infections.

Unfortunately, the world doesn't seem to be listening, at least according to a recent study conducted by an international group of researchers. The group attempted to determine whether our dependence on antibiotics has lessened to any extent over the last decade and a half. The results show our hunger for these drugs may be even greater now than it was before resistance was considered a crisis.

The team attempted to calculate the number of antibiotics used over the course of 15 years, from 2000 to 2015. They collected information from a rather extensive database of global antibiotic sales. Data was obtained from 76 countries and crunched to identify trends in consumption. The information was also used to estimate the future of antibiotic use until the year 2030. The general aim was to see a general reduction or at least a slowing trend in antibiotic use, with the potential for even greater reduction in the future. But when the results came back, any hope was not just dashed — it was obliterated.

The team found the amount of antibiotics had gone up by a shocking 65 per cent over the 15-year period. At least half of the countries had seen significant increases in antibiotic prescriptions. As for the projections towards 2030, the data suggested an even greater rise over time. An unbelievable 161 per cent more antibiotics would be seen if no changes were made to prescribing policies.

The hard data was bad enough, but the nature of the countries consuming the most antibiotics made the picture even more worrisome. The highest users were mostly low- and middle-income countries with poorly regulated health systems in place. This meant major changes at the governmental and institutional level would be needed before any reductions in prescribing could be realized. The likelihood of that would be low at best.

Thankfully, there was a little good news to be had. Nineteen countries, including Canada, the United States and Hong Kong had dropped their use over the years. Yet, as these are all high-income countries with structured health systems in place, the realization was that these nations were the outliers rather than the norm.

The results of this study combined with the news from Public Health England reveal a rather ominous future for human health. We are heading towards that post-antibiotic era and there seems to be little that can be done to stop it.

Yet, as with all global struggles, we can do our part locally to help improve the situation. Canada has already reversed the trend of rising consumption, and individually we can do two things to keep this trend alive. First, avoid asking for antibiotics when visiting the doctor. If an antibiotic is needed, it will be prescribed. In addition, seek out meats from animals raised without antibiotics. By using the pressure of our wallets, we may be able to reduce the levels of these drugs in agriculture. By keeping up with these two actions, you can be sure that moving forward, you are helping to improve the situation and stand as a leader against antibiotic resistance.

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