Antimicrobial Resistance and Drug Development

Antimicrobial resistance (AMR) is one of the greatest threats to public health today and puts many of the medical advances of modern times, like effective antibiotics, at risk. Improper and excessive use of antibiotics in medicine, veterinary practice, and farming has given rise to new and resistant microorganisms, making diseases once simple to treat increasingly hard to control. This has resulted in greater illness, deaths, longer hospital stays and higher costs to healthcare systems. In fact, the use of antibiotics increased during the recent COVID-19 pandemic, further driving AMR. In this review, we address the historical evolution of antibiotics, along with how antimicrobial resistance arose. We look at the key drivers for AMR, including the processes by which microorganisms become resistant, and the growing evidence linking antibiotic use to impacts on the human gut microbiota and the dissemination of AMR genes. We explore the extensive effects AMR is having on public health, including a particular focus on the problems encountered in low- and middle-income countries where issues around use of antibiotics, access to diagnostics, and infection control are problematic. To combat AMR we need an integrated set of interventions, including good practice in prescribing (stewardship), monitoring and surveillance, better education of patients, prevention and control of infections, vaccination and investment in novel antibiotics and alternative treatments. It will be important to implement a ‘One Health’ approach that addresses humans, animals and the environment to curb the increase in resistance and maintain effective antibiotics for generations to come.