NHS Existence Resistance

Overusage

One must understand how frequently antibiotics are used.  The IMS Health Midas database released an analysis of antibiotic consumption in retail pharmacies and health pharmacies. The 2010 study stated that 22.0 standard unties of antibiotics were prescribed per person in the US. This means that 22 doses (one pill, a single capsule, or ampoule) of antibiotics was prescribed for every single American. This distinctly shows the daily over usage of these drugs.

This figure demonstrates the frequency of antibiotic prescriptions. Note that some states have more prescriptions than number of people!

Requires Global Cooperation

Also, this problem needs to be solved on a global basis. Without cooperation from the entire world, a solution cannot be developed. This is because antibiotic use needs to be monitored everywhere to make a difference. As of right now, some countries don’t even require a prescription to use antibiotics, this contributes to their misusage. Some of the richer countries can still rely on the latest antibiotics to wipe out some forms resistant bacteria. For this reason, they do not view this as a major problem.

Reversibility

Studies have been conducted to reverse resistance. These studies have yielded no positive results, they tried to switch out resistant bacteria with clones, but it only slowed the process. This deterred researchers further because resistance cannot be reversed. This process is also complicated by the fact that the trends for resistance are completely unpredictable, but emergence is eventually inevitable.

The following graph depicts the correalation between antibiotic introduction and resistance. Since 1996 resistance has increased dramatically compared to previous resistance rates. 

Lack of New Antibiotics

This figure shows that new antibiotics are not being created, which would temporarily solve the problem. Without research being invested into advancements, prevention would have no funding.

Advancements to create new antibiotics have been stalled for multiple reasons. 15 out 18 of the world’s largest pharmaceutical companies have abandoned the antibiotic field completely. Therefore not only has advancement been slowing, it will continue to decline. They have left the antibiotic field because it poses no economic gain for the company. This is because antibiotics therapy for each individual person would only cost about $1,000. This is comparatively low to say chemotherapy which costs tens of thousands. An additional contributor is the way doctors would prescribe this antibiotic. It would be used as a “last defense” for an illness, because if they used it too frequently, the bacteria would become resistant to the new antibiotic. This would lower the profit for pharmaceutical companies even more. Also, clinical trial requirements for testing are expensive and pharmaceutical companies have no guarantee of a return of their investment. All of these factors have given companies enough reasons to search into other health problems, rather than antibiotic resistance.

Food Production

The agricultural industry is also to blame for the severe amount of antibiotic resistance. An estimated 80% of antibiotics sold in the U.S. are used in animals, primarily to promote growth and to prevent infection. This would create a sufficient environment for resistance to grow. Up to 90% of the antibiotics given to livestock are excreted in urine and stool, then widely dispersed through fertilizer, groundwater, and surface runoff. This introduces antibiotics into the entire ecosystem. Global consumption of antimicrobials in food animal production was estimated at 63,151 (±1,560) tons in 2010. By 2030, the projected amount is 105,596 (±3,605), which is a 67% increase. 

This map shows global antimicrobial consumption in livestock in milligrams per 10 km2 pixels (Top). This illustrates how extensive the usuage is in the world.

Lack of Empathy

People do not realize how large of a problem this is. Patients pressure doctors to prescribe antibiotics in hopes of eliminating a problem that many not even be bacterial. This misconception could account for the severity of over perscription. This is lack of empathy for the health of future generations. The government does not empathize with pharmaceutical companies that have no choice but to abandon the antibiotic field. This problem is worsened by lack of empathy by many people.