Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites stop responding to the medications used to combat them. All of this makes it difficult to treat infections and increases the risk of spreading disease and death. The World Health Organization (WHO) places antimicrobial resistance among the 10 most important public health problems, which it has called the “silent pandemic,” and estimates that it will cause more than 10 million deaths by 2050.

Many of the antibiotics often used to treat infections such as pneumonia, sepsis (bloodstream infections) and meningitis, which children often contract, are now less than 50 percent effective, reveals research, published in the scientific journal The Lancet Regional Health - Southeast Asia. The regions most affected by this situation are Southeast Asia and the Pacific, including Indonesia and the Philippines, but it turns out that antibiotics in countries like the United States are also becoming less effective.

Children are especially vulnerable to the effects of antibiotic resistance for several reasons. First, bacterial infections are common in childhood, from ear and respiratory tract infections to gastrointestinal infections.

Second, in areas where resistance is widespread, children are at greater risk of dying from previously treatable infections. This is especially concerning in regions with weak health systems or limited access to quality healthcare.

How do organisms develop resistance to antibiotics?

The more we use antibiotics, the more pressure we put on organisms to develop resistance. Certain bacteria can evade drugs designed to kill them through the natural process of evolution, through two main means: genetic mutation and horizontal gene transfer. These changes are then passed on to the next generation of bacteria to perpetuate resistance.

What are the main reasons that contribute to antibiotic resistance?

• Overuse and inappropriate use of antibiotics: One of the main factors driving antibiotic resistance is the overuse and sometimes inappropriate use of these medications. Many doctors, in an effort to protect their patients, unnecessarily prescribe antibiotics to treat a viral infection such as the flu, cold or diarrheal illness. This indiscriminate prescribing for viral infections, as well as self-medication and non-compliance with treatment regimens, has encouraged the development of resistant bacteria.
• Shortage of development of new antibiotics: Despite the growing threat of antibiotic resistance, research and development of new antibiotics has decreased significantly in recent decades. This phenomenon is due in part to the scientific and economic challenges associated with the creation of new antimicrobial drugs, which has led to a decrease in the arsenal of therapeutic options available to combat resistant infections. Most big pharmaceutical companies are not interested in pursuing new antibiotics, because they make more money on drugs that people have to take for months or years for chronic diseases than days or weeks for an infection.
• Antibiotic use in agriculture: The widespread use of antibiotics in agriculture, especially as growth promoters in animal husbandry, also contributes to antimicrobial resistance. Resistant bacteria can spread through the food chain, reaching humans, through contaminated food products and further contributing to the resistance burden.

To address this challenge, concerted action is needed at a global level. This includes implementing appropriate antibiotic use practices in medical settings, investing in research and development of new antibiotics and therapeutic alternatives, strengthening antimicrobial resistance surveillance, and promoting sustainable practices in agriculture.

Only through a comprehensive and collaborative approach, we can meet this challenge and ensure that antibiotics remain effective for future generations.