What are the possible consequences of antibiotic resistance?
Many of the available treatment options for common bacterial infections are becoming more and more ineffective. As a consequence, there are situations where infected patients cannot be treated adequately by any of the available antibiotics. This resistance may delay and hinder treatment, resulting in complications or even death. Moreover, a patient may need more care, as well as the use of alternative and more expensive antibiotics, which may have more severe side effects, or may need more invasive treatments, such as intravenous injection, to be given in hospitals.
A recent WHO report made a clear case that resistance of common bacteria to antibiotics has reached alarming levels in many parts of the world. In Europe, for example, there is an increase of the resistance to major antibiotics of common bacteria such as Escherichia coliwhich causes, among others, urinary tract infections, and also Staphylococcus aureus (the MRSA or methicillin-resistant Staphylococcus aureus), Klebsiella pneumoniae, and Pseudomonas aeruginosa.
For WHO, the consequence is that progress in modern medicine, which relies on the availability of effective antibacterial drugs, is now at risk. For instance:
Common infections such as pneumonia that can run in health care settings, may not respond to available or recommended drugs like penicillin, putting the lives of patients at risk;
Cystitis, one of the most common of all bacterial infections in women, may become untreatable or need to be treated by injected drugs, imposing also additional costs to the patients and to the health system in general;
Antibacterial drugs used to prevent infections after surgeries or to treat common infections in neonatal and intensive care may become less effective or ineffective.
One issue stated in the WHO report is that there are very few antibiotics discovered and developed since 1985 to replace those becoming ineffective.
One issue stated in the WHO report is that there are very few antibiotics discovered and developed since 1985 to replace those becoming ineffective.
Which are the main infections becoming resistant to antibiotics ?
Bacteria causing a wide range of common infections may become resistant to one or many antibiotics: urinary tract infection, pneumonia, skin infection, diarrhea, bloodstream infection. The high proportions of resistance to third generation cephalosporins reported for E. coli and K. pneumonia, for example, means that treatment of severe infections caused by these bacteria must now rely mainly on another antibiotic family that is more expensive and may not be available in resource-constrained settings. In addition, this can only last as long as these bacteria do not become resistant to this other alternative.
Patients in hospitals are at special risk for infections by resistant and very pathogenic bacteria that can be present in hospitals and clinics, the so-called nosocomial infections, and which are unrelated to their reason for admission.
