By Sabiha Essack
Antibiotics have revolutionised health care since their introduction into clinical practice in the 1930s and 1940s by dramatically decreasing the morbidity and mortality associated with bacterial infections in humans and animals.
Antibiotics have saved innumerable lives. They have also made possible major surgery, organ transplantation, treatment of pre-term babies, and cancer chemotherapy. They have advanced food security and food safety.
But infectious diseases remain the leading cause of death in the world. This is particularly in lower and middle income countries. Increasingly this is due to a rise in antibiotic resistance.
Antibiotic resistance has been recognised as a threat to the world economy. It affects developed and developing countries, which makes it a public health challenge with extensive health, economic and societal implications.
Antibiotic resistance is a direct consequence of the selection pressure from warranted and indiscriminate antibiotic use in human, animal and environmental health. Understanding how this happens is key to containing the problem.
How it happens
Resistance develops when bacteria no longer respond to antibiotics that were previously effective and cured infection.
This means that treatments no longer work for infections that are caused by microorganisms that have developed resistance. This is the case for both humans and animals. The increase in infections like this raises the risk of diseases spreading in communities as well as through flocks or herds.
Other outcomes are that illnesses last longer, mortality rates are higher and the cost of treatment goes up because alternatives need to be found.
