Antibiotics have long been essential in treating common infections and supporting complex medical interventions like surgeries, cancer chemotherapy, and organ transplants. However, the misuse and overuse of these critical drugs have catalysed a global health crisis: antimicrobial resistance (AMR). The 2023 annual report from the Indian Council of Medical Research (ICMR) has raised an alarm (1), revealing increasing antibiotic resistance for common infections, including urinary tract infections (UTIs), pneumonia, typhoid, and blood infections. This rising resistance emphasises the urgency for healthcare and pharmaceutical industries to develop evidence-based guidelines to ensure the responsible use of antibiotics and safeguard their efficacy.
The growing threat of antimicrobial resistance
AMR is a pressing issue, with the pace of bacterial resistance outstripping the development of new antibiotics. Between 1935 and 2003, the world saw the introduction of 14 new classes of antibiotics. However, over the last 20 years, new approvals have dwindled significantly. Most of these drugs fail to address emerging bacterial mechanisms, exacerbating the crisis. According to ICMR, infections that were once easily treatable are now becoming resistant to widely used antibiotics, leading to prolonged hospital stays, higher mortality rates, and rising healthcare costs.
The Global Research on Antimicrobial Resistance (GRAM) project, published in The Lancet, warns that by 2050, three deaths per minute could result from drug-resistant bacterial infections. This stark projection highlights the need for immediate action, including comprehensive surveillance systems, evidence-backed prescribing practices, and greater awareness about the responsible use of antibiotics.
Why AMR is a complex problem
AMR is often called a “silent pandemic” because its dangers are not widely understood, even by policymakers. Unlike acute health crises, AMR unfolds gradually, making it harder to garner the sense of urgency needed for a coordinated response. Addressing AMR requires a holistic approach involving all stakeholders, as its causes span the entire value chain—from improper prescriptions and unregulated access to antibiotics to environmental contamination from manufacturing processes.
Adding to the challenge is the broken marketplace for antibiotics. Developing new antimicrobial drugs is costly, and even when successful, these drugs must be used sparingly to prevent further resistance. This creates little financial incentive for pharmaceutical companies to invest in antibiotic research. Furthermore, the global supply chain for antibiotic ingredients is highly concentrated, with production shortages causing interruptions worldwide.
The role of pharmaceutical companies
Pharmaceutical companies are at the forefront of combating AMR. Beyond developing new antibiotics, they must focus on antimicrobial stewardship (AMS) initiatives that encourage the responsible use of existing antibiotics. These programs ensure that antibiotics are prescribed only when necessary, at the correct dose, and for the right duration. By reducing misuse, AMS programs help slow the development of resistance while improving patient outcomes.
The ICMR emphasises the importance of continuous surveillance of antimicrobial susceptibilities. Real-time data on resistance patterns can inform clinical decisions, ensuring that patients receive the most effective treatment while minimising the use of broad-spectrum antibiotics. Pharmaceutical companies can play a pivotal role by supporting these surveillance systems and providing resources for their implementation.
Public awareness and education
A critical but often overlooked aspect of combating AMR is public education. Misconceptions about antibiotics, such as their efficacy against viral infections, lead to widespread misuse. Self-medication and unnecessary prescriptions further exacerbate the problem. Public awareness campaigns led by pharmaceutical companies, healthcare providers, and regulatory bodies can help correct these misunderstandings.
Educating the public about the risks associated with antibiotic misuse and the importance of adhering to prescribed treatments can significantly reduce unnecessary antibiotic use. Such initiatives can also encourage patients to demand diagnostic tests before being prescribed antibiotics, fostering a culture of evidence-based medicine.
Collaboration: A collective responsibility
Tackling AMR requires a united effort from governments, pharmaceutical companies, healthcare providers, and consumers. Pharmaceutical manufacturers must ensure that antibiotics are produced sustainably, adhering to stringent environmental standards to minimise contamination. Healthcare providers need to prioritise diagnostics and evidence-based prescribing practices. Governments must incentivise antibiotic research and ensure equitable access to life-saving drugs.
Key collaborative efforts could include:
– Developing diagnostic tools to distinguish between bacterial and viral infections, reducing unnecessary antibiotic use.
– Improving surveillance systems to monitor resistance patterns and forecast antibiotic needs.
– Incentivising R&D through policy reforms, such as “pull incentives” that reward companies for bringing new antibiotics to market.
– Strengthening laboratory infrastructure worldwide to enhance diagnostic capabilities, especially in low- and middle-income countries.
A responsible model: Centrient pharmaceuticals
The fight against AMR also requires leadership from within the industry. Companies like Centrient Pharmaceuticals demonstrate how responsible manufacturing and stewardship can make a difference. As a global leader in sustainable antibiotics and a founding member of the AMR Industry Alliance, Centrient ensures stringent environmental compliance and advocates for a level playing field in combating AMR. Their commitment to quality, reliability, and sustainability underscores the role of responsible manufacturing in safeguarding the future of antibiotics.
By fostering collaborations across sectors and geographies, Centrient highlights the importance of collective action in addressing AMR. This approach ensures that antibiotics remain effective tools for treating infections and saving lives for generations to come.
Conclusion
Antimicrobial resistance is an urgent global health challenge that threatens to undo decades of medical progress. The 2023 ICMR report serves as a stark reminder of the need for evidence-based guidelines, robust surveillance systems, and public awareness campaigns to curb the spread of resistance. While pharmaceutical companies play a critical role in this fight, collaboration across the entire healthcare ecosystem is essential.
The inclusion of sustainable practices and innovative stewardship models by companies like Centrient Pharmaceuticals demonstrates that progress is possible. Through joint efforts, we can slow the rise of AMR and preserve the efficacy of antibiotics, ensuring a healthier future for all.