Antimicrobial resistance is never going to go away and we will never completely win. “But, there are key battles we should and must win,” says Lonnie King, DVM, MS, MPA, Dipl. ACVP, dean of the Ohio State University College of Veterinary Medicine.
King, who spoke to more than 170 participants at the National Institute for Animal Agriculture 2012 Antibiotics Symposium in Columbus, Ohio, said we are forced to co-exist with antimicrobial resistance.
Antimicrobial resistance presents an evolutionary challenge. “The problem can be improved and we can coexist with an inherent imbalance. We need to adapt, change and improve our position to help people, animals and environment.”
King said some people believe resistance is simplistic. Either a microbe is resistant or it isn’t. “That’s not true,” he said. “It’s a gradient reflective of the phenotype and genotype in microbial populations. Resistance is related to all uses of drugs, not just misuse.”
How did we get here?
Resistance worldwide is both spontaneous and can be caused through actions. The lack of adequate hygiene and sanitation enables rapid proliferation and spread of pathogens worldwide. “Using antibiotics we have improved animal, plant and human health. People live longer. We have improved child mortality rates in the developing world and have increased life expectancy.”
However, King noted that the success of those drugs through the decades resulted in cavalier attitudes about prescribing them. And, he noted that globally the problem will spread due to a variety of factors. “The acceleration of antimicrobial resistance has left this country and we’ll see new acceleration like we’ve never seen before in other parts of the world. There will be misuse and overuse in countries without good regulations.
Developing countries with increased wealth with more access to drugs. Counterfeit drugs will be an issue.”
Another issue is that the demand for protein will increase worldwide coupled with poor sanitation and disease prevention in the developing world. “It’s a perfect storm to accelerate the problem,” King said. “The sense of urgency about this problem needs to be an international strategy.”
Antimicrobial resistance occurs without antibiotic use, with judicious use, but especially with misuse and/or overuse, King said. “It can be a polarizing issue adding to difficulty in finding resolution. Society seems to be at a major impasse on this issue, and the costs of inaction are unacceptable.”