Increasing resistance to antibiotics due to improper use

How many people die in Germany from multi-resistant pathogens?

According to Study from 2018 there are around 2,400 deaths from resistant pathogens in Germany every year, many of them in hospital. The more antibiotics are used, the more likely it is that resistance will develop. And in the hospital, especially in the intensive care unit, many antibiotics are and must be used.

Antibiotic resistance is a global problem. In sub-Saharan Africa, for example, the problem is greatest overall. If multi-resistant bacteria develop there, they can also become a problem here. Therefore, a global view is necessary in the fight against antibiotic resistance.

Why aren’t new antibiotics developed that bacteria aren’t resistant to?

New antibiotics are being developed regularly, but they are often variants of existing ones. Although these often work well, bacteria that are resistant to the original antibiotic can then develop new resistances relatively quickly.

Actually, it needs completely new classes of active ingredients. But there are hardly any of them. On the one hand, it is simply difficult to find new active ingredients – but there is also a very important reason: it is simply not worth it. Because: A new antibiotic against which no bacterium is yet resistant would only be used in an emergency. This would reduce the risk of new resistance developing again.

The drug would therefore hardly sell and the manufacturer would be left with the development costs. These are usually between several hundred million and several billion euros. As soon as the patent protection for the new antibiotic expires, the market is then flooded by generic drug manufacturers. They do not have to recoup any development costs and can then offer the drug at a much lower price. This also pushes the price down for the developer.

One suggestion to make this more attractive is that companies that develop such an antibiotic – that they then patent protection for one other be allowed to extend their medication. This would enable them to recoup the development costs, even if the antibiotic is not used.

How can antibiotic resistance be prevented?

On the one hand, fewer antibiotics have to be used. Antibiotics are still often prescribed for a cold, for example, on suspicion if it is a bacterial infection, although it is likely a viral infection. And antibiotics don’t help at all.

However, general practitioners often only have a few minutes to make a decision. There is no time to have a blood test examined in the laboratory. They often prescribe antibiotics to protect themselves. A solution to this would be the development of so-called point-of-care tests – test devices that are easy to use and can be used to determine within minutes whether the infection is viral or bacterial.

On the other hand, antibiotic treatments must not be discontinued, for example because you feel healthy again and want to stop taking them. This also gives the bacteria the opportunity to develop resistance.

If there are any tablets left over after the treatment, they must not be flushed down the toilet. This is how they get into the environment, where resistance can develop again. Medicines can often be disposed of with the residual waste, sometimes they can also be handed in at the pharmacy or recycling center. Information on this is available in the pharmacy.

Are there alternatives to antibiotics?

There are some exciting approaches, such as antibody drugs. In addition, many manufacturers are currently working on so-called immune modulators, which are supposed to make the immune system fit and ramp it up so that it can then deal with the germs itself.

So-called phages or bacteriophages are also interesting. These are viruses that attack bacteria. They are very special and cannot infect us humans. A phage drug would have little or no side effects.

So far, however, it has not been proven that phages actually work as medicines. Such a drug would probably be very individual, i.e. it would have to be individually adapted for each patient. This would of course make this method very expensive. The phages would therefore probably be best suited for chronic diseases.

The best alternative, which already exists for at least some bacterial infections, is vaccination. If you don’t get sick in the first place, you don’t need medication.