Mobilising the public to combat the antimicrobial resistance crisis

Ford Stewart|11th January 2019

Imagine a world where entering a hospital for something as routine as a simple stomach operation ends with you finding yourself quarantined indefinitely. This may seem like a scenario from the middle ages, but it’s happening right now.

Pamela Bird has been quarantined for five years due to an untreatable infection, which she developed during a routine operation. The infection has meant she is unable to leave the hospital, it has attacked her internal organs and she has lost part of her bowel. Her illness is due to antimicrobial resistance (AMR) and it is not as rare as you might think. It is present in every country across the globe and by 2050 it will kill more people annually than cancer – unless things change.

WHAT IS ANTIMICROBIAL RESISTANCE?

Antimicrobial resistance is the rapid generation and sharing of genes which convey resistance to our current and novel antibiotic treatment methods. Infectious agents cause these therapies to become ineffective and infections harder to challenge. The information about the urgency and threatening nature of AMR is bountiful but conveying this threat to the public is still challenging.

There is an engaging and informative speech by Dame Sally Davies for the Royal Institution explaining the scope of AMR, the main causes and methods to combat resistance that you could watch. Alternatively, you could watch this video about whether you can use peanut butter to turn coal into a diamond. It’s one week old at the time of writing and has already attracted 9.1 million views, in comparison to the 19,000 views the AMR talk has accumulated during a two-year period. The public has made its decision about which topic it would rather hear about and AMR is nowhere near the top of the agenda. So how can we bring this crisis to the forefront of their minds?

THE CHALLENGE

There are numerous ways antimicrobials are misused and inappropriately prescribed. In part, this is due to GPs over-prescribing them to pushy members of the public who don’t fully grasp how antibiotics function and just want to recover. Patients feel acknowledged by GPs when they are given antibiotics for their illness, with one study showing that patients perceive receiving antibiotics as return on investment for visiting the doctor, regardless of whether the medication cures their illness or not.

The most recent estimate for the percentage of inappropriate antibiotic prescriptions in the UK is 23.1%, with coughs and sore throats yielding the largest portions of this at 22.2% and 23.0% respectively. Meaning close to a quarter of patients gain no medical benefit from antibiotics – they merely contribute to increased AMR.

Another top contributor to increasing AMR is the use of antimicrobial agents for non-therapeutic means such as animal agriculture. In the United States, roughly 80% of antibiotics sold are for use in animal agriculture, with 70% of those being critically important to human health.

In the US, the over-use in non-therapeutics, which even includes toothpaste and handwash, is largely driven by business and demand. Here, it seems money talks and antimicrobials reduce costs and inflate profits. The largest link between these two problems is the group with the greatest power to affect change in both areas – the public.

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